Scotland’s Nurses File a Pay Claim the Last Deal Left Open

Health unions in Scotland sent the Scottish Government a 2027/28 pay claim in the first week of October and told ministers to start talks by December. Staff side on the Scottish Terms and Conditions Committee, including the Royal College of Nursing, Unison and the Royal College of Midwives, wants a cost of living rise above inflation, a fresh inflation guarantee, and Agenda for Change scale changes agreed in 2024 but never paid.

The two-year deal covering board-employed NHS staff runs out in March 2027. Nurses employed by GP practices are still waiting to hear what they will get for 2026/27, even though GPs have already been told they will receive 3.5%.

Scotland’s Two-Year Nurse Pay Deal

In April 2025 the then health secretary, Neil Gray, set out a two-year pay offer to almost 170,000 staff on Agenda for Change contracts, a group that includes nurses, midwives, paramedics, allied health professionals and porters. The envelope was £701 million. Gray said the offer would keep Scottish NHS pay the best in the UK, even after an estimated £191 million extra cost from higher employer national insurance.

The first year was advertised at 4.25%. The deal also promised that each year would sit at least one percentage point above average consumer price index inflation for the calendar year. When 2025 CPI was confirmed at 3.4%, that clause added 0.15% and took the 2025-26 rise to 4.4%. Jane Hamilton, deputy director in the health workforce pay division, issued the circular on 23 January 2026. Staff saw the extra in February pay, with most arrears in March, backdated to 1 April 2025.

Year two is 3.75% from 1 April 2026, applied to the new 4.4% baseline. The Scottish Government’s own factsheet now lists the package as an 8.15% total rise in two stages. The same CPI-plus-one-point test still sits on 2026-27, so a further top-up could land in early 2027 if the 2026 calendar average runs hot enough to overtake 3.75%. The Office for National Statistics put CPI at 3.1% in the year to August 2026, up from 2.9% in July. The Scottish Terms and Conditions Committee tracks the monthly figures for the guarantee.

THE 2025 TO 2027 AFC SETTLEMENT

RCN members in Scotland voted in May 2025, with around half of those eligible taking part and 60% of ballots in favour. Colin Poolman, then RCN Scotland director, said current wages still did not match nursing’s safety-critical role, and that the college would keep pressing for reform of the pay scheme. That unfinished reform is now back on the table.

What the Unions Put in the Claim

The RCN and the other health unions submitted a 2027-28 pay claim in the week of 2 October 2026. They want talks under way quickly, and by December at the latest, so any award can be in pay packets in April 2027 rather than weeks or months later. They have not put a single percentage on the claim. They have asked for a “significant and above inflation cost of living” rise, a guarantee that protects that rise from inflation, and modernised Agenda for Change scales.

The 2024 proposals, still unpaid, cover incremental stages, the gaps between incremental points, and pay on promotion. Poolman, now executive director at RCN Scotland and chair of staff side on the committee, tied that demand to the government’s wider NHS plans.

The annual increase is nursing staff’s only protection against the inflation that continues to cause anxiety and stress for our members. That’s why we need to see a substantial increase backed by an inflation guarantee, all confirmed as quickly as possible.

Colin Poolman, Executive Director, RCN Scotland

He also said that with the Scottish Government proposing “radical reform” of the NHS, Agenda for Change itself needs reform, and that the 2024 scale changes should be put in place in this round. “Reform is needed but it can’t come at the expense of nursing staff’s pay or be based on affordability,” he said. Unsafe staffing, he argued, leads to burnout, lower job satisfaction, occupational injury and poorer patient outcomes.

Unison’s Scottish Ambulance Service branch set out the same joint claim on 30 September 2026, for the period 1 April 2027 to 31 March 2028. The Royal College of Podiatry confirmed on 8 October that it had signed the filing too.

WHAT STAFF SIDE ASKED FOR

• Cost of living: An above-inflation rise across all Agenda for Change rates and allowances.
• Inflation floor: Any offer underpinned by a CPI-plus guarantee, of the kind that lifted 2025-26 from 4.25% to 4.4%.
• 2024 spine rewrite: The outstanding modernisation on increments, relative incremental values and pay on promotion, on top of the cash rise.
• Extra allowances: A further rewrite of on-call, subsistence and Distant Islands Allowance.

The ambulance branch also listed rising household costs, higher pension contributions, safe staffing concerns, and frustration where nationally agreed terms are not delivered on the ground.

📢 NHS SCOTLAND PAY CLAIM 2027/28 – STAFF SIDE CLAIM SUBMITTED

NHS trade unions representing staff covered by Agenda for Change in Scotland have agreed a joint pay claim for the period 1 April 2027 to 31 March 2028.

The claim recognises the continued pressures facing NHS staff… pic.twitter.com/UmLtBET4mq

— UNISON Scottish Ambulance Service (@unisonsas) September 30, 2026

Board-employed nurses in Scotland already sit on higher published bands than many of their counterparts elsewhere in the UK, and that comparison still dominates the public argument. It does not cover the two groups this claim is really dragging back into view.

Practice Nurses Are Still Waiting on This Year

Nurses who work in GP surgeries are not paid through the Agenda for Change settlement that STAC negotiates with the Scottish Government. They are employed by practices. Their rise depends on the General Medical Services contract and on whether each practice passes the money on.

