This page contains every NHS Agenda for Change pay scale from 2018 to 2025. Whether you need to check back pay calculations, track your career progression, or understand how NHS salaries have changed over time, you will find all the figures here.

NHS pay follows financial years running from April to March. So when we talk about 2024/25, we mean the period from 1 April 2024 to 31 March 2025.

Quick Reference: Pay Awards by Year

Financial Year Pay Award Notes
2025/26 3.6% Current year
2024/25 5.5% Higher recent increase
2023/24 5.0% Following industrial action
2022/23 £1,400 flat rate Approximately 4% average
2021/22 3.0% Post-deal single year award
2020/21 2.0%-3.3% Final year of New Pay Deal
2019/20 1.7%-3.3% Year 2 of New Pay Deal
2018/19 3.0% New Pay Deal begins — major reform

Understanding NHS Financial Years vs Calendar Years

Many people search for “Agenda for Change 2024” when they actually need the 2024/25 financial year figures. This is a common mix-up that can cause confusion.

The NHS operates on financial years that run from 1 April to 31 March. This is different from calendar years that run January to December.

Here is how to find what you need:

If You Search For You Actually Need
Agenda for Change 2024 2024/25 pay scales (April 2024 to March 2025)
Agenda for Change 2023 2023/24 pay scales (April 2023 to March 2024)
Agenda for Change 2022 2022/23 pay scales (April 2022 to March 2023)
Agenda for Change 2018 2018/19 pay scales (April 2018 to March 2019)

This matters for back pay calculations. If you received a pay award in August 2024, it was backdated to April 2024 — the start of the 2024/25 financial year.

Current Pay Scales 2025/26 (April 2025 – March 2026)

The 2025/26 pay award gave Agenda for Change staff a 3.6% increase. The government accepted the recommendations of the NHS Pay Review Body to give this uplift to all AfC staff including nurses, midwives, ambulance staff, porters and cleaners.

The average starting salary for a nurse is now around £31,050, up from around £27,050 in 2023.

England 2025/26 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £24,465 £24,465
Band 3 £24,937 £26,598
Band 4 £27,485 £30,162
Band 5 £31,049 £33,487 £37,796
Band 6 £38,682 £40,823 £46,580
Band 7 £47,810 £50,273 £54,710
Band 8a £55,690 £58,487 £62,682
Band 8b £64,455 £68,631 £74,896
Band 8c £76,965 £81,652 £88,682
Band 8d £91,342 £96,941 £105,337
Band 9 £109,179 £115,763 £125,637

Band 1 is closed to new entrants. Any remaining staff on Band 1 contracts are paid as if they are on Band 2.

England 2025/26 Hourly Rates

Band Entry Intermediate Top
Band 2 £12.51 £12.51
Band 3 £12.75 £13.60
Band 4 £14.06 £15.43
Band 5 £15.88 £17.13 £19.33
Band 6 £19.78 £20.88 £23.82
Band 7 £24.45 £25.71 £27.98
Band 8a £28.48 £29.91 £32.06
Band 9 £55.84 £59.20 £64.25

Scotland 2025/26 Pay Scales

Scotland negotiates NHS pay separately. Scottish staff received a 4.25% increase for 2025/26.

Band Entry Point Top of Band
Band 2 £25,560 £27,900
Band 3 £28,011 £30,230
Band 4 £30,353 £33,016
Band 5 £33,247 £41,424
Band 6 £41,608 £50,702
Band 7 £50,861 £59,159
Band 8a £62,681 £67,665
Band 9 £122,736 £128,051

Wales 2025/26 Pay Scales

Band Entry Point Top of Band
Band 2 £23,970 £23,970
Band 3 £24,433 £26,060
Band 4 £26,928 £29,551
Band 5 £30,420 £37,029
Band 6 £37,898 £45,636
Band 7 £46,840 £53,601

Northern Ireland 2025/26 Pay Scales

Band Entry Point Top of Band
Band 2 £22,383 £22,383
Band 3 £22,816 £24,336
Band 4 £25,147 £27,596
Band 5 £28,407 £34,581
Band 6 £35,392 £42,618
Band 7 £43,742 £50,056

Agenda for Change Pay Scales 2024/25 (April 2024 – March 2025)

The 2024/25 financial year saw one of the more substantial pay increases in recent times. NHS staff on Agenda for Change received a 5.5% pay rise.

