Current Status of the 2026/27 NHS Pay Round

The 2026/27 pay round is now complete. Here is the confirmed timeline of events:

What Was Decided

• Pay uplift: 3.3% consolidated increase for all Agenda for Change pay points
• Effective date: 1 April 2026
• Payment timing: April 2026 salaries (no delayed backpay)
• Structural reforms: Ongoing discussions with NHS Staff Council, with changes backdated to April 2026 once agreed

The government accepted the Pay Review Body’s recommendation in full. Additional funding will be provided by increasing Integrated Care Board (ICB) allocations and NHS Payment Scheme prices. NHS England will issue interim guidance to ICBs and trusts on cash flow and reporting requirements.

Latest News & Updates

22 February 2026— CPI inflation fell to 3.0% in January 2026 (down from 3.4% in December), per ONS data released 18 February. This means the 3.3% NHS pay award now marginally exceeds current CPI inflation, though RPI inflation remains at 3.8%. The Bank of England expects CPI to fall to around 2.1% by April 2026.

22 February 2026 — Unite health visitors in Cwm Taf Morgannwg University Health Board (Wales) begin four weeks of strike action over pay banding disputes. The strikes will run until 20 March 2026.

22 February 2026 — NHS England publishes FAQ on Band 5 nurse review process and confirms preceptorship programme will cover all Band 5 professions, not only nurses

16 February 2026 — Northern Ireland Health Minister Mike Nesbitt reaffirms his commitment to delivering the 3.3% pay award for HSCNI Agenda for Change staff, and progressing towards HSC becoming a Real Living Wage employer. However, delivery remains dependent on the final NI Executive budget settlement. The Department of Health’s funding settlement for 2026-27 represents just a 0.9% increase to £8.5 billion.

12 February 2026 — Government confirms 3.3% pay rise for NHS Agenda for Change staff. Health Secretary Wes Streeting announces staff will be paid in April — the first on-time payment in six years. Unions criticise the award as below current inflation.

12 February 2026 — NHS England confirms every Band 5 nurse will have their job description reviewed, with additional funding to support the process. A national nursing preceptorship programme will launch to ensure every nurse has the best career start.

12 February 2026 — Government commits to structural pay reform discussions with NHS Staff Council. Priorities include raising pay for the lowest bands and improving graduate pay. Once agreed, changes will be backdated to 1 April 2026.

12 February 2026 — RCN General Secretary Professor Nicola Ranger calls the 3.3% award “an insult”, stating it is “below the current level of inflation.”

12 February 2026 — UNISON’s Helga Pile says NHS staff are “downright angry at another below-inflation pay award.

7 February 2026 — Unite confirms NHS health visitors in Cwm Taf Morgannwg University Health Board (Wales) will strike from 23 February to 20 March 2026 over pay banding disputes. Unite general secretary Sharon Graham says the issue is “rapidly evolving into a national concern” across all Welsh health boards.​

2 February 2026 — The NHS Confederation describes resident doctors voting for further strikes as “bitterly disappointing”, warning that strikes cannot be allowed to “roll through 2026, using up yet more scarce resources and impeding progress in reducing waiting lists.”​

1 February 2026 — BMA resident doctors in England vote to renew their strike mandate for another six months, maintaining pressure on the government over pay restoration demands.​

29 January 2026 — RCN confirms Scottish NHS staff will receive an additional 0.15% pay top-up for 2025/26, backdated to April 2025. This brings Scotland’s total 2025/26 increase to 4.4%, triggered by the inflation guarantee clause (CPI averaged 3.4% in 2025, activating the CPI+1% floor).​

14 December 2025 — The government publishes its economic evidence to the Pay Review Bodies for the 2026/27 pay round. Brightmine data included in the evidence shows private sector organisations are forecasting a median 3% pay award.​

31 October 2025 — NHS Employers submit their evidence to the NHSPRB, highlighting workforce shortages, recruitment difficulties, and the need for structural reform of Agenda for Change pay bands.

30 October 2025 — The DHSC submits written evidence proposing a pay uplift of up to 2.5% for 2026/27.

We update this section regularly. Bookmark this page to stay informed

The 3.3% Pay Award Explained

The NHS Pay Review Body recommended a 3.3% consolidated pay increase for all Agenda for Change staff, and the government accepted this recommendation on 12 February 2026.