For 2025-26, RCN Scotland told those staff they should receive a 4.25% pay increase for 2025-26, in line with the original AfC offer and funded for practices to pass on, backdated to 1 April 2025. That figure was never lifted to 4.4% when the inflation clause was triggered for board-employed staff. The college’s own page, last updated on 31 August 2026, still said talks had not started on the 2026/27 GMS settlement, and that it would call for parity with staff employed directly by NHS Scotland “as a minimum”.

GPs were not left in the same queue. On 12 August 2026 the Scottish Government accepted the Review Body on Doctors’ and Dentists’ Remuneration recommendation of a 3.5% rise for 2026-27 for consultants, GPs, SAS doctors and dentists, backdated to 1 April 2026 and due in salaries at the end of September. Health Secretary Angela Constance set that out in a letter to the BMA. Practice nurses had still not had a 2026/27 update by 8 October.

GP NURSING IN SCOTLAND AT MARCH 2026

• Headcount: 2,396 nurses were in post in GP practices on 31 March 2026.
• Whole-time equivalent: The survey recorded 1,664.8 whole-time equivalent nurses, down 4.1% on 2025.
• Job mix: General practice nurses were 58.7% of that headcount.
• GP numbers: GP whole-time equivalent, excluding specialist trainees, was 3,600.8, up 0.3% from 3,591.5.

The survey, run with a 100% response rate after completion was tied to extra funding, is the cleanest recent count of the primary care nursing workforce. A 4.1% fall in nurse time, against a slight rise in GP time, is the backdrop against which another delayed pay round lands. RCN Scotland is still collecting cases in which the 2025-26 4.25% did not arrive, and it publishes a template letter for staff to send their employer.

Unfinished Business From the 2024 Pay Review

The cash claim is only half of what staff side has tabled. As part of the 2023-24 settlement, both sides agreed to review Agenda for Change in Scotland on a Once for Scotland basis. A working group took proposals to STAC in November 2023 on the pay spine, pay on transfer, pay on promotion, on-call, compensatory rest, unsocial hours and Annex 21 training pay.

Staff side’s long-standing complaint is that the gaps between bands have become too small to make promotion worth it, and that a move up a band can even cut take-home pay once unsocial hours and overtime drop away. The equality impact assessment on that review put the cost of suggested pay spine enhancements at just over £248 million, just over 3.1% of a predicted 2023-24 Agenda for Change paybill of £7,910 million.

Those changes were treated as agreed in 2024. They were not built into the 2025-27 cash deal. When STAC staff side filed its 2025/26 claim in January 2025, it already called the modernisation paper “unfinished business”. The two-year settlement then parked it again. Poolman’s October statement puts the same paper back inside the 2027/28 round, and says it should not be traded off against the cost of living rise or trimmed to what the budget can stand.

Some other 2023-24 review items did move. Protected learning time was written into the handbook. Band 5 nursing roles were opened to review. The working week was cut. The spine rewrite, the item with the large modelled bill, is the piece that never reached payroll.

Band 5 Now Starts at £34,544

From 1 April 2026 the full-time week for Agenda for Change staff in NHS Scotland is 36 hours, down from 37.5, with no cut in annual salary. Overtime now starts after 36 hours. The Scottish Government’s published hourly rates sit on that shorter week, which is why the cash rise and the hour cut stack on the same pay points.

A newly qualified Band 5 nurse, the standard registered nurse entry point, is on £34,544 in 2026-27, which is £1,249 more than 2025-26 and £18.40 an hour. At the top of Band 5 the salary is £43,039, or £22.93 an hour.

BAND 5 IN SCOTLAND THIS YEAR

Those Agenda for Change pay bands for 2026-27 are the floor the next claim will be argued from. They also show why staff side wants the 2024 promotion rules changed. The jump from the top of Band 5 (£43,039) to the first point of Band 6 (£43,231) is £192 a year before any loss of enhancements. That is the compression the 2024 paper was meant to fix.

December Talks or a Late April Pay Packet

Poolman’s sharpest line is about the calendar, not the percentage. “NHS nursing staff deserve to get their much-needed and fully deserved pay increase when it is due next April, not weeks or months later.” The last deal is the exhibit. Even after members accepted it in May 2025, the inflation top-up for 2025-26 was only confirmed in January 2026 and paid in February and March. Practice nurses, on a separate track, are still waiting on 2026/27 in October.

THE ROAD TO AN APRIL AWARD

1. 8 April 2025: Neil Gray publishes the two-year AfC offer of 4.25% then 3.75%, with the CPI-plus-one-point guarantee.
2. 15 May 2025: RCN members in Scotland accept, 60% of those who voted.
3. 23 January 2026: The 0.15% inflation top-up is confirmed, taking 2025-26 to 4.4%.
4. 1 April 2026: The 3.75% year-two rise and the 36-hour week both take effect.
5. 12 August 2026: The Scottish Government accepts 3.5% for GPs and other DDRB groups, for salaries at the end of September.
6. 31 August 2026: RCN Scotland still records no start to 2026/27 GMS talks for practice-employed nurses.
7. Week of 2 October 2026: STAC staff side files the 2027/28 claim and sets December as the latest date to open talks.
8. April 2027: The date staff side says the next rise is due in pay.

A two-year deal bought board-employed staff an inflation floor and a known 3.75% for 2026-27. It did not pay the 2024 scale rewrite, and it did not pull practice nurses onto the same clock. The new claim puts both of those debts into the first annual round after the deal expires. If talks miss December, the people who already waited through February and March 2026 for a 0.15% correction will be asked to wait again, and the nurses in GP surgeries who have not had a 2026/27 figure at all will be a further year behind the bands on the government website.