2024/25 Pay Award Summary

  • Pay increase: 5.5% for all Agenda for Change staff
  • Announcement date: June 2024
  • Implementation: August 2024 salaries
  • Backdated to: 1 April 2024

This award followed significant discussions between the government, NHS Employers, and trade unions. It was one of the higher increases seen in recent years.

England 2024/25 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £23,615 £23,615
Band 3 £24,071 £25,674
Band 4 £26,530 £29,114
Band 5 £29,970 £32,324 £36,483
Band 6 £37,338 £39,394 £44,962
Band 7 £46,148 £48,526 £52,809
Band 8a £53,755 £56,461 £60,504
Band 8b £62,215 £66,239 £72,293
Band 8c £74,290 £78,813 £85,601
Band 8d £88,168 £93,575 £101,677
Band 9 £105,385 £111,740 £121,271

2024/25 Hourly Rates

Band Entry Intermediate Top
Band 2 £12.08 £12.08
Band 3 £12.31 £13.13
Band 4 £13.57 £14.89
Band 5 £15.33 £16.53 £18.66
Band 6 £19.10 £20.15 £22.99
Band 7 £23.60 £24.82 £27.01
Band 8a £27.49 £28.87 £30.94

Agenda for Change Pay Scales 2023/24 (April 2023 – March 2024)

The 2023/24 pay award came after significant industrial action by NHS unions during 2022-2023. Nurses, ambulance workers, and other staff took strike action over pay.

2023/24 Pay Award Summary

  • Pay increase: 5.0% for all bands
  • Announcement: July 2023
  • Implementation: August/September 2023
  • Backdated to: 1 April 2023

The 5% award was a direct response to the widespread strikes. It was higher than originally proposed by the government.

England 2023/24 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £22,383 £22,383
Band 3 £22,816 £24,336
Band 4 £25,147 £27,596
Band 5 £28,407 £30,639 £34,581
Band 6 £35,392 £37,350 £42,618
Band 7 £43,742 £46,002 £50,056
Band 8a £50,952 £53,520 £57,349
Band 8b £58,972 £62,785 £68,525
Band 8c £70,417 £74,703 £81,138
Band 8d £83,571 £88,691 £96,376
Band 9 £99,891 £105,914 £114,949

Agenda for Change Pay Scales 2022/23 (April 2022 – March 2023)

The 2022/23 pay award was unique. Instead of a percentage increase, staff received a £1,400 flat rate increase. This worked out to approximately 4% on average, but meant lower bands received a higher percentage increase than higher bands.

2022/23 Pay Award Summary

  • Pay increase: £1,400 flat rate for all bands
  • Average percentage: Approximately 4%
  • Context: Cost of living crisis beginning

This approach was unusual. The government chose a flat cash amount rather than a percentage to give proportionally more to lower-paid staff during the cost of living crisis.

England 2022/23 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £21,318 £21,318
Band 3 £21,730 £23,177
Band 4 £23,949 £26,282
Band 5 £27,055 £29,180 £32,934
Band 6 £33,706 £35,571 £40,588
Band 7 £41,659 £43,815 £47,672
Band 8a £48,526 £50,972 £54,619
Band 8b £56,164 £59,800 £65,262
Band 8c £67,064 £71,146 £77,274
Band 8d £79,591 £84,468 £91,787
Band 9 £95,135 £100,870 £109,475

Agenda for Change Pay Scales 2021/22 (April 2021 – March 2022)

The 2021/22 financial year was the first year after the three-year New Pay Deal ended. Staff received a 3.0% pay increase.

2021/22 Pay Award Summary

  • Pay increase: 3.0% for all bands
  • Context: COVID-19 pandemic ongoing
  • Structure: New simplified pay structure now fully implemented

By April 2021, all staff had transitioned to the new pay structure introduced in 2018. The transition period was complete.

England 2021/22 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £19,918 £19,918
Band 3 £20,330 £21,777
Band 4 £22,549 £24,882
Band 5 £25,655 £27,780 £31,534
Band 6 £32,306 £34,172 £39,027
Band 7 £40,057 £42,213 £45,839
Band 8a £46,540 £48,986 £52,253
Band 8b £53,818 £57,454 £62,001
Band 8c £64,251 £68,333 £73,664
Band 8d £76,233 £81,138 £87,754
Band 9 £91,004 £96,735 £104,927

The New Pay Deal 2018-2021: Understanding the Major Reform

The year 2018 was a turning point for NHS pay. The government, NHS Employers, and trade unions agreed a three-year pay deal that completely restructured the Agenda for Change pay system.