Key Details

How It Compares

As of January 2026, CPI inflation stands at 3.0% (down from 3.4% in December 2025), meaning the 3.3% award now marginally exceeds current CPI inflation. However, RPI inflation remains at 3.8%, and services inflation stands at 4.4%. Unions prefer RPI as their benchmark, arguing the 3.3% award still represents a real-terms cut by that measure. The OBR’s forecast inflation for the full 2026/27 year is 2.2%.

Why Unions Say 3.3% Is Not Enough

Health unions have strongly criticised the 3.3% award:

• RCN: Professor Nicola Ranger called it “an insult” and said it is “below the current level of inflation”
• UNISON: Helga Pile said staff are “downright angry at another below-inflation pay award”
• Pharmacists’ Defence Association: Described it as “a real-terms pay cut” compared to recent price increases

British Dietetic Association (BDA): Sonila Ellahi, Director of Trade Union and Employment Relations, said: “Whilst we welcome any improvement in pay for our members, we’re once again seeing a real-terms pay cut for the dietetic workforce. It highlights why the Pay Review Body recommendations are completely out of touch with reality.”

• Current RPI inflation sits higher than 3.3%
• Scotland’s deal guarantees at least CPI + 1%
• The award was imposed without union involvement in negotiations
• The PRB process was used instead of the proposed multi-year deal discussions

The NHS Pay Review Body’s Thirty-Ninth Report recommended a consolidated 3.3% increase with effect from 1 April 2026 for all AfC pay points. The recommendation took into account:

• The need to recruit, retain and motivate staff
• Regional labour market variations
• Available funds to Health Departments
• The Government’s inflation target

When Will You Be Paid

For the first time in six years, NHS staff will receive their pay award on time.

April 2026 Payment Confirmed

The government has instructed NHS Business Services Authority to ensure staff receive the 3.3% uplift in their April 2026 pay packets4. Staff paid through ESR (Electronic Staff Record) will see the increase reflected immediately.

This is a significant change from recent years:

What This Means For You

• No backdated lump sum — the increase simply applies from your April pay
• No waiting — you see the benefit immediately
• Full 12 months — you receive the higher rate for the entire 2026/27 financial year

What About Structural Reform Back Pay?

The government has committed to discussing structural pay reforms with the NHS Staff Council. Once agreed, any additional improvements will be backdated to 1 April 2026.

This means if negotiations result in further increases (for example, higher graduate starting pay), you would receive a backdated lump sum at that point covering the period from April onwards.

What to Check on Your April Payslip

When you receive your April pay, verify:

• Your new annual salary reflects a 3.3% increase
• Your band and pay point are correctly recorded
• Any HCAS supplement has been updated (if applicable)
• Pension contributions reflect the new tier (if you’ve crossed a threshold)

When Will NHS Staff in Each Nation Be Paid?

Northern Ireland Health Minister Mike Nesbitt has stated that pay remains his department’s first priority and that he intends to proceed with a 3.3% award for HSCNI AfC staff. However, final confirmation depends on the NI Executive budget settlement. The Minister has committed to implementing an interim “downpayment” for Health and Social Care staff from 1 April 2026 to avoid the delays that have characterised previous years. Despite this, the Department of Health’s 2026-27 funding settlement represents just a 0.9% increase to £8.5 billion, and the cost of implementing the 2025-26 pay award (paid in February 2026) will be deducted from the 2026-27 budget.

Historic Change: April Payment

For the first time since the 2019/20 financial year, NHS staff will receive their pay award in their April pay packets. The NHS Business Services Authority confirmed the increase will be applied in line with ESR lead times.

This means:

• No waiting until August, September, or October
• No backdated lump sum — the increase is simply applied from April
• Staff see the full benefit immediately in their monthly pay

Agenda for Change Pay Scales 2026/27 (Official Confirmed Rates)

These are the confirmed pay scales following the 3.3% award, effective from 1 April 2026. All figures are from NHS Employers.

Annual Salaries 2026/27 (England)

Band 1 is closed to new entrants

Hourly Rates 2026/27 (England)

Band 1 is closed to new entrants

Source: NHS Employers Pay Circular, 12 February 2026. Official rates published by NHS Pay Review Body Thirty-Ninth Report

High Cost Area Supplements (HCAS) 2026/27

NHS staff working in London and the surrounding areas receive High Cost Area Supplements on top of their basic salary. Here are the confirmed HCAS rates for 2026/27.

