NHS pay bands range from £24,465 at Band 2 to over £125,000 at Band 9 for 2025/26. The Agenda for Change system covers more than one million NHS workers across England, Scotland, Wales, and Northern Ireland.
This guide shows you exactly what each band earns, what jobs fit each level, and how to move up the pay scale.
What is Agenda for Change?
Agenda for Change is the NHS pay framework. It started in 2004 to replace lots of different local pay agreements with one clear system.
Before Agenda for Change, two nurses doing the same job in different hospitals could earn very different amounts. That was not fair. The new system fixed this problem.
What Agenda for Change Covers
- Pay bands and how much you earn at each level
- Pay progression rules (how your salary goes up over time)
- Overtime rates and unsocial hours payments
- London weighting and high-cost area supplements
- Annual leave entitlements
- NHS pension arrangements
Who Does Agenda for Change Apply To?
Agenda for Change covers most NHS staff including:
Table of Contents
Toggle- Nurses and midwives
- Healthcare assistants and support workers
- Allied health professionals (physiotherapists, occupational therapists, etc.)
- Paramedics
- Administrative staff
- Porters and domestic staff
- NHS managers
Who is NOT Covered?
- Doctors and dentists (they have separate pay scales)
- Very senior managers (executive level)
- NHS contractors and agency staff
NHS Pay Bands 2025/26: Complete Salary Tables
All Agenda for Change staff in England received a 3.6% pay award from 1 April 2025. Scotland received a higher increase of 4.25%.
Here is every NHS pay band with current salaries:
Band 1 (Closed to New Staff)
Band 1 is no longer used. Any staff still on Band 1 contracts now get paid at Band 2 rates.
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0+ | £24,465 | £12.51 |
Band 2: Entry Level Support Roles
Typical jobs: Healthcare support worker, porter, domestic assistant, catering assistant, clerical assistant
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £24,465 | £12.51 |
| 2+ years | £24,465 | £12.51 |
Band 2 has a flat rate with no progression. This is because it was merged with the old Band 1.
Band 3: Clinical Support Workers
Typical jobs: Clinical support worker, trainee nursing associate, emergency care assistant, therapy assistant, pharmacy assistant, clinical coding officer, estates officer
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £24,937 | £12.75 |
| 2+ years | £26,598 | £13.60 |
Pay progression time: 2 years to reach top of band
Total pay growth: £1,661
Band 4: Associate Practitioners and Nursing Associates
Typical jobs: Registered nursing associate, assistant practitioner, pharmacy technician, dental nurse, theatre support worker, bed manager, senior clerical staff
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-3 years | £27,485 | £14.06 |
| 3+ years | £30,162 | £15.43 |
Pay progression time: 3 years to reach top of band
Total pay growth: £2,677
Band 5: Newly Qualified Professionals
Typical jobs: Staff nurse, newly qualified midwife, paramedic, physiotherapist, occupational therapist, speech and language therapist, operating department practitioner, podiatrist, radiographer
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £31,049 | £15.88 |
| 2-4 years | £33,487 | £17.13 |
| 4+ years | £37,796 | £19.33 |
Pay progression time: 4 years to reach top of band
Total pay growth: £6,747
Band 5 is where most registered healthcare professionals start their NHS careers after university.
Band 6: Experienced Practitioners and Team Leaders
Typical jobs: Junior sister, deputy charge nurse, experienced midwife, senior paramedic, senior physiotherapist, senior occupational therapist, newly qualified pharmacist, biomedical scientist, school nurse
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £38,682 | £19.78 |
| 2-5 years | £40,823 | £20.88 |
| 5+ years | £46,580 | £23.82 |
Pay progression time: 5 years to reach top of band
Total pay growth: £7,898
Band 7: Senior Clinical and Management Roles
Typical jobs: Ward sister, charge nurse, senior midwife, advanced practitioner, specialist nurse, senior physiotherapist, senior pharmacist, deputy matron
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £47,810 | £24.45 |
| 2-5 years | £50,273 | £25.71 |
| 5+ years | £54,710 | £27.98 |
Pay progression time: 5 years to reach top of band
Total pay growth: £6,900
Band 7 staff usually manage teams and make decisions about patient care and service delivery.
