How NHS Pay Bands Work

The NHS uses Agenda for Change (AfC) to set pay for most staff. This system divides roles into 9 pay bands, with Band 2 being entry-level and Band 9 covering senior executives.

Each band has pay step points. You start at the entry point and move up through steps based on years of service. This is called pay progression.

NHS Pay Scales Explained (2026/27)

NHS pay scales refer to the salary ranges and pay points within each NHS pay band. Each band has a minimum, one or more progression points, and a maximum salary. Staff move through these scales based on time served and performance gateways.

Note: Band 1 is closed to new entrants.

NHS Pay Bands vs Pay Scales

• • Pay bands define job level and responsibility

• • Pay scales define how much you earn within that band

• • Every band has its own pay scale

NHS Pay Award 2026/27: Key Facts

The government initially proposed 2.5%, but the NHS Pay Review Body recommended 3.3%, which was accepted in full.

Union Response:

The Royal College of Nursing (RCN) General Secretary Professor Nicola Ranger described the pay award as “an insult,” warning that unless inflation falls, the government is “forcing a very real pay cut on its NHS workers.”

UNISON’s head of health, Helga Pile, said staff will be “downright angry” at the “below-inflation” pay award, adding that having the increase on time “is only small comfort.”

Most unions had withdrawn from the NHS Pay Review Body process this year, expecting direct negotiations instead. The RCN has warned it will compare this award with other public sector settlements before deciding its next steps, and consultative ballots are expected in May 2026.

Is the 3.3% Above Inflation?

It depends on which inflation measure you use:

–Government position: The 3.3% award exceeds the Office for Budget Responsibility’s (OBR) forecast inflation of 2.2% for 2026/27. The government describes this as a “real-terms pay rise.”

Union position: CPI inflation was running at 3.4% when the award was announced in February 2026. Unions argue the 3.3% is therefore a real-terms pay cut based on current prices.

Key context: The government’s comparison uses a forward-looking inflation forecast for the year ahead. The unions’ comparison uses backward-looking inflation already observed. Both approaches are commonly used in public-sector pay debates.

The OBR expects inflation to fall to 2.4% by Q2 2026. If inflation drops as forecast, the 3.3% award would represent a genuine real-terms increase. If inflation stays elevated, it would not.

How the 3.3% Award Was Decided

The NHS Pay Review Body (NHSPRB) submitted its 39th report to the government in early February 2026 after gathering evidence from the Department of Health and Social Care (DHSC), NHS Employers, NHS Providers, trade unions and other stakeholders.

The government’s initial written evidence to the NHSPRB, submitted in November 2025, indicated that 2.5% was affordable within departmental budgets. However, the NHSPRB recommended 3.3% based on recruitment, retention and inflation evidence. The government accepted this recommendation in full on 12 February 2026 — the fastest response in recent history.

Health Secretary Wes Streeting confirmed the government had accelerated the pay review process by issuing remit letters to the NHSPRB and the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) in July 2025 — months earlier than previous years.

England NHS Pay Bands 2025/26 (Current)

These are the confirmed pay scales currently in effect for Agenda for Change staff in England, following the 3.6% pay award implemented in August 2025.

Bands 2–4 (2025/26)

Bands 5–7 (2025/26)

Bands 8–9 (2025/26)

England NHS Pay Bands 2026/27 (Confirmed)

The following rates are confirmed and effective from 1 April 2026.

Bands 2–4 (2026/27 Confirmed)

Bands 5–7 (2026/27 Confirmed)

Bands 8–9 (2026/27 Confirmed)

Complete Hourly Rates 2026/27 (England)

Based on a standard 37.5-hour working week (1,957.5 annual hours). Useful for overtime calculations, bank shift comparisons, and part-time contract planning.

Band	Entry Hourly	Mid Hourly	Top Hourly
Band 2	£12.92	—	£12.92
Band 3	£13.17	—	£14.05
Band 4	£14.52	—	£15.93
Band 5	£16.40	£17.69	£19.97
Band 6	£20.44	£21.57	£24.61
Band 7	£25.26	£26.56	£28.90
Band 8a	£29.42	£30.90	£33.11
Band 8b	£34.05	£36.25	£39.55
Band 8c	£40.66	£43.13	£46.84
Band 8d	£48.26	£51.21	£55.65
Band 9	£57.68	£61.16	£66.37

Bands 2–4 have only two pay points (entry and top), so there is no mid-point hourly rate.

Wales NHS Pay Bands 2026/27 (Confirmed)

Wales accepted the same 3.3% pay award as England, effective 1 April 2026. Welsh NHS staff on Agenda for Change contracts receive identical rates to England.

Scotland NHS Pay Bands 2026/27 (Confirmed)

Scotland negotiated directly with the Scottish Government and agreed on a 2-year pay deal. The 2026/27 rates are already confirmed at 3.75% above 2025/26 levels.

This deal also includes an inflation guarantee — if CPI inflation exceeds expectations, staff receive at least 1 percentage point above it.

If CPI inflation in 2026 averages higher than 2.75% over the period January–December 2026, Scottish staff will receive at least 1 percentage point above CPI.