Inner London (20% supplement, minimum £5,794)

Outer London (15% supplement, minimum £4,870)

Fringe Areas (5% supplement, minimum £1,346)

Band 2 Pay 2026/27

Band 2 roles include healthcare assistants, porters, and maternity support workers.

Support staff on Band 2 are often overlooked in pay discussions, but make up a significant proportion of the NHS workforce. UNISON, which represents many healthcare assistants and support workers, has specifically highlighted the impact on lower-banded staff in its campaign for direct pay negotiations.

Note: Band 2 received interim uplifts during 2025/26 to maintain compliance with National Minimum Wage requirements, in addition to the headline 3.6% award.

Band 3 Pay 2026/27

Band 3 roles include senior healthcare assistants and administrative support staff.

Band 4 Pay 2026/27

Band 4 roles include nursing associates and pharmacy technicians.

Band 5 Pay 2026/27 (Staff Nurses, Pharmacists)

Band 5 is where most newly qualified nurses, midwives, paramedics, and pharmacists begin their careers.

Note for practice nurses: Most practice nurses employed directly by GP surgeries are not on Agenda for Change contracts, so the 3.3% pay award does not automatically apply. Practice nurse pay is typically informed by separate recommendations from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). Many GP practices use AfC rates as a benchmark, but are not obligated to match them. For 2025/26, the government recommended a 4% pay increase for practice staff, though not all practices have passed this on in full because practice funding is handled separately from NHS trust budgets.

Band 6 Pay 2026/27

Band 6 roles include junior sisters, charge nurses, and experienced midwives.

Band 7 Pay 2026/27

Band 7 roles include ward sisters, senior midwives, and senior pharmacists.

Higher Bands (8a–9) Summary

Source: NHS Employers 2026/27 pay circular

Structural Pay Reforms: What’s Coming Next

Alongside the 3.3% pay award, the government has committed to ongoing discussions with the NHS Staff Council on structural reforms to Agenda for Change pay.

What This Means

The government will work with unions to address long-standing concerns about the AfC pay structure. Key priorities include:

• Raising pay for the lowest bands — addressing the compression between Band 2/3 and the minimum wage
• Improving graduate pay — better starting salaries for newly qualified nurses, pharmacists, occupational therapists, and other graduates
• Updated job evaluation — ensuring pay bands reflect modern nursing and healthcare roles

Backdating Confirmed

Once structural reforms are agreed, the additional pay increases will be backdated to 1 April 2026. This means:

• Staff won’t lose out while negotiations continue
• Any agreed improvements apply from the start of the financial year
• Back pay will be calculated from April, regardless of when the agreement is reached

Nursing-Specific Commitments

NHS England announced specific actions for nurses alongside the pay award:

• Every Band 5 nurse will have their job description reviewed by their employer
• Additional funding was provided to support this review process
• National nursing preceptorship launching to ensure every nurse has the best career start
• Graduate pay prioritised in structural reform discussions

Timeline

The government has asked the NHS Staff Council to conduct talks identifying which parts of the pay structure need reform. These talks are ongoing, with the aim of reaching an agreement during 2026.

The PRB report clarified that graduate pay uplifts will apply to all professions, not only nurses4. The NHS Staff Council will determine the level of increase as part of structural reform discussions.

This affects newly qualified:

• Nurses and midwives
• Radiographers
• Physiotherapists
• Occupational therapists
• Pharmacists
• Dietitians
• Other graduate-entry Band 5 roles

Once agreed, improvements will be backdated to 1 April 2026.

Band 5 Nurse Review: What’s Happening

• Every Band 5 nursing role will be reviewed by employers
• Additional national funding has been allocated on a fair share basis to support this process
• The aim is to ensure every nurse is in the correct band
• This is separate from the headline 3.3% pay award
• Board-level oversight required — NHS England has instructed employers to “ensure local plans are in place to complete this work at pace, with board-level oversight and engagement with staff side partners”
• NHS England regions will maintain oversight of progress to ensure consistency

Duncan Burton, Chief Nursing Officer for England, said these measures represent a positive step for nursing, recognising the value and responsibility of nurses at the beginning of their careers while ensuring their pay and job descriptions better reflect the work they actually do.

Further details on delivery timescales and assurance arrangements will be published by NHS England. Frequently asked questions are available on the NHS England website.

Part-Time, Bank and Agency Staff

Part-Time Staff

The 3.3% pay rise applies equally to part-time staff. Your full-time equivalent salary increases by 3.3%, and your actual pay is calculated pro-rata based on your contracted hours. There is no reduced rate for part-time workers.

