Agenda for Change 2026/27 Pay Award: Current Status by Country

The NHS Pay Review Body recommended a 3.3% pay rise for Agenda for Change staff in England, and the government has accepted this recommendation. Here is the current status across all four UK nations.

For the first time in six years, NHS staff in England will receive their pay uplift in their April 2026 pay packets. Electronic Staff Record (ESR) colleagues have confirmed the increase will be processed in time for April salaries.

Related Guide: Agenda for Change Scotland: 2025/26 & 2026/27 Pay Scales

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 initially proposed a 2.5% pay increase in its November 2025 evidence submission to the NHS Pay Review Body. However, the Pay Review Body recommended 3.3%, and the government accepted this recommendation in full on 12 February 2026.

As part of the 2026/27 pay package, the Department of Health and Social Care will begin fast-paced discussions with trade unions and employers through the NHS Staff Council to agree funded improvements to the pay structure. Priorities include raising pay for the lowest bands and improving pay for graduates across professions. Once agreed, these reforms will provide some staff with additional pay increases backdated to 1 April 2026

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

Figures calculated using 3.75% uplift on the 2025/26 Scotland baseline

Scotland Hourly Rates 2026/27

As part of the 2025-26 and 2026-27 pay settlement, there is a guarantee that each year of this pay deal will be 1 percentage point higher than average CPI inflation. If CPI inflation in 2026 averages higher than 2.75% over the period January 2026 – December 2026, then pay will be adjusted

Scottish NHS staff will see these rates in their April 2026 payslips. There is no need to wait for backdated payments.

Confirmed England Agenda for Change Pay Scales 2026/27

The government has confirmed a 3.3% pay increase for all Agenda for Change staff in England, effective from 1 April 2026. Here are the official pay scales published by NHS Employers.

England Annual Pay Scales 2026/27

Source: NHS Employers Pay Scales 2026/27. Band 1 is closed to new entrants.

NHS staff in England will see these rates in their April 2026 payslips. For the first time in six years, there is no need to wait for backdated payments.

England Hourly Rates 2026/27 (Confirmed)

These are the official hourly rates for NHS staff in England from 1 April 2026.

Source: NHS Employers

Important: The National Living Wage rose to £12.21 per hour from April 2025. Band 2 entry at £12.92 per hour remains close to statutory minimums. The government has committed to addressing this through funded pay structure reform discussions

Related Guide: NHS Planning Guidance 2026/27

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)

Inner London Pay Scales 2026/27 (Confirmed)

Source: NHS Employers

Outer London Pay Scales 2026/27 (Confirmed)

Source: NHS Employers

Fringe Pay Scales 2026/27 (Confirmed)

Source: NHS Employers

NHS Pay Rise 2026/27: Timeline and Key Dates

The 2026/27 pay award process moved significantly faster than previous years. Here is what happened:

Key point: For the first time in six years, NHS staff will receive their pay uplift in April pay slips. There is no need to wait for backdated payments. Electronic Staff Record (ESR) colleagues have confirmed the increase will be processed in time

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 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.

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 future-proofed 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 Award

NHS trade unions have responded critically to the confirmed 3.3% pay award.

What the Unions Are Saying

The Royal College of Nursing stated that the 3.3% pay award “will be imposed on all NHS Agenda for Change staff in England without any union involvement. The RCN’s General Secretary said unions “were misled to expect direct negotiations with government on the pay award”.

The British Dietetic Association (BDA) described it as “a real-terms pay cut for the dietetic workforce” and stated the Pay Review Body recommendations are “completely out of touch with reality”.

UNISON’s Helga Pile said: “Hard-pressed NHS staff will be downright angry at another below-inflation pay award. Yet again, they’re expected to keep delivering more while effectively being given less, as pay slides behind living costs. Having an increase in time for once is only a small comfort.”

GMB’s Rachel Harrison said: “This award is just not enough to make up for more than a decade of pay cuts under the Tories. NHS workers deserve more, and GMB will fight for that at the long overdue agenda for change structural talks we have now been promised.”

Royal College of Midwives’ Gill Walton said: “Without fixing the unfair pay system, this real-terms pay cut is an insult to midwives who work 100,000 unpaid hours every week just to keep maternity services running. Our members are sick and tired of these broken promises to sort out pay, and staffing, and their anger is justified.”