If you are looking up pay from this period, it helps to understand what changed and why.

What Changed in 2018?

The 2018 framework agreement introduced several major changes:

Removal of Band Overlaps

Before 2018, pay bands overlapped. This meant someone in a lower band could actually earn more than someone in a higher band with more responsibility. The 2018 deal removed these overlaps to prevent this from happening.

Fewer Pay Points

The old system had multiple spine points within each band. Some bands had seven or more individual pay points. The new system simplified this to just 2-3 pay step points per band.

New Progression System

Under the old system, staff progressed through pay points automatically each year. The new system changed this to progression every 2-3 years, subject to meeting appraisal standards.

Minimum 6.5% Increase

Over the three years of the deal (2018/19, 2019/20, 2020/21), minimum salaries increased by at least 6.5%. This was funded by new government money, not by taking funding from patient care.

Unsocial Hours Protected

Importantly, unsocial hours payments were not affected by the changes.

Why This Matters for Your Pay History

If you worked in the NHS between 2018 and 2021, your pay progression followed different rules than today. Some staff were placed on transitional arrangements as they moved from the old spine point system to the new structure.

Understanding which system applied helps you verify whether your payments during this period were correct.


Agenda for Change Pay Scales 2020/21 (April 2020 – March 2021)

This was the final year of the three-year New Pay Deal. Pay increases varied by band, ranging from 2.0% to 3.3%.

2020/21 Pay Award Summary

  • Pay increase: 2.0%-3.3% varied by band
  • Context: COVID-19 pandemic first full year
  • Milestone: Final year of transition to new pay structure

By the end of this year (April 2021), all staff had fully transitioned to the new pay structure.

England 2020/21 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £19,337 £19,337
Band 3 £19,737 £21,142
Band 4 £21,892 £24,157
Band 5 £24,907 £26,970 £30,615
Band 6 £31,365 £33,176 £37,890
Band 7 £38,890 £40,984 £44,503
Band 8a £45,753 £47,568 £51,668
Band 8b £53,168 £55,831 £62,001
Band 8c £63,751 £66,574 £73,664
Band 8d £75,914 £78,730 £87,754
Band 9 £91,004 £93,821 £104,927

Agenda for Change Pay Scales 2019/20 (April 2019 – March 2020)

This was the second year of the three-year New Pay Deal. Pay increases varied, with a combination of percentage increases and lump sum payments.

2019/20 Pay Award Summary

  • Pay increase: 1.7% plus 1.1% lump sum paid in April 2019
  • Second year of the three-year deal
  • Continued transition to new structure

Some staff were still on transitional arrangements during this year as the NHS moved from the old spine point system to the new pay step structure.

England 2019/20 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £18,005 £18,005
Band 3 £18,813 £19,918
Band 4 £21,089 £23,761
Band 5 £24,214 £26,220 £30,112
Band 6 £30,401 £32,525 £37,267
Band 7 £37,570 £40,322 £43,772
Band 8a £44,606 £46,841 £50,819
Band 8b £52,306 £54,912 £60,983
Band 8c £62,655 £65,536 £72,497
Band 8d £74,512 £77,386 £86,687
Band 9 £89,537 £92,411 £103,860

Agenda for Change Pay Scales 2018/19 (April 2018 – March 2019)

This was the first year of the New Pay Deal and a major reform year for NHS pay. The new framework agreement began transforming how NHS staff were paid.

2018/19 Pay Award Summary

  • Pay increase: 3.0% (Year 1 of New Pay Deal)
  • Major structural reform began
  • Old spine point system started phasing out
  • New pay step points introduced

In June 2018, employers and unions announced that NHS staff in England had accepted the deal to reform the Agenda for Change system. The changes included removal of overlapping pay points between bands and incremental pay progression no longer occurring on a yearly basis.