NHS Bank Staff

Bank staff rates are typically updated to reflect the Agenda for Change pay award, though timing varies by Trust. If you work through NHS Professionals or a local trust staff bank, check with your bank coordinator for when the new rates take effect. Bank staff who also hold substantive NHS posts will see the increase on their substantive salary automatically.

Staff on Maternity, Paternity or Sick Leave

The 3.3% applies to your substantive pay band and spine point regardless of your current leave status. Maternity pay and sick pay calculations based on your salary will reflect the new rate from April 2026.

Agency Staff

Agency staff working in the NHS are not employed under Agenda for Change contracts. Agency pay rates are set by the agency and the trust. While trusts may update agency rate caps to reflect the new AfC rates, this is not guaranteed.

What Should Band 5 Nurses Do Now?

You do not need to take any action at this stage. Your employer will contact you once specific timescales and deadlines for the review process have been agreed nationally, ahead of 1 April 2026. Employers will be required to adhere to agreed national timescales.

If the review finds you are working above Band 5 level, you will be regraded to the appropriate band and receive backpay to April 2026. Additional funding has been allocated specifically for this process — it is separate from both the 3.3% pay award and the structural reform discussions.

This review is significant because many Band 5 nurses routinely perform duties equivalent to Band 6 without receiving matching pay. Unlike other graduate NHS professions such as midwives and paramedics — who typically progress automatically to Band 6 following a structured preceptorship and competency assessments — nursing has historically lacked this automatic progression pathway. In January 2026, following RCN campaigning, a change to the national NHS Terms and Conditions Handbook made it clearer and easier for nurses on Band 5 to progress to Band 6 when appropriate.

National Preceptorship Programme

Update (22 February 2026): NHS England has confirmed the preceptorship programme will cover all Band 5 professions, not only nurses. This includes newly qualified midwives, paramedics, physiotherapists, radiographers, dietitians, and other graduate-entry Band 5 roles.

The PRB report confirmed that preceptorships will be available for all new Band 5 staff, not only nurses.

Minimum Wage and Band 2: The Narrowing Gap

The National Living Wage (for workers aged 21 and over) rises to £12.71 per hour from April 2026 — an increase of 4.1% (up from £12.21). The national living wage (NLW) is to increase by 4.1% to £12.71 per hour from April 2026. The rate was set by the Low Pay Commission and accepted by the government.

This is critical — the government has announced that the National Living Wage (NLW) will increase by 4.1% to £12.71 an hour from April 2026. Your current 6.7% figure is wrong and has been wrong since the page was published.

With the confirmed 3.3% pay award, here is how NHS pay compares:

UNISON highlighted this concern directly, stating that for thousands at the bottom of the salary scale in England, half their increase has gone on bringing their hourly pay rate up to the legal minimum.

The crisis has been narrowly averted — Band 2 staff will earn 21p above the legal minimum. However, this razor-thin margin highlights the structural problems unions have long warned about.

UNISON has written to NHS trusts warning that the pay system remains at “constant risk” of breaching minimum wage rules in future years if awards continue to lag behind NMW increases.

The government has committed to addressing pay for the lowest bands as a priority in structural reform discussions.

Related Guide: NHS Minimum Wage Crisis 2026

Union Response and Strike Risk

Union Reaction to the 3.3% Award

Health unions have criticised the confirmed 3.3% pay award:

RCN — Professor Nicola Ranger, General Secretary, called the award “an insult” and said it is “below the current level of inflation.” She added: “With too many leaving nursing and too few joining, we need urgent and fundamental pay reform, not derisory pay deals.”

UNISON — Helga Pile, head of health, said NHS staff are “downright angry at another below-inflation pay award.”

Pharmacists’ Defence Association — Described the award as “a real-terms pay cut” compared to how prices have increased over the past year.

Why Unions Are Angry

Despite the award exceeding the government’s 2.5% affordability position, unions argue:

• 3.3% is below current inflation — real-terms pay continues to fall
• No union involvement — the award was imposed through the PRB process, not negotiated
• Scotland got a better deal — 3.75% minimum with an inflation guarantee
• Multi-year deal rejected — unions wanted direct negotiations on a longer-term settlement

Related Guide: NHS Planning Guidance 2026/27

The Process Dispute

Fourteen health unions had called for the PRB process to be “set aside” in favour of direct negotiations with ministers. Instead, the government used the traditional PRB route and imposed the recommendation without union agreement.

