Scotland has confirmed its NHS pay award for 2026/27 at 3.75%. England, Wales, and Northern Ireland are still waiting for their final pay decision. The government has proposed a 2.5% increase for England, but the NHS Pay Review Body has not yet published its recommendations.
This guide gives you everything you need to know about Agenda for Change pay bands for the 2026/27 financial year. You will find confirmed figures where available, projected pay scales, and clear explanations of what happens next.
Agenda for Change 2026/27 Pay Award: Current Status by Country
The NHS uses different pay processes across the UK. This means each country announces its pay award at different times.
| Country | Status | Rate | When to Expect Decision |
|---|---|---|---|
| Scotland | ✅ Confirmed | 3.75% uplift | Already announced |
| England | ⏳ Pending | 2.5% proposed | Summer/Autumn 2026 |
| Wales | ⏳ Pending | Follows England timeline | Late 2026 |
| Northern Ireland | ⏳ Pending | Separate process | Late 2026 |
The NHS Pay Review Body (NHSPRB) looks at evidence from the government and trade unions. It then makes recommendations to ministers. The Department of Health and Social Care makes the final decision for England.
The government submitted its written evidence to the NHS Pay Review Body in November 2025, claiming it can only afford a 2.5% pay rise for healthcare staff in 2026/27. Trade unions have criticised this proposal, arguing it falls way behind inflation and may not even be enough to ensure the NHS complies with minimum wage laws.
Scotland runs its own NHS pay negotiations. This is why Scottish staff often know their pay award earlier than colleagues in England.
Confirmed Scotland Agenda for Change Pay Scales 2026/27
Scotland has agreed a 3.75% pay increase for all Agenda for Change staff from 1 April 2026. Here are the full pay scales.
Scotland Annual Pay Scales 2026/27
| Band | Entry Point | Top of Band |
|---|---|---|
| Band 2 | £26,519 | £28,946 |
| Band 3 | £29,062 | £31,364 |
| Band 4 | £31,491 | £34,254 |
| Band 5 | £34,494 | £42,978 |
| Band 6 | £43,168 | £52,603 |
| Band 7 | £52,768 | £61,378 |
| Band 8a | £65,031 | £70,202 |
| Band 8b | £76,778 | £82,134 |
| Band 8c | £90,678 | £97,198 |
| Band 8d | £107,655 | £112,264 |
| Band 9 | £127,338 | £132,853 |
Figures calculated using 3.75% uplift on 2025/26 Scotland baseline
Scotland Hourly Rates 2026/27
| Band | Entry Hourly Rate | Top Hourly Rate |
|---|---|---|
| Band 2 | £13.75 | £15.00 |
| Band 3 | £15.06 | £16.26 |
| Band 4 | £16.32 | £17.76 |
| Band 5 | £17.88 | £22.28 |
| Band 6 | £22.38 | £27.27 |
| Band 7 | £27.35 | £31.81 |
Scottish NHS staff will see these rates in their April 2026 payslips. There is no need to wait for backdated payments.
Projected England Agenda for Change Pay Scales 2026/27
England has not confirmed its 2026/27 pay award yet. The government submitted evidence to the NHS Pay Review Body proposing a 2.5% increase. However, the final award may differ.
The Department of Health and Social Care has stated that financial and delivery plans currently allow for a pay uplift of 2.5% without having to make trade-offs against headline government health commitments. Should the independent pay review bodies recommend an award above this level, they would need to consider whether and how this could be made affordable from existing budgets.
Some analysts predict the final settlement could be around 3% across all bands, with the possibility of a slightly higher settlement depending on negotiations.
England 2026/27 Pay Scales at 2.5% (Government Proposal)
These figures show what NHS staff in England would earn if the government’s proposed 2.5% increase goes ahead.
| Band | 2025/26 Entry | Projected 2026/27 Entry | 2025/26 Top | Projected 2026/27 Top |
|---|---|---|---|---|
| Band 2 | £24,465 | £25,077 | £24,465 | £25,077 |
| Band 3 | £24,937 | £25,560 | £26,598 | £27,263 |
| Band 4 | £27,485 | £28,172 | £30,162 | £30,916 |
| Band 5 | £31,049 | £31,825 | £37,796 | £38,741 |
| Band 6 | £38,682 | £39,649 | £46,580 | £47,745 |
| Band 7 | £47,810 | £49,005 | £54,710 | £56,078 |
| Band 8a | £55,690 | £57,082 | £62,682 | £64,249 |
| Band 8b | £64,455 | £66,066 | £74,896 | £76,768 |
| Band 8c | £76,965 | £78,889 | £88,682 | £90,899 |
| Band 8d | £91,342 | £93,626 | £105,337 | £107,970 |
| Band 9 | £109,179 | £111,908 | £125,637 | £128,778 |
2025/26 baseline figures from NHS Employers. Projections calculated at 2.5% uplift.