England 2018/19 Annual Pay Scales

Band Entry Point Intermediate Top of Band
Band 2 £17,460 £17,460
Band 3 £17,787 £18,702
Band 4 £19,020 £21,582
Band 5 £23,023 £24,547 £29,608
Band 6 £28,050 £30,401 £36,644
Band 7 £35,577 £38,765 £41,723
Band 8a £42,414 £45,519 £48,514
Band 8b £49,969 £53,168 £58,217
Band 8c £60,202 £63,751 £69,168
Band 8d £72,051 £75,573 £82,434
Band 9 £86,687 £90,213 £98,453

Comparing Old and New Pay Structures

Element Pre-2018 (Old System) Post-2018 (New System)
Pay points Multiple spine points per band 2-3 step points per band
Progression Annual automatic increments 2-3 year cycles
Band overlaps Yes — could earn more in lower band No — promotion always means more pay
Progression requirement Often automatic Subject to appraisal standards
Years to top of band 7-8 years for some bands Maximum 5-6 years

How NHS Pay Has Changed: 2018 to 2025 Cumulative Analysis

Looking at individual years is helpful, but many people want to see how much NHS pay has actually grown over time. Here is the bigger picture.

Total Pay Growth by Band (2018-2025)

Band 2018/19 Entry 2025/26 Entry Total Increase Percentage Growth
Band 2 £17,460 £24,465 £7,005 40.1%
Band 3 £17,787 £24,937 £7,150 40.2%
Band 5 £23,023 £31,049 £8,026 34.9%
Band 6 £28,050 £38,682 £10,632 37.9%
Band 7 £35,577 £47,810 £12,233 34.4%

Year-by-Year Cumulative Growth

Year Award Cumulative from 2018
2018/19 3.0% 3.0%
2019/20 ~2.8% ~5.9%
2020/21 ~2.5% ~8.5%
2021/22 3.0% ~11.8%
2022/23 ~4.0% ~16.3%
2023/24 5.0% ~22.1%
2024/25 5.5% ~28.8%
2025/26 3.6% ~33.4%

Has Pay Kept Up With Inflation?

This is a question many NHS staff ask. The answer depends on how you measure it.

In nominal terms (actual pounds), NHS pay has increased substantially. A Band 5 nurse starting salary has risen from approximately £23,000 in 2018 to over £31,000 in 2025 — an increase of about 35%.

However, inflation has also been high during parts of this period. After the 2008 financial crisis, NHS pay was frozen in 2011 for two years, followed by increases capped at just 1% for several more years. Many staff argue they are still catching up from that period.

Analysis suggests that starting pay for nurses has broadly kept up with CPI inflation in real terms, with current salaries being roughly £2,000–£2,500 higher than what inflation alone would predict. However, mid-career and senior staff may have seen less favourable progression during the pay cap years.


Regional Variations: England, Wales, Scotland, Northern Ireland

The NHS is devolved across the four UK nations. This means each country negotiates pay separately and announces awards at different times.

Why Pay Differs Across the UK

  • England — Covered by NHS Employers and the NHS Pay Review Body
  • Scotland — NHS Scotland negotiates separately; often announces earlier
  • Wales — Generally follows England but can have slight differences
  • Northern Ireland — Health and Social Care Northern Ireland; often announces later

2025/26 Regional Comparison

Band England Wales Scotland Northern Ireland
Band 2 Entry £24,465 £23,970 £25,560 £22,383
Band 5 Entry £31,049 £30,420 £33,247 £28,407
Band 5 Top £37,796 £37,029 £41,424 £34,581
Band 7 Entry £47,810 £46,840 £50,861 £43,742
Band 7 Top £54,710 £53,601 £59,159 £50,056

Scotland consistently pays higher than the other nations. For 2025/26, Scottish staff received a 4.25% increase compared to England’s 3.6%.


How to Verify Your Back Pay Calculations

If you received a backdated pay award and want to check the calculation was correct, follow these steps.

Step-by-Step Back Pay Verification

Step 1: Identify the Financial Year

Which financial year does the back pay cover? Remember, NHS financial years run April to March.

Step 2: Find Your Band and Step Point

Look up your pay band and step point for that year in the tables above. Were you at entry, intermediate, or top of your band?

Step 3: Check the Timeline

When was the pay award announced? When did new rates appear on your payslip? The difference tells you how many months were backdated.

Step 4: Calculate the Difference

Work out the monthly difference between your old rate and new rate.

Step 5: Multiply by Backdated Months

Multiply the monthly difference by the number of months backdated.

Example Calculation

Let’s say you are a Band 5 nurse at the entry point checking your 2024/25 back pay.