UNISON’s “Pay Up For NHS Staff” campaign continues, with the Health Service Group Executive agreeing to “refresh and escalate” activities if talks fail to progress.

Is Strike Action Likely?

Strike risk remains elevated:

• BMA resident doctors renewed their strike mandate in February 2026 for another six months
• Unite health visitors in Wales are striking from 23 February to 20 March 2026 over pay banding disputes
• RCN has warned it could raise a formal dispute if structural reforms don’t progress
• Northern Ireland — RCN remains in formal dispute over unfunded 2025/26 award

The NHS Confederation described the continued strike mandates as “bitterly disappointing,” warning strikes cannot be allowed to “roll through 2026.”

Does This Pay Rise Apply to Doctors?

No. The 3.3% pay award covers Agenda for Change staff only. Doctors and dentists have their pay reviewed by a separate body — the Review Body on Doctors’ and Dentists’ Remuneration (DDRB).

Recommendations from the DDRB for medical and dental staff (including those working in primary care) are not expected until early April 2026.

BMA resident doctors in England renewed their strike mandate in February 2026 for another six months, maintaining pressure on the government over pay restoration demands.

For details on doctor pay, see our Junior Doctor Salary UK guide.

Scotland’s Separate 2-Year Pay Deal

NHS Scotland works differently. Staff there negotiated directly with the Scottish Government — not through the PRB.

The result? A much better deal.

The Scottish deal includes an inflation guarantee. This means the 2026/27 increase will be at least one percentage point above CPI inflation. If inflation runs higher, staff get more.

Scottish NHS workers will also see their working week reduced by 1.5 hours from 1 April 2026.

The inflation guarantee in Scotland’s deal is based on CPI (Consumer Prices Index), not RPI. CPI averaged 3.4% in calendar year 2025. Because the deal guarantees CPI + 1%, the minimum increase was 4.4% — triggering an additional 0.15% top-up for 2025/26. For 2026/27, the same mechanism applies: if CPI in 2026 averages above 2.75%, Scottish staff will receive more than the agreed 3.75%. This is a significant advantage that English staff do not have. For more details, see our NHS Scotland Pay Rise 2026/27 guide.

Related Guide:NHS Scotland Pay Rise 2026/27

RCN members in Scotland voted to accept this deal. Unions in England point to Scotland as proof that direct negotiations work better than the PRB process.

Wales and Northern Ireland

The Welsh Government has committed to paying the real living wage (Living Wage Foundation rate) from 1 April 2026. This means the increase for the lowest-paid NHS staff in Wales will range from 3.8% to 5.9%, significantly above both inflation and the headline 3.3% award for higher bands

NHS Wales Pay Rise 2026/27

Wales follows the same Agenda for Change framework as England. For 2025/26, Welsh NHS staff received the same 3.6% increase.

For 2026/27, Wales has confirmed the same 3.3% pay award as England, effective from 1 April 2026.

The RCN in Wales has told ministers they have a “short window to reach agreement on investment in the nursing workforce, or risk escalation to a formal dispute”.

In February 2026, Unite members working as health visitors in Cwm Taf Morgannwg University Health Board voted for four weeks of strike action from 23 February to 20 March. The dispute centres on pay banding classifications. Unite says the issue extends beyond one health board and is campaigning across all NHS Wales trusts for fair pay banding.

The Welsh Government’s Draft Budget for 2026-27 proposes that funding for the Health and Social Care sector increases by 3.6% to £12.7 billion. However, NHS Wales is forecasting a deficit of £173.2 million for 2025-26, requiring savings of approximately £275 million.

The commitment to paying the Living Wage Foundation rate to the lowest bands means some Welsh NHS staff will receive effective increases of 3.8% to 5.9%. However, UNISON has raised concerns about pay compression — where staff in different bands end up on the same or very similar rates of pay — and has written to Cabinet Secretary for Health and Social Care Jeremy Miles MS demanding urgent talks to resolve this issue.

Update (23 February 2026): Unite health visitors in Cwm Taf Morgannwg University Health Board began their four-week strike action today. The strikes will continue until 20 March 2026.

Northern Ireland (HSCNI): Pay Award and Funding Crisis

Northern Ireland faces the most uncertain situation of any UK nation regarding the 2026/27 pay award.

