NHS Hourly Rate 2026/27: Every Band, Every Region

NHS hourly rates in 2026/27 range from £12.91 per hour at Band 2 to £66.30 per hour at the top of Band 9 in England. Following the 3.3% pay rise effective from 1 April 2026, every Agenda for Change pay band has increased.

Whether you’re a healthcare assistant checking your new rate or a nurse working out your take-home pay, this guide gives you every hourly rate across all UK nations—including overtime pay, London weighting, and how to calculate your earnings.

NHS Hourly Rates by Band 2026/27 (England)

The Agenda for Change pay system covers over 1.5 million NHS staff. The government accepted the Pay Review Body’s recommendation of a 3.3% increase, making this the earliest pay award has been implemented in six years.

Here are the current NHS hourly rates for England from 1 April 2026:

Fact: Band 1 closed to new starters on 1 December 2018. Anyone still on a Band 1 contract now gets paid at Band 2 rates (£12.91 per hour).

These rates are based on a 37.5-hour working week. Your pay goes up automatically as you gain experience—this is called pay progression under the Knowledge and Skills Framework.

NHS Annual Salaries 2026/27 (England)

For reference, here are the full annual salaries that the hourly rates above are calculated from:

NHS Hourly Rates Across All UK Nations

Pay rates differ in England, Scotland, Wales, and Northern Ireland. Scotland generally pays the highest rates, whilst Northern Ireland pays the lowest.

Scotland NHS Hourly Rates 2026/27

Scotland secured a two-year pay deal with a 3.75% increase for 2026/27—higher than the 3.3% in England:

Fact: Scottish NHS staff work 37 hours per week compared to 37.5 hours elsewhere. This means their hourly rate is calculated on fewer annual hours (1,924 versus 1,957.5), making each hour worth more.

For more details on how Agenda for Change works in Scotland, see our dedicated guide.

Wales NHS Hourly Rates 2026/27

Wales accepted the same 3.3% Agenda for Change pay award as England, effective 1 April 2026. However, the Welsh Government has committed to paying the Living Wage Foundation rate to the lowest-paid NHS staff.

This means:

• Bands 2–3: Receive increases of 3.8% to 5.9% (above the headline 3.3%)
• Bands 4–9: Receive the standard 3.3% increase (identical to England rates)

Source: Welsh Government Written Statement, 12 February 2026

Northern Ireland NHS Hourly Rates 2026/27

Northern Ireland has the lowest NHS pay rates in the UK. The exact timing of when staff will receive the uplift is still being confirmed:

Waiting for confirmation.

Quick Regional Comparison 2026/27

Here’s how the same job pays differently across the UK:

*Northern Ireland rates pending budget confirmation

Fact: A Band 2 healthcare assistant in Scotland earns £1.99 more per hour than the same role in Northern Ireland. Over a full-time year, that’s roughly £3,900 extra.

NHS Overtime and Enhancement Rates 2026/27

When you work extra hours or unsociable hours, you get paid more. This is one of the best parts of NHS employment.

Overtime Pay Rates by Band

If you work more than your contracted hours, you get time and a half (1.5 times your normal rate). On public holidays, you get double time (2 times your normal rate).

Here are the actual figures for England 2026/27:

Use our NHS overtime pay calculator to work out your exact earnings.

Fact: Staff in Bands 8 and 9 in England, Wales, and Northern Ireland are not entitled to overtime payments. However, Scottish NHS staff at all bands can receive overtime pay.

Unsocial Hours Payments

If you work nights, evenings, or weekends, you also get extra pay called unsocial hours payments. These are calculated as a percentage on top of your basic rate.

Part-time workers get their standard hourly rate for any hours up to 37.5 per week. Only hours beyond this count as overtime.

High Cost Area Supplement (London Weighting)

If you work in or around London, you get extra money on top of your basic salary. This is called the High Cost Area Supplement, or HCAS for short.

There are three zones:

HCAS Hourly Rates 2026/27 (Inner London)

Here’s what you actually earn per hour if you work in Inner London:

Fact: A Band 5 nurse at the top of their scale earns £23.94 per hour in Inner London compared to £19.94 per hour outside London—that’s £4.00 more every hour.

How to Calculate Your NHS Hourly Rate

Your payslip shows your annual salary, but you might want to know your hourly rate. Here’s how to work it out yourself.

The NHS Hourly Rate Formula

For England, Wales, and Northern Ireland:

Hourly Rate = Annual Salary ÷ 1,957.5

For Scotland:

Hourly Rate = Annual Salary ÷ 1,924

The difference comes from Scotland’s 37-hour week versus 37.5 hours elsewhere.

Worked Example

Let’s say you’re a Band 5 nurse in England at the entry point:

• Annual salary: £32,073
• Calculation: £32,073 ÷ 1,957.5 = £16.38 per hour

Part-Time Calculations

If you work part-time, your hourly rate stays exactly the same. A 0.6 WTE (whole time equivalent) Band 5 nurse earns £16.38 per hour, just like a full-timer—they simply work fewer hours.

Part-time staff get their standard rate for all hours up to 37.5 per week. Only hours beyond this qualify for overtime rates.

Working Out Your Take-Home Pay

The hourly rates shown above are gross pay—before any deductions. Your actual take-home pay depends on:

• NHS Pension contributions (between 5.1% and 14.7% depending on your salary)
• National Insurance (8% on earnings between £242 and £967 per week, 2% above that)
• Income Tax (20% basic rate on earnings between £12,570 and £50,270)

A Band 5 nurse earning £16.38 per hour gross might take home around £12.80-£13.50 per hour after deductions, depending on their tax code and pension tier.

Use our NHS take-home pay calculator to get your exact figure.

