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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.
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.
Agenda for Change covers most NHS staff including:
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 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 |
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.
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
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
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.
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
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.
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.
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.
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.
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
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.
Your salary depends on where you work. Each UK country negotiates NHS pay separately.
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.
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) |
Band 5 Nurse in Inner London
Band 7 Ward Sister in Inner London (top of band)
Your pay does not stay the same forever. Under Agenda for Change, your salary increases as you gain experience.
Since the 2018 NHS pay deal, progression works on years of experience at each band:
Since April 2021, you must meet certain standards to get your annual pay increase:
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.
| 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 yearsTotal increase: £6,747
There is no automatic progression between bands. You must apply for jobs at the higher band.
When you get promoted:
Sometimes staff move to lower bands (by choice or due to restructuring). Usually:
If you cover a higher band role temporarily:
If you leave the NHS and return within one month, you usually re-enter at your previous pay step.
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 |
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 |
NHS staff who work evenings, nights, weekends, or bank holidays receive extra pay.
| 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.
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.
Band 9 is the highest pay band under Agenda for Change. Top of Band 9 pays £125,637 in England for 2025/26.
Yes. NHS staff in London receive a high-cost area supplement (London weighting) of up to 20% extra for inner London.
The latest pay increase was 1 April 2025. England received 3.6%, Scotland received 4.25%.
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.
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.
This depends on your band:
Scotland negotiates NHS pay separately from England. Scottish staff have historically received slightly higher pay awards.
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.
Each level has greater scope of responsibility:
There is no automatic progression between these bands. You must apply for each level.
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).
The Agenda for Change pay system ensures:
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.