The NHS Pay Review Body recommendation of 3.3% applies equally to Health and Social Care (HSCNI) staff in Northern Ireland. However, unlike England and Wales, the Northern Ireland Executive has not yet confirmed funding for the award.

What Has Been Confirmed

Health Minister Mike Nesbitt has stated that pay is his department’s first priority for 2026/27. He intends to proceed with a 3.3% pay award for all AfC staff. He is progressing towards HSCNI becoming a Real Living Wage employer. He has committed to an interim “downpayment” for HSC staff from 1 April 2026 to avoid the delays that have plagued previous years. Structural reforms will be pursued on a tri-nation basis with England and Wales through the NHS Staff Council.

What Remains Uncertain

The Department of Health’s funding settlement for 2026-27 represents just a 0.9% increase to £8.5 billion. The cost of implementing the 2025-26 pay award (announced November 2025, paid February 2026) will be deducted from the 2026-27 budget, creating additional financial pressure. The Minister has cautioned that current draft budget proposals suggest an “extremely challenging year” ahead. Final confirmation of the pay award depends on the NI Executive agreeing a budget.

2025/26 Pay Award Status

The 2025/26 pay award of 3.6% for HSCNI AfC staff was eventually confirmed and paid in February 2026 pay packets, backdated to 1 April 2025. This restored pay parity with England and Wales after months of delay.

The RCN remains in formal dispute with the Northern Ireland Executive and HSCNI employers over the repeated pattern of delayed and unfunded pay awards.

HSCNI staff should note that pension contribution rates in Northern Ireland are marginally higher than in England and Wales. The maximum member contribution rate is 12.7% (compared to 12.5% in England), and the employer contribution rate is 23.2% (compared to 23.7% in England).

NHS Pay Rise 2026/27 Calculator

Want to know exactly how the 2026/27 pay rise will affect your take-home pay? Use our free NHS Take Home Pay Calculator to see your monthly and annual salary after tax, National Insurance, student loan repayments, and NHS Pension contributions.

Simply select your band, pay point, and any additional allowances — the calculator does the rest.

Use the NHS Take Home Pay Calculator now.

How the Pay Rise Affects Your NHS Pension

Your NHS Pension contribution is based on your pensionable pay, calculated in tiers. As your salary increases with the pay award, you may move into a higher contribution tier — meaning a slightly larger percentage is deducted from your pay. Here are the member contribution tiers as of 2025/26.

The 2026/27 tier thresholds will be adjusted upwards — first by the September 2025 CPI rate (3.8%) on 1 April 2026, and then again if the 3.3% AfC pay award exceeds that CPI figure. This two-step mechanism is specifically designed so that staff do not move into a higher contribution tier solely as a result of the national pay award. The NHSBSA will publish confirmed 2026/27 tier boundaries before April.

Note: These are 2025/26 thresholds. All boundaries are expected to rise by at least 3.8% from April 2026 based on September 2025 CPI.

These tier thresholds may be adjusted when the 2026/27 pay award is implemented, as has happened in previous years. If you are close to a tier boundary, even a small pay rise could push you into the next tier and slightly reduce your take-home increase.

The full employer contribution rate is 23.7% of pensionable pay. However, employers only pay 14.38% through their payroll — NHS England covers the remaining 9.4% through central funding. The DHSC has confirmed this arrangement continues for 2026/27. This means the total pension contribution going into your pot is significantly more than just your employee contribution.

2025/26 NHS Pay Rise Recap

If you are still catching up on what happened last year, here is a quick summary:

The 3.6% award for AfC staff in England came from the NHS Pay Review Body recommendation, which the government accepted.

Practice nurses employed directly by GP practices were told they should receive a 4% pay rise for 2025/26, though this has not always been passed on by all practices.

For full details on last year’s pay scales, see our Agenda for Change Pay Scales 2025/26 guide. Doctors follow separate pay structures — see our Junior Doctor Salary UK guide.

What Happens Next? Key Dates to Watch

The 2026/27 pay award is now confirmed. Here is what to look out for:

UNISON’s Health Service Group Executive will continue to review the campaign and may escalate further if structural reform talks do not progress.

Frequently Asked Questions

Will there be another NHS pay rise in 2026?

Yes — it’s already confirmed. The government announced a 3.3% pay rise on 12 February 2026, effective from 1 April 2026. This is the final figure for the 2026/27 financial year. Further structural reforms may provide additional increases later in the year, backdated to April.