Alternative Scenarios: What If the Award Is Higher?
Trade unions have rejected 2.5% as too low. The final award could be higher. Here is what a 3% increase would look like for key bands.
| Band | Entry at 3% | Top at 3% |
|---|---|---|
| Band 5 | £31,980 | £38,930 |
| Band 6 | £39,843 | £47,977 |
| Band 7 | £49,244 | £56,351 |
Based on 3% uplift prediction
England Hourly Rates 2026/27 (Projected at 2.5%)
Many NHS staff want to know their hourly rate. This helps with overtime calculations and comparing pay to other jobs.
| Band | Entry Hourly Rate | Top Hourly Rate |
|---|---|---|
| Band 2 | £12.82 | £12.82 |
| Band 3 | £13.07 | £13.94 |
| Band 4 | £14.41 | £15.81 |
| Band 5 | £16.27 | £19.81 |
| Band 6 | £20.27 | £24.42 |
| Band 7 | £25.06 | £28.68 |
| Band 8a | £29.19 | £32.86 |
| Band 9 | £57.24 | £65.86 |
Important: The National Living Wage rises to £12.21 per hour from April 2025, with further increases expected in April 2026. This puts Band 2 entry hourly rate dangerously close to minimum wage levels, raising serious compliance concerns.
Higher Cost Area Supplements (HCAS) 2026/27
NHS staff working in and around London receive extra pay. This is called the Higher Cost Area Supplement or London weighting.
Current HCAS Rates (2025/26)
| Area | Percentage | Minimum | Maximum |
|---|---|---|---|
| Inner London | 20% of basic salary | £5,414 | £8,172 |
| Outer London | 15% of basic salary | £4,551 | £5,735 |
| Fringe | 5% of basic salary | £1,258 | £2,122 |
Inner London Pay Scales 2025/26 (Current)
| Band | Entry (inc HCAS) | Top (inc HCAS) |
|---|---|---|
| Band 2 | £30,074 | £30,074 |
| Band 3 | £30,546 | £32,207 |
| Band 5 | £37,259 | £45,356 |
| Band 6 | £46,419 | £55,046 |
| Band 7 | £56,276 | £63,176 |
HCAS rates for 2026/27 will be confirmed when the pay award is announced.
NHS Pay Rise 2026/27: Timeline and Key Dates
Understanding when things happen helps you plan your finances. Here is the expected timeline for England.
| Stage | What Happens | Expected Date |
|---|---|---|
| Evidence submission | Government and unions send evidence to NHSPRB | ✅ Complete (November 2025) |
| Review Body analysis | NHSPRB studies the evidence | February – May 2026 |
| Recommendations published | NHSPRB tells government what it suggests | June – July 2026 |
| Government decision | Ministers announce the final pay award | August – September 2026 |
| Implementation | New rates appear on payslips | October – November 2026 |
| Backdating | Arrears paid from 1 April 2026 | With implementation |
The government remitted the NHSPRB to provide recommendations for the 2026/27 pay award over 2 months earlier than the previous year. Employers welcomed this progress and would like to see further improvements to return to a 1 April pay award implementation.
Key point: Even if the award is announced in September 2026, your new pay will be backdated to 1 April 2026. You will receive a lump sum for the months between April and when the new rate starts.
Universal Credit Warning: When pay awards are backdated to 1 April, it increases the risk of staff in lower pay bands losing out on Universal Credit as their monthly income impacts on the value of UC payments. Some organisations now offer staff the option to have their pay uplifts paid in multiple instalments to reduce the impact on UC.
How the 2026/27 Pay Award Compares to Previous Years
Looking at past pay awards helps you understand the current situation. NHS staff have seen varied increases in recent years.
| Financial Year | Pay Award | Notes |
|---|---|---|
| 2021/22 | 3.0% | July 2021 announcement |
| 2022/23 | £1,400 flat rate | Approximately 4% average |
| 2023/24 | 5.0% | After industrial action |
| 2024/25 | 5.5% | One of the higher recent increases |
| 2025/26 | 3.6% | Current year |
| 2026/27 | 2.5% proposed (England) | Pending confirmation |
| 2026/27 | 3.75% confirmed (Scotland) | Already agreed |
Historical Context: Between 2010 and 2015, average NHS nursing salaries increased by just over 2%. Then between 2015 and 2017, a fixed 1% pay rise was implemented – the well-known ‘pay cap’. The New Pay Deal from 2018 to 2021 saw minimum salaries increase by at least 6.5%.