  • Pay award announced: June 2024
  • New rate effective from: 1 April 2024
  • First payment at new rate: August 2024
  • Backdating period: April, May, June, July (4 months)

Old monthly salary: £28,407 ÷ 12 = £2,367 New monthly salary: £29,970 ÷ 12 = £2,498 Monthly difference: £131 Expected back pay: £131 × 4 = £524

If you received less than this, check whether deductions were made for tax, National Insurance, or pension contributions. Back pay is taxable, so the gross amount may be higher than what you actually received.

Common Back Pay Issues

  • Wrong band or step point used — Check your contract matches what payroll used
  • Part-time hours not calculated correctly — Back pay should be pro-rated for part-time staff
  • Tax deducted at wrong rate — Lump sums can push you into a higher tax bracket temporarily
  • Universal Credit impact — Large lump sums can affect UC entitlement for that month

Understanding Pay Progression Within Bands

Your pay can increase in two different ways. Many NHS staff get confused between these.

1. Annual Pay Award

This is the percentage increase announced by the government each year. It applies to everyone on Agenda for Change contracts. For example, if the award is 3.6%, all salaries in all bands go up by 3.6%.

You receive this automatically. You do not need to apply for it.

2. Incremental Progression

This is movement through the pay step points within your band. When you join a band, you start at the entry point. After a certain number of years, you move to the intermediate point, then eventually to the top of the band.

Band Entry to Intermediate Intermediate to Top Total Time to Top
Band 2 N/A (spot rate) N/A Already at top
Band 3 2 years N/A 2 years
Band 4 3 years N/A 3 years
Band 5 2 years 2 years 4 years
Band 6 2 years 3 years 5 years
Band 7 2 years 3 years 5 years
Band 8a-8d 2 years 3 years 5 years
Band 9 2 years 3 years 5 years

There is no automatic advancement from Band 8a to 8b, from 8b to 8c, from 8c to 8d, or from 8d to 9. These require applying for a higher-graded post.

You Get Both Increases

Here is the important part: you receive both the annual pay award AND incremental progression. They work together.

The annual pay award raises all the figures in the pay scale. Your incremental progression moves you to a higher row in that scale. Combined, this can mean significant salary jumps in years when you also progress.

Conditions for Progression

Moving up a pay point is not automatic. Following the 2018 pay deal, progression is subject to:

  • Meeting the required standards for your role
  • Completing your annual appraisal satisfactorily
  • Not having any unresolved performance concerns

The NHS Knowledge and Skills Framework (KSF) sets out what you need to demonstrate at each level.


Historical Context: Why Understanding 2018 Matters

If you are researching NHS pay history, understanding what happened in 2018 helps make sense of the numbers.

Problems with the Pre-2018 System

The old Agenda for Change structure had several issues:

Multiple Spine Points

Each band had many individual spine points — sometimes seven or more. This made the system complex and hard to understand.

Overlapping Bands

Pay bands overlapped, meaning the top of one band might pay more than the bottom of the band above. This created a situation where taking a promotion could actually mean a pay cut.

Automatic Annual Progression

Staff moved up a spine point every year almost automatically. This was expensive and did not link pay to performance or development.

Slow Route to Top of Band

With so many spine points, it could take 7-8 years to reach the top of a band.

What the 2018 Framework Agreement Fixed

The NHS Staff Council negotiated a three-year deal that addressed these problems:

  • Removed overlapping pay between bands — promotion now always means more money
  • Simplified to 2-3 pay points per band — easier to understand
  • Made progression conditional on meeting standards — links pay to performance
  • Guaranteed minimum 6.5% increase over three years — meaningful pay rise
  • Protected unsocial hours payments — no loss of existing benefits
  • Faster route to top of band — maximum 5-6 years instead of 7-8

The transition to the new system took three years (2018-2021) to complete. Staff moved from their old spine point to the nearest equivalent in the new structure.


Higher Cost Area Supplements (HCAS)

Staff working in and around London receive additional pay 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

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
Band 8a £64,156 £71,148
Band 9 £117,645 £134,103

Outer London Pay Scales 2025/26

Band Entry (inc HCAS) Top (inc HCAS)
Band 2 £29,179 £29,179
Band 3 £29,651 £31,312
Band 5 £35,763 £43,466
Band 6 £44,485 £52,521
Band 7 £53,751 £60,651

Fringe Pay Scales 2025/26

Band Entry (inc HCAS) Top (inc HCAS)
Band 2 £25,768 £25,768
Band 3 £26,240 £27,928
Band 5 £32,602 £39,686
Band 6 £40,617 £48,778
Band 7 £50,008 £56,908

Which Jobs Are Covered by Agenda for Change?

