Monitoring long-term pay trends is an essential part of predicting a future pension. By default our modellers assume that pay scales rise by 0% a year (while still accounting for promotions, incremental pay rises and changes in work pattern) and that CPI inflation is 0%: in other words, that pay scales stay level against inflation. Choosing 0%, and not, say, 2% or 2.5%, gives every figure in real terms, which makes the future value of money easier to comprehend. Neither approach is perfect.
History tells a different story. Average pay for the main NHS staff groups is lower against inflation than it was in March 2009, and the gap has not been static: it has widened and narrowed from year to year. The charts below track it month by month, against the wider economy, using official statistics only.
a very poor measure of general inflation7, mainly because its formula tends to overstate price rises. It is offered here because it does cover household costs that CPI leaves out, notably mortgage interest payments and council tax, and because the government still uses it to set student loan interest8. CPIH is the official measure that includes housing costs. Read RPI figures as an upper bound, not as the central estimate.
The link saves your choice of inflation measure, end date and lines. A link without an end date always opens on the latest data.
Three independent checks, recalculated in your browser from the data now loaded.
The same method applied to the ONS’s own public and private sector series, for the end date and inflation measure selected above. The public sector series covers the whole public sector across Great Britain, so it is a cross-check on direction and scale, not a like-for-like match for any one NHS group.
The IfG publishes the data behind its chart, to June 20259. It was built independently of this page. All NHS staff, nurses and consultants should match; resident doctors differ slightly because the IfG weights training grades by each month’s headcount.
“Rise needed to restore” is larger than the fall because it is measured from the lower figure: a 20% fall needs a 25% rise to reverse it.
The method was set out by John Burn-Murdoch at the Financial Times in April 20235. Dr Tony Goldstone added consultants, the 12-month averaging of the ONS series and the further ONS comparators, and has published updates since May 20236. The Institute for Government’s Performance Tracker builds its chart of NHS hospital staff pay the same way: March 2009 base, CPI, a headcount-weighted resident doctor group and a 12-month rolling ONS comparator9.
Most disagreements about NHS pay come from four choices: the start date, the inflation measure, whether pay scales or actual earnings are measured, and whether prices are taken for one month or averaged over a year. None of these is wrong in itself, but figures built on different choices cannot be compared with one another.
| Source | Starts | Inflation | Pay measure | Headline | Points to note |
|---|---|---|---|---|---|
| This page | March 2009 | CPI by default; CPIH or RPI on request | Mean earnings per person | See “Limits of this method” above. | |
| Financial Times5 | March 2009 | CPI | Mean earnings per person | To Dec 2022: junior doctors about 24% down, nurses about 12% | The original of this method. Plots single months for the ONS series. Use “Compare with” above for a side-by-side view. |
| Institute for Government9 | March 2009 | CPI | Mean earnings per person | To June 2025: consultants 19.4% down, resident doctors 15.3%, nurses 9.4% | Same construction as this page, built independently. Resident doctor weights follow each month’s headcount instead of fixed shares. Use “Compare with” above for a side-by-side view. |
| British Medical Association10 | 2008/09 | RPI, single month each year | Pay awards (pay scales) | Resident doctors about 21% down to 2025/26 | The BMA’s case for RPI: it says RPI is the better guide to its members’ living costs because it includes housing costs such as mortgage payments, and because the government itself uses RPI to set the interest on student loans8,10. Medical students can graduate with student debt above £100,00015. Against that: the ONS discourages the use of RPI as a measure of inflation7. The figure measures the pay award, so it is not affected by workforce mix, but it is not what people were actually paid. A single month’s inflation gives a larger fall than a 12-month average. |
| Full Fact10 | 2008/09 | Household Costs Index, 12-month average | Pay awards, as the BMA | Resident doctors about 6–7% down | The Household Costs Index is an “official statistic in development”, not yet a fully accredited one. Full Fact’s own range runs from about 3% (CPIH) to about 18% (RPI, averaged). |
| Nuffield Trust11 | 2010/11 | CPI, financial-year average | Average full-time earnings | To 2024/25: resident doctors 8.6% down, consultants 10.0%, nurses 10.7% | Starts in 2010/11, which is simply where the current NHS tables begin, and so leaves out the falls of 2009–10 (see “The 2010 starting point” below). Its own separate comparison of methods shows how much the start year and the index change the answer12. It measures full-time earnings only, so any shift towards less-than-full-time working is left out of its figures; earnings per person, as used here, include it. |
| Resolution Foundation13 | August 2010 | CPI and RPI | Average pay | Junior doctors to March 2023: 19% down (CPI), 30% down (RPI) | Starts in August 2010, the first period in the current NHS tables, and so also leaves out the falls of 2009–10. |
The base month is a deliberate choice. The 12 months to March 2009 are the 2008/09 pay year. That is the last full year before public sector pay restraint began: restraint was imposed in the 2009 pay round as the economy worsened16, a 1% cap on public sector pay rises was announced in December 200917, and a two-year pay freeze covering most NHS staff followed in the June 2010 Budget18. It is also the first full year that the NHS earnings data cover.
A base year should sit before the change being measured. The Financial Times and the Institute for Government use the same base month, and the BMA starts from the same pay year. A base that starts part-way through the period of restraint leaves out the first part of it.
Several analyses start in 2010 or 2010/11. That is where the current NHS earnings tables begin (the 12 months to August 2010). In this page’s view it is a starting point of convenience and not a meaningful baseline: nothing about pay makes August 2010 special, only the layout of one official spreadsheet.
The earlier months are official statistics too. They sit in an older edition of the same NHS publication1 and can be joined to the current tables, as the Financial Times, the Institute for Government and this page all do. Starting in 2010 leaves out what had already happened by then: A fall measured from 2010 is therefore smaller than the fall since 2009, and the two are not measuring the same thing. Quoting a 2010-based figure against a 2008 or 2009-based one, without saying so, compares unlike with unlike.
A fall and the rise needed to reverse it are different numbers. A 20% fall needs a 25% rise to restore the starting value, so “pay is down 20%” and “a 25% rise is needed” describe the same position.
This page is checked against the official sources twice an hour and updates itself when new figures are published. Contains public sector information licensed under the Open Government Licence v3.0. Data engine ; dataset built .