Nurses' unions are calling for a 'substantial' but differential pay increase next year, claiming that it is needed to keep experienced staff in the health service.

Staff-side chair Maggie Dunn said it was the first time a differential increase had been sought and it was necessary because different groups of staff varied in their comparison with other workers in the economy.

'The gap between nurses, midwives and health visitors and their comparators differs from grade to grade and we are looking for the review body to close that gap across all grades.'

Unions believe this year's award boosted recruitment by raising starting salaries for newly qualified nurses.

Now they want a bigger rise for E-grade nurses, who comprise a third of all nursing staff, and for unregistered nurses in A to C grades.

Ms Dunn said the top rate for E-grade nurses was less than£18,000 - 'which is ludicrous' - while 95 per cent of unregistered nurses were on A-grade, where the maximum salary is£10,650 a year.

There is also considerable anger that many midwives are still not automatically put on G-grade, despite government guidance produced four years ago. The unions are asking the review body to 'do what the service has failed to do'.

Ms Dunn made it clear that the unions were relying on the government's reputed£12bn 'war chest' to pay for a substantial increase.

But chief secretary to the Treasury Alan Milburn said last week there would be no 'cash give-aways' from it.

Ms Dunn responded that the flow of registered nurses leaving the profession would not stop unless the government did 'something substantial about salaries'.

But NHS Confederation human resources chair Andrew Foster said NHS organisations had a duty to balance their books within resources allocated to the service in the comprehensive spending review.

'The chancellor may have a large war chest, but it hasn't been allocated yet,' he said.

The unions' approach, set out in a submission to the pay review body for nursing staff, midwives, health visitors and professions allied to medicine, contrasts with the employers' call for an equal rise for all staff, including those outside the pay review bodies, and the government's appeal for a 'realistic and affordable' increase.

'We would call what we are seeking reasonable and fair,' Ms Dunn said. 'We have nurses who are responsible for peoples' lives on a ward of 30 patients who cannot afford a family holiday and are worried about paying bills.'

Pay round-up

Nursing unions are calling for a differential pay rise, while health visitors seek an increase that will attract new staff (above). Pay scales for nurse consultants have been agreed (right), but junior doctors have snubbed a deal (below).

Main points of nurses' claim

A 'substantial' increase for all nurses, midwives and health visitors.

'Special attention' for E-grade nurses to aid retention.

'Special attention' for A-C grades to improve earnings and career prospects.

Discretionary points added automatically to the top of F-I grades.

London allowances increased by a flat rate across all grades.