NHS Jobs by Pay Band

Not sure which band your job falls into? Here’s a guide to typical roles at each level.

NHS Pay Rise 2026/27 Explained

The 2026/27 pay award of 3.3% came into effect on 1 April 2026. This is the earliest the Pay Review Body recommendations have been accepted and implemented in six years.

How the 3.3% Rise Was Decided

The government accepted the NHS Pay Review Body’s recommendation. Ministers called it an “above-inflation” rise, based on the Office for Budget Responsibility’s forecast that inflation would fall to around 2.2%.

However, unions including the Royal College of Nursing called the award “an insult,” pointing out that current inflation was running at 3.4% when the announcement was made. They argued this represents a real-terms pay cut for NHS staff.

Fact: The RCN and almost all other unions withdrew from the Pay Review Body process, calling it “not fit for purpose.” The 3.3% award was imposed without union involvement in negotiations.

Scotland’s Better Deal

Scotland negotiated a two-year pay deal through direct talks with unions:

• 2025/26: 4.25% pay rise
• 2026/27: 3.75% pay rise

This gives Scottish NHS staff an 8% total increase over two years, with a guarantee to be at least one percentage point above inflation each year.

Band 5 Nurse Review

Alongside the pay award, the government announced that every NHS nurse paid at Band 5 will have their role reviewed. This aims to ensure nurses are in the correct band for their responsibilities, with additional funding available to support the process.

Comparison: 2025/26 vs 2026/27 Rates

Use our NHS pay rise calculator to see how the increase affects your salary.

Recent NHS Pay Award History

What Is Agenda for Change?

Agenda for Change (often called AfC) is the pay system used for most NHS staff. It was introduced in December 2004 and replaced over 30 different pay systems that existed before.

Who Does It Cover?

Agenda for Change covers:

• Nurses and midwives
• Healthcare assistants and support workers
• Allied health professionals (physios, OTs, radiographers)
• Administrative and clerical staff
• Estates and facilities workers
• Scientists and technicians

Who Isn’t Covered?

Some NHS workers have separate pay arrangements:

• Doctors and dentists (separate pay scales)
• Very senior managers
• Some NHS contractors

How Pay Progression Works

Since the 2018 pay deal, progression depends on:

• Years of experience at your current band
• Satisfactory performance reviews
• Meeting the competencies in the Knowledge and Skills Framework (KSF)

There’s no overlap between bands anymore. This means someone at the top of Band 3 can’t earn more than someone at the bottom of Band 4—which happened under the old system.

For a full breakdown of how the system works, see our guide on NHS pay bands explained.

Fact: Agenda for Change was the biggest overhaul of NHS pay in over 50 years when it launched, creating a single framework for more than 1.5 million workers.

NHS Annual Leave and Other Benefits

Your hourly rate is just part of the package. NHS staff also get generous benefits.

Annual Leave Entitlement

Use our NHS annual leave calculator to work out your exact entitlement.

NHS Pension

The NHS Pension Scheme is one of the best in the country. Your contribution rate depends on your salary, ranging from 5.1% to 14.7%. The employer also contributes, making your pension worth much more than private sector equivalents.

Sick Pay

NHS staff get occupational sick pay, which is more generous than statutory sick pay. The exact amount depends on your length of service. Use our NHS sick pay calculator to check your entitlement.

NHS Discounts

Staff can access exclusive discounts through the NHS discount scheme, covering everything from groceries to holidays.

Frequently Asked Questions

How much does NHS pay per hour in 2026/27?

NHS hourly rates range from £12.91 at Band 2 in England to £66.30 at the top of Band 9. Your exact rate depends on your band, experience, and which UK nation you work in. Scotland pays the highest rates.

How much is Band 3 NHS hourly in 2026/27?

Band 3 hourly rates in England start at £13.16 and go up to £14.03 after two years. In Scotland, Band 3 pays more—from £15.07 to £16.26 per hour.

What is the NHS hourly rate for overtime?

Overtime is paid at time and a half (1.5 times your basic rate). On bank holidays, you get double time (2 times your basic rate). For example, a Band 5 nurse on £16.38 per hour earns £24.57 for overtime.

How do I calculate my NHS hourly rate?

Divide your annual salary by 1,957.5 (or 1,924 in Scotland). For example, £32,073 ÷ 1,957.5 = £16.38 per hour.

Does NHS pay differ between England and Scotland?

Yes, Scotland pays higher rates at most bands. A Band 2 healthcare assistant earns £13.82 per hour in Scotland compared to £12.91 in England. Scotland also has a 37-hour week versus 37.5 hours elsewhere.

What is HCAS and who gets it?

HCAS stands for High Cost Area Supplement. It’s extra pay for staff working in London. Inner London gets 20% extra, Outer London gets 15%, and the Fringe zone gets 5%.

Are Band 8 and 9 staff entitled to overtime?

In England, Wales, and Northern Ireland, staff at Bands 8 and 9 do not receive overtime payments. However, Scottish NHS staff at all bands can claim overtime.

What was the 2026/27 NHS pay rise?

NHS staff in England and Wales received a 3.3% pay rise from 1 April 2026. Scotland received 3.75% as part of their two-year deal. Unions called the England award “an insult” as it was below the current inflation rate of 3.4%.

When is the next NHS pay rise?

The 2027/28 pay award will be announced later in 2026. The NHS Pay Review Body will make recommendations, though most unions have withdrawn from this process.

The NHS Agenda for Change pay system gives you clear hourly rates based on your band and experience. Scotland pays the highest rates, particularly for lower bands, whilst Northern Ireland has the lowest. Remember to factor in overtime, unsocial hours payments, and London weighting if they apply to you—these can make a significant difference to your actual earnings.