An end to a wave of strikes by NHS workers in England was in sight on Thursday after health unions agreed to recommend a substantially improved pay offer by the government to their members.

The Royal College of Nursing, GMB and Unison unions backed the offer negotiated with the government, which falls far below their original wage goals but represents a significant advance on the pay terms previously outlined by ministers.

The offer would give nurses, ambulance staff and other NHS workers in England a new, non-consolidated payment worth 2 per cent of their wages in 2022-23, with an additional bonus of at least £1,250, depending on their wage band and experience.

In 2023-24, a consolidated pay rise of 5 per cent will then be made, with a bigger increase for the lowest paid.

Meanwhile junior doctors, who finished three days of strike action on Wednesday and were not involved in the pay talks, wrote to health secretary Steve Barclay accepting his proposal to discuss wages. He has set a precondition that they must suspend further strikes while talks take place.

However, what began as a winter of discontent in the public and private sectors over pay is set to spread into the spring as teachers, civil servants and rail workers remain locked in dispute with Rishi Sunak’s government.

On Thursday, the PCS union said more than 1,000 members working in Passport Offices in England, Scotland and Wales would walk out for five weeks in April and May — hitting the delivery of new passports ahead of the summer holidays — “because, in sharp contrast with other parts of the public sector, ministers have failed to hold any meaningful talks with us”.

Unveiling the NHS pay deal, the prime minister praised “hardworking NHS staff” and noted it was “affordable for the taxpayer and continues to deliver on my promise to halve inflation”.

Rachel Harrison, national secretary of the GMB union, said the offer was “far from perfect” but that it was “the best that can be achieved at this stage”.

Unite, which represents some of the ambulance workers who have taken strike action, was alone in saying it would not recommend the offer to members.

The NHS industrial action, which began in December, has led to more than 140,000 appointments and operations across the health service being cancelled.

Health leaders, who have already had to prune back plans to afford the £1,400 flat-rate pay rise initially awarded for 2022-23, have expressed concerns that a more generous offer would further strain limited budgets.

Chancellor Jeremy Hunt’s allies insisted the money for the new pay deal can be found from within the existing health department budget through efficiency savings.

However, Sunak has insisted that frontline services will not be affected and government insiders have left open the possibility that the department will receive more money.

An internal Treasury memorandum seen by the Financial Times concluded that a public sector pay rise of 5 per cent in 2023-24 would not fuel inflation. Hunt expects most public sector pay deals to fall in roughly that range.

Ben Zaranko, economist at the Institute for Fiscal Studies, a think-tank, said that funding the one-off payment for NHS workers in 2022-23 was less of a challenge, but raising wages by 5 per cent in 2023-24, rather than the 3.5 per cent the government had said was affordable, would add around £1.5bn to the NHS remuneration bill.

The 5 per cent uplift for 2023-24 means NHS pay is set to grow slightly faster than both consumer price inflation and private sector wages in the next financial year, based on the latest official forecasts.

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