Scotland: Working Week Reduction (37 → 36 Hours)

From 1 April 2026, all NHS Scotland AfC staff will move to a 36-hour working week with no loss of pay. This is the final stage of a commitment made in the 2023/24 pay deal.

The first 30-minute reduction (from 37.5 to 37 hours) was implemented on 1 April 2024. The remaining one-hour reduction (from 37 to 36 hours) will be delivered as a single reduction on 1 April 2026.

This effectively increases Scottish NHS staff’s hourly rate beyond the headline 3.75% pay rise:

– England full-time hours: 37.5 per week (1,957.5 annual hours)
– Scotland full-time hours from April 2026: 36 per week (1,872 annual hours)

Because the same annual salary is divided across fewer hours, Scottish staff receive a hidden hourly rate boost of approximately 2.8% on top of the 3.75% annual salary increase.

Part-time staff will have their hours reduced pro rata. New part-time hours are calculated as: (current part-time hours ÷ 37) × 36 = new part-time hours.

Staff will see no loss of overall earnings as a result of the reduction in hours. Decisions on how individual staff reduce their working week will be made locally.

England has no equivalent agreement — staff continue to work 37.5 hours per week.

Scotland Bands 1–4 (2026/27 Confirmed)

Scotland Bands 5–7 (2026/27 Confirmed)

Scotland Bands 8–9 (2026/27 Confirmed)

Band 5 Nursing Review (New for 2026/27)

As part of the 2026/27 pay package, the government announced significant changes for nursing and midwifery staff:

• Every Band 5 nurse will have their job description reviewed by their employer
• National funding has been allocated for this review process
• Nurses working at a higher level may receive band uplifts with additional pay
• A national nursing preceptorship programme will launch to support newly qualified nurses
• Graduate pay will be prioritised in ongoing Agenda for Change reforms

This review applies to nurses and midwives employed on AfC Band 5 contracts in NHS England. The Royal College of Midwives (RCM) has called for urgent reform of NHS pay structures for maternity support workers, noting that Band 2 maternity support workers provide hands-on patient care while earning close to minimum wage.

Pay Structure Reforms (Coming 2026)

The Department of Health and Social Care will begin “fast-paced discussions” with trade unions to agree funded improvements to the Agenda for Change pay structure. Priorities include:

• Raising pay for the lowest bands
• Improving pay for graduates across professions (nurses, pharmacists, occupational therapists, speech therapists)

Once agreed, some staff will receive additional pay increases backdated to 1 April 2026

England vs Scotland: Pay Comparison 2026/27

Scotland’s deal is significantly better than what England and Wales staff receive. Here is a direct comparison:

Scottish NHS staff earn £1,300–£3,400 more than their English counterparts at equivalent bands.

High Cost Area Supplements (HCAS) for 2026/27

Example: Band 5 with HCAS (2026/27 Confirmed)

Band 6 with HCAS (2026/27)

Band 7 with HCAS (2026/27)

Pay Progression Explained

You do not stay at entry-level pay forever. NHS staff progress through pay step points based on years of service and meeting performance standards.

Example: A Band 5 nurse starts at £32,073. After 4 years (meeting gateways), they reach the top of the band at £39,043 — an increase of £6,970 through progression alone, before any annual pay awards.

Learn more:NHS Pay Bands Explained — How the banding system works

NHS Pension Contributions 2026/27

The pension contribution percentage rates shown below have been in effect since April 2024 and have not changed. However, the pensionable pay thresholds (the salary ranges that determine which tier you fall into) are adjusted annually.

How Pension Thresholds Are Updated Each Year

The NHS pension uses a two-step adjustment process:

Step 1 (1 April): Pensionable pay thresholds increase by the previous September’s CPI rate. For 2026/27, September 2025 CPI was 3.8%, so thresholds will first be increased by 3.8%.

Step 2 (After pay award): If the Agenda for Change pay award exceeds CPI, thresholds are adjusted again — backdated to 1 April. Since the 2026/27 AfC award (3.3%) is lower than September CPI (3.8%), no second adjustment will be needed. The CPI-indexed thresholds will stand.

This two-step approach was specifically designed to prevent NHS staff from experiencing a drop in take-home pay because the pay award pushes them into a higher pension contribution tier.

England & Wales Pension Contributions 2025/26

These ranges were updated to align with the 3.6% Agenda for Change pay award from August 2025.

Northern Ireland Pension Contributions 2025/26

Northern Ireland has higher contribution rates than England/Wales at most tiers.

Scotland Pension Contributions 2025/26

Scotland has 9 tiers compared to 6 tiers in England/Wales.

Key Differences by Nation

Note: These rates will be reviewed again from 1 April 2026 when the new 3.3% pay award takes effect. Contribution tier ranges may be adjusted accordingly

Related Guide: NHS Planning Guidance 2026/27

Understanding Your Take-Home Pay

Your gross salary is reduced by Income Tax (20% basic rate on earnings above £12,570, 40% higher rate above £50,270), National Insurance (8% on earnings between £12,570 and £50,270), and pension contributions (5.2% to 12.5% depending on salary).