Has Pay Kept Up With Inflation? Starting pay for a Band 5 nurse has increased from £21,692 in 2015 to £31,049 in 2025. In nominal terms, this is a pay rise of approximately £9,357, representing a 43% increase over the 10-year period. Analysis suggests that starting pay for nurses has broadly kept up with CPI inflation in real terms, with the 2025/26 salary being roughly £2,000–£2,500 higher than what inflation alone would predict.
Minimum Wage Compression: Impact on Lower Bands
A growing problem affects staff in Band 2 and Band 3. Their pay is getting very close to the National Living Wage.
The Problem
National Living Wage increases are outpacing NHS pay uplifts. Due to the narrow buffer between NLW and NHS pay, lower bands are at risk of falling below statutory minimums, forcing employers to implement interim measures to remain compliant.
The uplift to the NLW in 2025/26 exceeded the hourly pay for Band 1 and Band 2 roles, resulting in an interim uplift being required. The entry point of Band 3 also received an uplift to maintain the differentials with the top of Band 2.
This compression is also impacting access to salary sacrifice and net deduction schemes, with many staff unable to benefit from this element of the NHS reward package.
NHS Employers’ Recommendations
NHS Employers have called for:
- Competitive pay for entry-level roles: Establish a futureproofed plan to create and retain a sustainable competitive market position on pay for entry-level roles
- Targeted action at band 5 entry point: Ensure the NHS remains an attractive career destination for graduates
- Pay incentives for promotion: Develop a sustainable and targeted plan for more appropriate pay increases on promotion between pay bands, starting with gaps between bands 2 and 3, bands 6 and 7, and bands 7 and 8a
Union Response to the 2026/27 Pay Proposal
NHS trade unions have spoken out against the proposed 2.5% increase for England. They say it is not enough.
What the Unions Are Saying
UNISON and the Royal College of Nursing (RCN) expressed disappointment that the government is proposing such a low increase. Their main arguments are:
- The proposed 2.5% falls way behind inflation
- It likely won’t even be enough to ensure the NHS complies with minimum wage laws
- Staff deserve to have a say on their pay
- There need to be urgent and properly funded talks to resolve deep-rooted issues with the NHS pay structure
Trade unions responded critically to the 3.6% NHS pay award for 2025/26 as well, arguing that it fails to keep pace with inflation and does not address long-standing issues in NHS pay structures. UNISON highlighted that the increase still leaves some staff earning below the real living wage and consulted members on potential industrial action.
Key Structural Problems Unions Want Fixed
Bands 2-3:
- Band 2 has become a spot rate with no reward for progression
- The rate for Band 3 is not a great deal more than Band 2
- Combined with a reduction in unsocial hours payments, this creates a massive disincentive for staff looking to take on more responsibility
Bands 5-6:
- Greatest risk of losing new clinical staff in the first two years
- The progression from entry to intermediate in Band 5 is too small
- Promotion to Band 6 does not come with enough of a pay rise for experienced staff
Bands 7-9:
- At 8a, staff often lose all eligibility for unsocial hours payments and overtime
- Working at Band 8a often means a big jump in responsibility without decent reward
New Graduates:
- Graduate entry into the NHS is at Band 5
- Compare this with teachers’ starting pay rates and private sector jobs which are often higher
- Risk of not being able to fill vacancies if NHS pay falls behind
Could There Be Strikes?
Indicative ballot results revealed strong opposition to the 2025/26 pay award. As next steps, unions are demanding urgent talks with the government and preparing to move toward formal ballots, which could lead to industrial action if negotiations do not begin promptly.
Pay award disparities between staff groups are also fuelling discontent, particularly where Agenda for Change staff perceive themselves as undervalued compared to medical and dental colleagues who have received higher uplifts and additional payments.
Pay Structure Reform: What’s Being Discussed
The government remains committed to providing the NHS Staff Council with a funded mandate to begin to resolve outstanding concerns with the AfC pay structure. Changes are expected from 1 April 2026.
