Northern Ireland nurses open strike ballot as 2026/27 pay award stalls

The Royal College of Nursing (RCN) in Northern Ireland opened a ballot for industrial action and strike action on 14 October 2026 over the continued failure to deliver a 2026/27 pay award to Health and Social Care (HSC) staff on Agenda for Change terms. Eligible members have until 12 noon on Friday 20 November 2026 to return ballot papers to Civica Election Services, the RCN said, with the result expected shortly after the ballot closes.

The NHS Pay Review Body recommended a 3.3 per cent increase for staff across all pay bands, and health care workers in England and Wales have already received it, according to the RCN. Staff in Northern Ireland are still waiting to learn when, or if, the award will be implemented, which the union attributes to ongoing political deadlock over Northern Ireland’s budget.

What the union and the department said

The RCN is urging members to vote for both action short of strike and full strike action. It said former Health Minister Mike Nesbitt had committed to implementing the award, and that nursing staff in Northern Ireland are forced to fight for a pay award year after year.

Strike action is always a last resort.

Professor Rita Devlin, Executive Director, RCN Northern Ireland

Devlin also said: “Nursing staff have had enough of the delays, the excuses and the broken promises.”

In a statement the same day, the Department of Health said Health Minister Robbie Butler understands the frustration felt by nurses and other HSC staff, who it said have waited too long for clarity on this year’s award. The department said the Minister is clear that the 2026/27 award should be implemented and pay parity with colleagues in NHS England restored as soon as possible. It warned that every day of delay risks further deterioration in relations with staff and trade unions and increases the prospect of industrial action during the winter, with consequences for patients, waiting lists and service delivery.

The department added that Butler remains committed to introducing the Real Living Wage across HSC, and that work on Agenda for Change structural pay reform is continuing with colleagues in England and Wales alongside efforts to resolve this year’s award.

What was not disclosed

Neither the RCN nor the Department of Health gave a cost for implementing the 3.3 per cent award in Northern Ireland, and the department did not say when funding would be confirmed or mention the Executive’s budget. The RCN release does not say how many members are being balloted.

Our reading

• The Healthcare Daily’s reading: the department does not dispute that the award should be paid, and the union points to political deadlock over Northern Ireland’s budget as the obstacle. That makes this a funding and timing problem rather than a disagreement over the size of the award.
• The ballot closes on 20 November, so any action could fall in the winter period, when the department itself warns industrial action would have consequences for patients, waiting lists and service delivery. HSC trusts and independent providers holding commissioned activity in Northern Ireland will want to reflect that in winter planning.
• The RCN describes the gap with England and Wales as recurring. Until the cost of the award is published, it is not possible to judge how much it would add to pressure on the Northern Ireland health budget this year.