Calculate yours: Use our NHS Tax Calculator or NHS Pension Calculator for exact figures

Frozen Tax Thresholds and Fiscal Drag

The Personal Allowance remains frozen at £12,570 and the Higher Rate threshold at £50,270. This means:

– Bands 2–6: Most of your 3.3% increase will be taxed at the basic rate (20% income tax + 8% NI), meaning you keep roughly 70% of the rise.
– Band 7 and above: For those at the top of Band 7 and above, your salary exceeds £50,270. The entirety of your increase will be taxed at the higher rate (40%), meaning you keep less of the headline figure.

Because tax thresholds are frozen while salaries rise, a larger portion of your pay is being pulled into higher tax brackets each year. This effect — known as fiscal drag — reduces the real-world impact of the 3.3% award.

Band 5 Entry Example (£32,073):

After approximately £3,900 income tax, £1,560 National Insurance, and £2,662 pension contributions (8.3%), your annual take-home pay is approximately £23,950 — around £1,996 per month.

Band 6 Entry Example (£39,959):

A Band 6 at entry level takes home approximately £2,500–£2,650 per month after all deductions, depending on pension tier and student loan status.

Band 7 Entry Example (£49,387):

A Band 7 at entry level takes home approximately £3,050–£3,200 per month after all deductions.

Calculate Your Exact Take-Home Pay

Want to know exactly how the 3.3% pay rise affects your monthly salary? Our free NHS Take Home Pay Calculator includes all confirmed 2026/27 rates, automatic pension tiering, tax, National Insurance, student loans, and London weighting. Select your band and see your exact figure.

NHS Take Home Pay Calculator

Note: There is no official government NHS pay calculator. Our tool is independently maintained and updated with confirmed NHS Employers figures.

Frequently Asked Questions

What are the NHS pay bands for 2026/27?

NHS pay bands for 2026/27 in England are confirmed at 3.3% above 2025/26 rates, effective 1 April 2026. Wales also receives 3.3%. Scotland has confirmed 3.75% as part of a 2-year deal.

How much does a Band 5 nurse earn in 2026/27?

In England, a Band 5 nurse earns between £32,073 (entry) and £39,043 (top). In Scotland, Band 5 ranges from £34,494 to £42,977. With Inner London HCAS, Band 5 entry rises to £38,488.

When do NHS pay bands change?

NHS pay band rates change on 1 April each financial year. For 2026/27, staff will receive the increase in their April pay packets—the first on-time payment in six years

Is Band 1 still used?

No. Band 1 is closed to new entrants. Existing Band 1 staff remain on their current terms, but no new staff are hired at this level.

What is the Band 5 nursing review?

Every Band 5 nurse in NHS England will have their job description reviewed by their employer. This is to ensure nurses working at a higher level are paid appropriately. National funding has been allocated for this process, and any resulting band uplifts will include additional pay.

Will there be additional pay increases in 2026/27?

Possibly. The government has committed to funding improvements to the Agenda for Change pay structure. Once reforms are agreed with unions, some staff will receive additional pay increases backdated to 1 April 2026

Does this guide cover consultant pay?

No. This guide covers Agenda for Change (AfC) staff only. NHS consultants are employed under separate Medical and Dental terms and conditions with different pay scales set by the Doctors’ and Dentists’ Review Body (DDRB).

How do I calculate my NHS take-home pay?

Your take-home pay depends on tax, National Insurance, and pension contributions. A Band 5 nurse at entry level (£32,073) takes home approximately £1,996 per month after deductions. A Band 6 at entry (£39,959) takes home around £2,650 per month. Use the pension contribution information above to estimate your contributions based on your salary.

When will the NHS pay rise 2026 be paid?

The 3.3% increase will be in April 2026 salaries. ESR (Electronic Staff Record) has confirmed the update will be processed in time. This is the first on-time payment in six years — no backdated lump sum is needed.

For NHS trusts not on ESR, individual employers may take several payroll cycles to update systems. Where payroll adjustments are made after April, arrears will be backdated to 1 April 2026.

Does this apply to practice nurses in GP surgeries?

Most practice nurses employed directly by GP surgeries are not on Agenda for Change contracts and this announcement does not apply to them. Practice nurse pay is typically covered by separate recommendations. Primary care nurses have expressed disappointment at being excluded, citing potential damage to recruitment and retention efforts in general practice.

Is the NHS pay rise above inflation?

The government says yes — the OBR forecasts inflation at 2.2% for 2026/27, making 3.3% an above-inflation rise. Unions say no — CPI inflation was 3.4% when the award was announced in February 2026, making it a real-terms pay cut at current prices. The OBR expects inflation to fall to 2.4% by mid-2026.

Why Trust Our Figures

All salary data on this site is verified against official NHS Employers pay circulars. Some competitor sites still display outdated 2024/25 rates—showing Band 5 nurses earning £29,969 when the actual 2025/26 salary is £31,049 (a £1,080 difference).

Our figures match the Government’s confirmation that “the band 5 starting salary will now be around £31,050.

England 2025/26 Pay Figures