Band 8a: Senior Management and Advanced Practice
Typical jobs: Matron, modern matron, advanced clinical practitioner, nurse consultant (some specialties), service manager, speciality manager, consultant prosthetist/orthotist
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £55,690 | £28.48 |
| 2-5 years | £58,487 | £29.91 |
| 5+ years | £62,682 | £32.06 |
Pay progression time: 5 years to reach top of band
Total pay growth: £6,992
Important: There is no automatic advancement from Band 8a to Band 8b. You must apply for 8b posts.
Band 8b: Heads of Service
Typical jobs: Lead pharmacist, lead clinician, senior psychologist, head of therapy services
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £64,455 | £32.96 |
| 2-5 years | £68,631 | £35.10 |
| 5+ years | £74,896 | £38.30 |
Pay progression time: 5 years to reach top of band
Total pay growth: £10,441
Important: There is no automatic advancement from Band 8b to Band 8c.
Band 8c: Senior Heads of Service
Typical jobs: Head of clinical service, senior HR manager, tactical response lead, service owner
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £76,965 | £39.36 |
| 2-5 years | £81,652 | £41.76 |
| 5+ years | £88,682 | £45.35 |
Pay progression time: 5 years to reach top of band
Total pay growth: £11,717
Important: There is no automatic advancement from Band 8c to Band 8d.
Band 8d: Deputy Directors
Typical jobs: Deputy director of clinical services, deputy chief nurse, consultant clinical scientist, departmental head
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £91,342 | £46.71 |
| 2-5 years | £96,941 | £49.58 |
| 5+ years | £105,337 | £53.87 |
Pay progression time: 5 years to reach top of band
Total pay growth: £13,995
Band 9: Directors and Chief Officers
Typical jobs: Nurse consultant (senior), director of clinical services, chief nursing officer
| Years | Annual Salary | Hourly Rate |
|---|---|---|
| 0-2 years | £109,179 | £55.84 |
| 2-5 years | £115,763 | £59.20 |
| 5+ years | £125,637 | £64.25 |
Pay progression time: 5 years to reach top of band
Total pay growth: £16,458
Band 9 is the highest pay band under Agenda for Change. Very senior managers above this level have separate contracts.
NHS Pay by UK Region
Your salary depends on where you work. Each UK country negotiates NHS pay separately.
England vs Scotland vs Wales vs Northern Ireland
Here is how Band 5, 6, and 7 compare across the UK:
Band 5 Comparison
| Region | Entry | Mid | Top |
|---|---|---|---|
| England | £31,049 | £33,487 | £37,796 |
| Scotland | £33,247 | £35,525 | £41,424 |
| Wales | £30,420 | £32,809 | £37,029 |
| Northern Ireland | £28,407 | £30,639 | £34,581 |
Band 6 Comparison
| Region | Entry | Mid | Top |
|---|---|---|---|
| England | £38,682 | £40,823 | £46,580 |
| Scotland | £41,608 | £43,441 | £50,702 |
| Wales | £37,898 | £39,996 | £45,636 |
| Northern Ireland | £35,392 | £37,350 | £42,618 |
Band 7 Comparison
| Region | Entry | Mid | Top |
|---|---|---|---|
| England | £47,810 | £50,273 | £54,710 |
| Scotland | £50,861 | £52,804 | £59,159 |
| Wales | £46,840 | £49,254 | £53,601 |
| Northern Ireland | £43,742 | £45,996 | £50,056 |
Scotland pays the highest NHS salaries. Scottish staff received a 4.25% pay rise for 2025/26 compared to 3.6% in England.