Agenda for Change covers more than 1 million NHS staff across the UK. However, not everyone working in the NHS uses these pay bands.

Covered by Agenda for Change

Role Type Typical Bands
Healthcare assistants Band 2-3
Nursing assistants and senior HCAs Band 3-4
Nursing associates Band 4
Registered nurses Band 5-7
Midwives (newly qualified to senior) Band 5-7
Physiotherapists Band 5-7
Occupational therapists Band 5-7
Speech therapists Band 5
Paramedics Band 5-6
Pharmacists (newly qualified to lead) Band 6-8b
Biomedical scientists Band 5-7
Admin and clerical staff Band 2-6
Porters and domestic staff Band 2-3
Bed managers Band 4
Ward sisters and charge nurses Band 7
Matrons and advanced practitioners Band 8a
Service managers and speciality leads Band 8a
Psychologists and lead clinicians Band 8b
Heads of clinical service Band 8c
Deputy directors Band 8d
Nurse consultants and directors Band 9

NOT Covered by Agenda for Change

Role Type Pay System
Junior doctors Separate medical pay scales
Consultants Consultant contract
Dentists Dental pay scales
GPs GP contract
Very senior managers (VSMs) VSM pay framework (3.25% in 2025/26)
GP practice staff Practice-specific arrangements
Agency and bank workers Different rates apply

Frequently Asked Questions

What was the NHS pay rise in 2024?

NHS staff on Agenda for Change received a 5.5% pay increase for the 2024/25 financial year. This was announced in June 2024, implemented in August 2024 salaries, and backdated to 1 April 2024.

What was the Agenda for Change pay rise in 2023/24?

The 2023/24 pay award was 5.0% for all Agenda for Change bands. This followed significant industrial action by NHS unions during 2022-2023.

How much did a Band 5 nurse earn in 2024/25?

A Band 5 nurse earned between £29,970 (entry point) and £36,483 (top of band) in the 2024/25 financial year.

What changed in the 2018 Agenda for Change reform?

The 2018 New Pay Deal introduced major structural changes including:

  • Removal of band overlaps
  • Simplification to 2-3 pay points per band
  • Conditional progression based on appraisal
  • Minimum 6.5% salary increase over three years

How do I check if my back pay was correct?

Find your band and step point for the relevant financial year in the tables above. Calculate the difference between your old and new rate, multiply by the number of backdated months, and compare to what you received (accounting for tax and other deductions).

Why does Scotland have different NHS pay?

The NHS is devolved across the UK. Scotland negotiates its own pay awards through NHS Scotland, which is why rates and announcement timings differ from England.

When did the NHS pay structure change?

The current simplified pay structure was introduced through the 2018 Framework Agreement (New Pay Deal) and fully implemented by April 2021.

How has NHS pay changed over the last 5 years?

From 2020/21 to 2025/26, total cumulative pay increases amount to approximately 24% for most bands through annual awards of ~2.5%, 3.0%, ~4.0%, 5.0%, 5.5%, and 3.6%.

What happened to yearly pay progression?

Following the 2018 NHS pay deal, pay progression changed from historic yearly incrementation (spine points) to a system based on years of experience at each band. Most bands now progress every 2-3 years rather than annually.

Why is there no overlap between NHS pay bands?

The 2018 NHS pay deal removed the overlap between bands to prevent someone with a lower level of responsibility from being paid more than someone with a higher level of responsibility. Promotion now always results in higher pay.

What Comes Next: Looking Ahead to 2026/27

The government has committed to providing the NHS Staff Council with a funded mandate for 2026/27 to begin resolving outstanding concerns within the Agenda for Change pay structure, including issues with pay banding and career progression.

Scotland has already announced a 3.75% pay increase for 2026/27.

For England, the proposed increase is 2.5%, though this remains subject to NHS Pay Review Body recommendations expected in summer 2026.

We will continue updating this archive as new pay scales are confirmed.

Last updated: February 2026. All figures are from official NHS Employers circulars and NHS Scotland pay documentation.