Unite’s Sharon Graham said: “It beggars belief that a Labour Government should seek to ride roughshod over the health unions when deciding on NHS pay. For too long, NHS workers have been overworked, underpaid and undervalued. Today’s announcement will simply increase the problems of low pay that have seen thousands of healthcare workers leave, worsening the recruitment and retention crisis in our NHS.”

Key union concerns include:

• The 3.3% award was imposed without negotiation
• Multiple unions, including the RCN, have withdrawn from the Pay Review Body process, arguing it is not fit for purpose
• Unions continue to push for collective bargaining as a fairer alternative

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.

Fairer Deal for Nurses: What’s Been Announced

Alongside the 3.3% pay award, the government announced additional measures specifically for nurses.

Key Commitments:

1. Band 5 Nursing Role Review. Every Band 5 nurse in NHS England will have their role reviewed by employers to ensure job descriptions and pay bands reflect the work they are actually doing. Additional recurrent national funding is being made available to support this review and any resulting salary uplift.
2. Graduate Pay Priorit:y The NHS Staff Council will be asked to prioritise graduate pay in upcoming pay structure reform discussions. This applies to nursing graduates and all graduates under the Agenda for Change contract.
3. National Nursing Preceptorship A single national nursing preceptorship framework will be established to support newly qualified nurses.

Funding: This is separate and additional to the funding for annual pay rises and pay structure reform. Employers will be required to adhere to agreed national timescales, with further details expected ahead of 1 April 2026

Pay Structure Reform: What’s Being Discussed

The government has confirmed that as part of the 2026/27 pay package, the Department of Health and Social Care will begin fast-paced discussions with trade unions and employers through the NHS Staff Council to agree funded improvements to the pay structure3. Once agreed, these reforms will provide some staff with additional pay increases backdated to 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:

1. Entry-level pay: Must be futureproofed with a clear plan to maintain competitiveness against rising statutory minimums
2. Graduate entrants: Need structured progression, especially at Band 5, where slow earnings growth risks deterring new professionals
3. Promotion incentives: Must be rebalanced as narrow pay gaps between bands reduce the financial appeal of taking on more responsibility
4. Apprenticeship pay: Introduction of a consistent national pay framework to govern the rate of pay for apprentices in the NHS
5. 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

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

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

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 (Confirmed 3.3%)

Your 2026/27 salary = Current 2025/26 salary × 1.033

Example: Band 5 nurse at entry point

• Current salary: £31,049
• Calculation: £31,049 × 1.033 = £32,074

This matches the confirmed figure of £32,073 published by NHS Employers (minor rounding difference)

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 the Scottish government website)
• England 2026/27: NHS Employers pay scales document
• Wales 2026/27: Following England rates
• Northern Ireland 2026/27: 3.3% pay award

Frequently Asked Questions

Is the NHS getting a pay rise in 2026?

Yes. All four UK nations are providing a pay rise for Agenda for Change staff in 2026/27:

• Scotland: 3.75% confirmed
• England: 3.3% confirmed
• Wales: 3.3% confirmed
• Northern Ireland: Northern Ireland has received the 3.3% pay award

Staff in England will see the increase in their April 2026 payslips for the first time in six years

What is the expected pay increase for 2026?

Scotland has confirmed 3.75%. England and Wales have confirmed 3.3%. Northern Ireland has received a recommendation of 3.3%.

When will the 2026/27 pay rise be paid?

• Scotland: April 2026 payslips
• England: April 2026 payslips
• Wales: April 2026 payslips
• Northern Ireland: 3.3% pay award

For the first time in six years, NHS staff will receive their pay uplift in April without delay. No backdating is required.

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 the 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?

Trade unions have expressed disappointment with the 3.3% award. The RCN stated it was “imposed without any union involvement”. UNISON said “ministers should have done the right thing” and called the return to the Pay Review Body process a “handbrake turn”. Unions continue to demand proper talks on pay structure reform.

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?

This additional pressure above affordability will be managed by DHSC and ALBs (including NHSE central budgets) but none of the pay increases will be paid for by cutting frontline services.

Last updated:13 February 2026. England pay scales reflect the confirmed 3.3% award announced on 12 February 2026