London Weighting: High-Cost Area Supplement
NHS staff working in and around London receive extra pay. This is called the High-Cost Area Supplement or London weighting.
| Area | How Much Extra |
|---|---|
| Inner London | 20% of basic salary (minimum £5,414, maximum £8,172) |
| Outer London | 15% of basic salary (minimum £4,551, maximum £5,735) |
| Fringe Areas | 5% of basic salary (minimum £1,258, maximum £2,122) |
Examples With London Weighting
Band 5 Nurse in Inner London
- Basic salary: £31,049
- Plus minimum supplement: £5,414
- Total: £36,463
Band 7 Ward Sister in Inner London (top of band)
- Basic salary: £54,710
- Plus 20% supplement: £8,172 (capped at maximum)
- Total: £62,882
How NHS Pay Progression Works
Your pay does not stay the same forever. Under Agenda for Change, your salary increases as you gain experience.
The Pay Step System
Since the 2018 NHS pay deal, progression works on years of experience at each band:
- Start at the entry point when you join a new band
- First increment after 2 years (most bands)
- Second increment after another 2-3 years
- Top of band reached after 4-5 years total
What You Need for Pay Progression
Since April 2021, you must meet certain standards to get your annual pay increase:
- Have a pay step meeting with your manager
- Show you meet performance standards
- Complete required training
- Get sign-off from your line manager
Your manager arranges this meeting a few weeks before your increment date. If you pass, your pay goes up. If you do not meet standards, your manager explains what needs to improve.
Pay Progression Example: Band 5 Nurse
| When | What Happens | Salary |
|---|---|---|
| Day 1 | Start as newly qualified | £31,049 |
| Year 2 | First increment | £33,487 |
| Year 4 | Reach top of band | £37,796 |
Total time: 4 years Total increase: £6,747
Moving Between NHS Pay Bands
Getting Promoted to a Higher Band
There is no automatic progression between bands. You must apply for jobs at the higher band.
When you get promoted:
- You start at the minimum pay point of the new band
- If that would give you no pay rise, you go to the first point that does increase your pay
- Your increment date resets to the anniversary of your promotion
Example: Band 6 to Band 7 Promotion
- Current salary: £46,580 (top of Band 6)
- Band 7 entry: £47,810
- Immediate pay rise: £1,230
- New ceiling: £54,710 (£8,130 higher than Band 6 top)
Moving to a Lower Band
Sometimes staff move to lower bands (by choice or due to restructuring). Usually:
- You go to the closest pay point to your current salary
- Pay protection may apply for a period
Acting Up (Temporary Promotion)
If you cover a higher band role temporarily:
- You receive pay at the higher band rate
- This usually lasts 1-6 months
- When you return to your substantive post, your pay returns to normal
Returning After a Break
If you leave the NHS and return within one month, you usually re-enter at your previous pay step.
NHS Pay Bands: Quick Comparison Chart
Here is every band at a glance for England 2025/26:
| Band | Entry Salary | Top Salary | Typical Roles |
|---|---|---|---|
| 2 | £24,465 | £24,465 | Healthcare support worker, porter |
| 3 | £24,937 | £26,598 | Clinical support worker, therapy assistant |
| 4 | £27,485 | £30,162 | Nursing associate, pharmacy technician |
| 5 | £31,049 | £37,796 | Staff nurse, physiotherapist, paramedic |
| 6 | £38,682 | £46,580 | Junior sister, senior nurse, pharmacist |
| 7 | £47,810 | £54,710 | Ward sister, advanced practitioner |
| 8a | £55,690 | £62,682 | Matron, service manager |
| 8b | £64,455 | £74,896 | Lead clinician, senior psychologist |
| 8c | £76,965 | £88,682 | Head of service |
| 8d | £91,342 | £105,337 | Deputy director |
| 9 | £109,179 | £125,637 | Director, chief nursing officer |
Understanding Your Hourly Rate
Your hourly rate matters for overtime, bank shifts, and comparing jobs. Here are all bands:
| Band | Entry Hourly | Top Hourly |
|---|---|---|
| 2 | £12.51 | £12.51 |
| 3 | £12.75 | £13.60 |
| 4 | £14.06 | £15.43 |
| 5 | £15.88 | £19.33 |
| 6 | £19.78 | £23.82 |
| 7 | £24.45 | £27.98 |
| 8a | £28.48 | £32.06 |
| 8b | £32.96 | £38.30 |
| 8c | £39.36 | £45.35 |
| 8d | £46.71 | £53.87 |
| 9 | £55.84 | £64.25 |
Unsocial Hours Payments
NHS staff who work evenings, nights, weekends, or bank holidays receive extra pay.