Areas Under Discussion
The government asked the NHS Staff Council to conduct exploratory talks to identify the areas of the pay structure that it would like to see reformed. These talks are progressing to identify joint priorities and seek a consensus.
Key reform areas include:
- Entry-level pay: Must be futureproofed with a clear plan to maintain competitiveness against rising statutory minimums
- Graduate entrants: Need structured progression, especially at Band 5, where slow earnings growth risks deterring new professionals
- Promotion incentives: Must be rebalanced as narrow pay gaps between bands reduce the financial appeal of taking on more responsibility
- Apprenticeship pay: Introduction of a consistent national pay framework to govern the rate of pay for apprentices in the NHS
- Unsocial hours anomalies: Targeted action to address anomalies created by consolidated pay changes in previous years
Understanding Agenda for Change Pay Progression
Your pay can increase in two ways. Many people get confused between these.
1. Annual Pay Award
This is the percentage increase the government announces each year. It applies to everyone on Agenda for Change contracts. For example, if the award is 2.5%, all salaries go up by 2.5%.
2. Incremental Progression
This is movement through the pay step points within your band. Most bands have three points:
- Entry point – Where you start
- Intermediate point – After 2 years (most bands)
- Top point – After another 2-3 years
You move up a pay point on your pay step date (usually the anniversary of when you started in that band). This happens separately from the annual pay award.
Example: Band 5 Nurse Progression
| Year | Pay Point | 2025/26 Salary | With 2.5% Award |
|---|---|---|---|
| Year 1 | Entry | £31,049 | £31,825 |
| Year 2 | Entry | £31,049 | £31,825 |
| Year 3 | Intermediate | £33,487 | £34,324 |
| Year 4 | Intermediate | £33,487 | £34,324 |
| Year 5 | Top | £37,796 | £38,741 |
You get both increases. The annual pay award raises all the figures. Your progression moves you to the next row. This is why your salary can jump significantly in years when you also progress to a new pay point.
Conditions for Progression
Moving up a pay point is not automatic. You must:
- Meet the required standards for your role
- Complete your annual appraisal
- Not have any performance concerns
The NHS Knowledge and Skills Framework (KSF) sets out what you need to demonstrate at each level.
Which Jobs Are Covered by Agenda for Change?
Not everyone working in the NHS uses these pay bands. Here is a clear breakdown.
Covered by Agenda for Change
| Role Type | Typical Bands |
|---|---|
| Healthcare assistants | Band 2-3 |
| Nursing assistants | Band 2-4 |
| Registered nurses | Band 5-7 |
| Midwives | Band 5-7 |
| Physiotherapists | Band 5-7 |
| Occupational therapists | Band 5-7 |
| Radiographers | Band 5-7 |
| Paramedics | Band 5-6 |
| Admin and clerical staff | Band 2-6 |
| Porters and domestic staff | Band 2-3 |
| Biomedical scientists | Band 5-7 |
| Pharmacists | Band 6-8 |
The NHS employs over 177,000 Scientific, Technical and Therapeutic (STT) staff, over 411,000 clinical support staff and almost 212,000 staff in NHS infrastructure roles on AfC pay bands.
NOT Covered by Agenda for Change
| Role Type | Pay System |
|---|---|
| Junior doctors | Separate medical pay scales |
| Consultants | Consultant contract |
| Dentists | Dental pay scales |
| Very senior managers | VSM pay framework |
| GP practice staff | Practice-specific |
| Agency and bank workers | Different rates apply |
Medical and dental staff follow recommendations from the Doctors and Dentists Review Body (DDRB), not the NHS Pay Review Body.
What Band Do Newly Qualified Nurses Start At? All qualified nurses start at Band 5 – regardless of whether you qualify as an Adult, Children’s, Mental Health or Learning Disability Nurse.
What Is Agenda for Change?
You may have heard of the so-called ‘Agenda for Change’ (AfC). Essentially, AfC was a new system introduced in 2004 that underpinned the banding structure that applies to nursing pay today. It was implemented to correct historic problems with nursing pay – namely, to provide a more structured way of ensuring NHS staff get equal pay for work of equal value.
This idea of allocating roles to specific pay bandings was a new one, and broadly speaking, the system has remained largely unaltered since 2004.
Between April 2018 and March 2021 the new pay structure called the ‘New Pay Deal’ in NHS England was rolled out. This has since been followed by one-off, annual pay increases.
