Unions have attacked the Government after ministers confirmed that NHS and other public sector workers will have their pay frozen for a second year unless they earn £21,000 or less.
Employees earning less than that will receive a £250 rise next month, but the rest will face another wage freeze as ministers stressed the need for restraint in the current economic climate.
Unison said nurses, therapists, paramedics, midwives and other health staff have seen the value of their wages fall by 11.6% since the coalition came to power. The £250 award will still leave thousands of workers struggling to make ends meet because of the rising cost of living, said unions.
The pay announcement covers around 1.3 million NHS workers across the UK. The Department of Health said 450,000 workers in England will receive the £250 payment, including around 100,000 who work part-time.
The Government said it had accepted recommendations from public sector review bodies, covering NHS staff, as well as prison officers and the armed forces, who will also receive a rise of £250 if they earn £21,000 or less. Officials stressed that the pay freeze was first raised in the 2010 Budget.
Health Secretary Andrew Lansley said: "NHS staff carry out a vital role in caring for the nation. Pay restraint is essential right across the public sector, and the NHS as the largest public service in the country cannot be exempt from that.
"That's why we are reducing spending on managers, cutting back office administration costs and giving more power to doctors and nurses so we can put patients at the heart of the NHS. Every penny saved from the reduction in management cost will be re-invested into frontline care."
Christina McAnea, Unison's head of health, said: "Coupled with massive discontent about the hated Health and Social Care Bill, privatisation, cuts and job losses, the pay freeze sends out another message that the NHS is suffering under the coalition Government.
"We are disappointed at the Government's decision, which means the pay of staff in the NHS is now worse than when this Government came to power. It is a tough job being a nurse, paramedic, therapist or midwife and surely we want them to concentrate on their patients and not to be worrying about paying rapidly rising bills.
"Continuing to freeze pay in this way will also deter young people from entering healthcare professions and we could soon be back to the bad old days where gaps in the workforce could only be plugged by raiding the trained staff of other countries."