Standard Unsocial Hours Rates
| Time Worked | Extra Payment |
|---|---|
| Saturday (all day) | Time plus 50% |
| Sunday (all day) | Time plus 100% (double time) |
| Weekday evenings (8pm-6am) | Time plus 30% |
| Night shifts | Time plus 30% |
| Bank holidays | Time plus 60% |
These rates vary slightly depending on your contract and when you joined the NHS.
NHS Pension Contributions by Band
Your pension contribution depends on your salary. Higher earners pay a higher percentage.
| Annual Salary | Pension Contribution |
|---|---|
| Up to £13,259 | 5.2% |
| £13,260 to £26,831 | 6.5% |
| £26,832 to £32,691 | 8.3% |
| £32,692 to £49,078 | 9.8% |
| £49,079 to £62,924 | 10.7% |
| £62,925 to £75,032 | 11.6% |
| £75,033 to £111,569 | 12.5% |
| £111,570 and above | 13.5% |
The NHS pension is one of the best in the country. Your employer also contributes around 20% on top of what you pay.
Frequently Asked Questions
What is the highest NHS pay band?
Band 9 is the highest pay band under Agenda for Change. Top of Band 9 pays £125,637 in England for 2025/26.
Do NHS staff get paid more in London?
Yes. NHS staff in London receive a high-cost area supplement (London weighting) of up to 20% extra for inner London.
When did NHS pay bands increase?
The latest pay increase was 1 April 2025. England received 3.6%, Scotland received 4.25%.
Can I negotiate my NHS starting salary?
No. Agenda for Change uses fixed pay scales. You cannot negotiate your salary. However, if you have relevant experience, you may start at a higher pay point within your band.
What happens when I move to a higher band?
When promoted, you move to the lowest pay point in the new band that gives you a pay rise. Your increment date resets to the anniversary of your promotion.
How long does it take to reach top of band?
This depends on your band:
- Band 2: Flat rate (no progression)
- Bands 3-4: 2-3 years
- Bands 5-9: 4-5 years
Why does Scotland pay more?
Scotland negotiates NHS pay separately from England. Scottish staff have historically received slightly higher pay awards.
Is Band 5 a good starting salary?
Yes. Band 5 starts at £31,049, which is above the average UK graduate starting salary. NHS staff also receive excellent pension benefits worth around 20% of salary.
What is the difference between Band 8a, 8b, 8c, and 8d?
Each level has greater scope of responsibility:
- 8a: Senior practitioner or manager (matron level)
- 8b: Head of specialty or lead clinician
- 8c: Head of service or senior department head
- 8d: Deputy director level
There is no automatic progression between these bands. You must apply for each level.
How much tax do higher bands pay?
At Band 7 top (£54,710) and above, part of your salary falls into the 40% higher rate tax bracket (on earnings above £50,270).
Why Agenda for Change Matters
The Agenda for Change pay system ensures:
- Fair pay for NHS workers across the country
- Equal treatment regardless of where you work
- Clear career progression pathways
- Transparency about what each role earns
- Consistency between England, Scotland, Wales, and Northern Ireland
Whether you are a healthcare assistant just starting out or a director running clinical services, Agenda for Change gives you a clear structure for your NHS career and pay.