Key Changes from the New Pay Deal
- Over three years between March 2018 and April 2021, nurses saw a minimum salary increase of 6.5%
- Pay points were retired and a new banding system was introduced
- Band overlaps were removed to ensure that promotions come with meaningful pay increases
- The New Pay Deal was funded by new government money – not by removing funding from patient care
- Unsocial hours payments were not affected
Agenda for Change 2026/27 Calculator
Want to estimate your 2026/27 salary? Here is a simple way to calculate it.
Formula for England (Proposed 2.5%)
Your projected 2026/27 salary = Current salary × 1.025
Example: Band 5 nurse at entry point
- Current salary: £31,049
- Calculation: £31,049 × 1.025 = £31,825
Formula for Scotland (Confirmed 3.75%)
Your projected 2026/27 salary = Current salary × 1.0375
Example: Band 5 nurse at entry point (Scotland)
- Current salary: £33,247
- Calculation: £33,247 × 1.0375 = £34,494
Remember: These calculations assume no change to your pay point. If you are also due incremental progression, you need to apply the percentage to your new pay point figure.
Agenda for Change 2026/27 PDF Download
Looking for downloadable pay scale documents?
Available Now
- Scotland 2026/27: NHS Scotland circular (available from Scottish government website)
- England 2025/26: NHS Employers pay scales document
- Wales 2025/26: NHS Wales pay circular
Coming Soon
- England 2026/27: Will be published after government announces final pay award (expected Autumn 2026)
- Wales 2026/27: Usually follows shortly after England
- Northern Ireland 2026/27: Published when NICS pay negotiations complete
Frequently Asked Questions
Is NHS getting a pay rise in 2026?
Yes. All four UK nations will provide a pay rise for Agenda for Change staff in 2026/27. Scotland has confirmed 3.75%. England, Wales, and Northern Ireland have not announced final figures yet, but the government has proposed 2.5% for England.
What is the expected pay increase for 2026?
Scotland has confirmed 3.75%. For England, the government proposes 2.5%, but some analysts predict the final award could be around 3% once the NHS Pay Review Body makes its recommendations.
When will the 2026/27 pay rise be paid?
Scotland: From April 2026 payslips.
England: Likely October-November 2026, but backdated to 1 April 2026. You will receive a lump sum covering the months between April and when the new rate starts.
What was the Agenda for Change pay rise in 2025/26?
NHS staff in England received a 3.6% pay increase for 2025/26. This was paid in summer 2025 salaries and backdated to April 2025.
Will NHS Band 2 fall below minimum wage in 2026?
No, but it will be very close. National Living Wage increases are outpacing NHS pay uplifts, and the narrow buffer between NLW and NHS pay means lower bands are at risk of falling below statutory minimums. Employers have had to implement interim measures to remain compliant.
What is the NICS pay for 2026/27?
Northern Ireland Civil Service (NICS) pay follows a separate negotiation process. NHS staff in Northern Ireland covered by Agenda for Change will receive a pay award, but the timing and percentage may differ from England. No figures have been confirmed yet.
Could there be NHS strikes over 2026/27 pay?
Possible but not certain. Trade unions have rejected 2.5% as insufficient. Indicative ballot results revealed strong opposition to recent pay awards, and unions are demanding urgent talks with the government. If negotiations do not progress, formal ballots could lead to industrial action.
How do I know my pay band?
Your pay band should be stated in your employment contract. You can also ask your line manager or HR department. Each band has specific job profiles that describe the level of responsibility required. The NHS Job Evaluation Scheme determines which band each role falls into.
Do I get the pay rise automatically?
Yes, if you are employed on an Agenda for Change contract. The increase applies to your basic salary automatically once your trust implements the new pay scales. You do not need to apply for it.
What about bank and agency staff?
Bank and agency workers are not directly covered by Agenda for Change. However, many trusts adjust bank rates when Agenda for Change pay scales change. Agency rates are set by the agencies and may not follow the same pattern. There is a mandated reduction of at least 30% in agency spending and 10% in bank staff use across the NHS.
Why do NHS staff feel undervalued?
Pay award disparities between staff groups are fuelling discontent, particularly where Agenda for Change staff perceive themselves as undervalued compared to medical and dental colleagues who have received higher uplifts and additional payments. NHS staff have become disillusioned with the Pay Review Body system because they do not believe it is independent.
Will pay awards be fully funded?
The 2025/26 NHS pay awards were only partially funded by the government, with a central allocation covering 2.8% of the total cost. The remaining funding was sourced through internal savings and budget reprioritisation. For 2026/27, all pay must be funded from departmental budgets with no additional funding available above this for pay settlements.