The proposed pay rise for NHS staff has halved since plans were set out by the government in 2019, the boss of the health service has said.
Sir Simon Stevens said the NHS had been budgeting for a 2.1% pay increase in April this year, rather than the 1% which has been proposed.
He explained the proposed offer had been reduced because "things have changed" since the plan was drawn up.
The government's proposed a pay rise will amount to a real-terms pay cut when inflation is taken into account - it is estimated the 1% proposed increase will give most staff just £3.50 extra a week.
Nurses, doctors and health unions are outraged by the proposed pay rise, with the Royal College of Nursing (RCN) even preparing for strike action in protest at the "pitiful" offer.
But Sir Simon said he supports the government's approach.
"You would expect the head of the health service to want to see properly rewarded NHS staff, particularly given everything that the service has been through over the course of the last year," he said.
"And so I think the right way to resolve this is the path the government has actually set out which is to ask the independent pay review bodies to look at all of the evidence... and be able to independently make a fair recommendation so that NHS staff get the pay and reward that they deserve."
The government has defended the proposal, saying it is the most the country can afford at a time when the economy is under “huge pressure” as a result of the coronavirus pandemic.
Last week Boris Johnson's spokesperson said: "We recognise the impact Covid has had on the NHS and we want to honour this.
"But the pandemic has real consequences and we have done all that we can to protect jobs and save livelihoods.
"The recommended 1% pay rise for NHS staff is what is affordable while acknowledging their work and commitment over the last 12 months."
Sir Simon, speaking at the Science and Technology Committee, also said there is blackhole in NHS finances of up to £8 billion because there was nothing in the budget to cover the Covid19 treatment costs that will tip over into the new financial year.
On the NHS pay rise, Justice Secretary Robert Buckland said it is "important to note" that any increase is subject to a review by an independent body that "will not complete for some months".
But even when the review is complete, it will be the government that makes the final decision on how much NHS pay should increase by.
Speaking in the Commons during Treasury questions, Ian Lavery, Labour MP for Wansbeck, described the 1% rise as "incredibly insulting" and urged the Government to lift a wider pay freeze on 2.5 million public servants.
Mr Sunak replied: "A majority of those working in the public sector will see an increase in their pay in this forthcoming year as a result of our pay policy, and importantly those earning less than the median UK salary will receive a £250 increase in their pay as we want to protect those on the lowest incomes."
Mr Buckland added: "I think it's right for us to be honest about the pressures that we are under. Let's not forget that a large part of public sector workers will not be getting a pay rise.
"There's a pay freeze in operation, It's right that we acknowledge the outstanding contribution made by our NHS workers, but it does come in the context of significant pay rises in the last few years."
He added: "So let's see what the outcome [of the review] is, but I think the government is right to be absolutely straight forward that we're under considerable constraints here and to pretend anything else would be not right."
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