What is the expected pay increase for NHS staff in 2026?

The confirmed pay increase is 3.3% for all Agenda for Change staff in England and Wales. This exceeds the government’s initial 2.5% affordability position but falls below current inflation rates and Scotland’s 3.75% minimum.

When will the 2026/27 NHS pay rise be paid?

April 2026 — for the first time in six years, NHS staff will receive their pay award on time. The NHS Business Services Authority has confirmed the increase will be applied to April salaries for staff paid through ESR. No backdated lump sum is needed.

What is the minimum wage in the NHS from April 2026?

Band 2 staff will earn £12.92 per hour from April 2026, which is 21p above the National Minimum Wage of £12.71. Band 3 entry-level staff will earn £13.17 per hour (46p above NMW).

How does the NHS pay rise work?

The NHS Pay Review Body gathers evidence from the government, NHS Employers, and unions. It then recommends a pay award to ministers. The government decides whether to accept the recommendation. For 2026/27, the award is being paid in April — the first on-time payment in six years. In previous years, awards were typically paid 4–5 months late with backdated lump sums.

Will NHS staff go on strike in 2026?

Strike action is possible but not confirmed. UNISON has launched its “Pay Up For NHS Staff” campaign, and the Health Service Group Executive has agreed to escalate if talks fail. The RCN has warned it could raise a formal dispute. Northern Ireland is already in a formal dispute. The risk of industrial action increases if the government does not engage in direct negotiations or offer below-inflation increases.

Are doctors’ pay awards handled differently?

Yes. Doctors and dentists have their pay reviewed by the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), which is separate from the NHS Pay Review Body that covers Agenda for Change staff. The DDRB makes its own recommendations to the government.

What jobs are covered by Agenda for Change?

Agenda for Change covers most NHS staff outside doctors, dentists, and very senior managers. This includes nurses, midwives, paramedics, pharmacists, physiotherapists, radiographers, healthcare assistants, porters, administrative staff, and many other roles. Pay is structured in bands from 2 to 9, with progression through pay step points based on experience.

What is the predicted NHS pay rise for 2026/27?

The confirmed pay rise is 3.3% for all Agenda for Change staff in England and Wales, effective from 1 April 2026. The government accepted the NHS Pay Review Body’s recommendation in full on 12 February 2026.

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

A Band 5 nurse will earn between £32,073 (entry) and £39,043 (top of band) from April 2026. The intermediate step point is £34,592. With Inner London HCAS, entry-level rises to £38,488 and top of band to £46,852.

What is the NHS Band 3 hourly rate in 2026/27?

Band 3 entry-level staff will earn £13.17 per hour. The top of Band 3 is £14.05 per hour. These are the basic rates for England — HCAS supplements apply in London and fringe areas.

How does the NHS Scotland pay deal compare to England?

Scotland negotiated a two-year deal directly with the Scottish Government, bypassing the Pay Review Body process entirely. For 2026/27, Scottish NHS staff will receive a minimum of 3.75% with a CPI + 1% inflation guarantee. In contrast, England confirmed 3.3% with no inflation protection. Scottish staff also benefit from a 1.5-hour reduction in their working week from April 2026.

What is the NHS MARS scheme 2026?

MARS stands for Mutually Agreed Resignation Scheme. It allows NHS trusts to offer voluntary severance packages to staff whose roles are no longer needed. MARS is not directly related to the annual pay rise but is sometimes mentioned alongside pay discussions when trusts face budget pressures. The availability of MARS varies by trust and is subject to local approval.

Will Band 5 nurses get a pay rise in 2026?

Yes. Band 5 nurses will receive the 3.3% uplift from April 2026. Additionally, every Band 5 nurse will have their job description reviewed, with additional funding provided to support potential rebanding. Graduate pay is also a priority in structural reform discussions

What is the NHS Band 6 salary from April 2026?

Band 6 salaries range from £39,959 (entry) to £48,117 (top of band) from April 2026, with an intermediate point at £42,170.

Does the pay rise apply to part-time NHS staff?

Yes. The 3.3% increase applies to all Agenda for Change pay points regardless of hours worked. Your salary will increase by 3.3% of your full-time equivalent rate, and your actual pay will be calculated based on your contracted hours as normal.

Do NHS bank staff get the pay rise?

NHS bank staff rates are typically updated to reflect Agenda for Change pay awards, though the timing may vary by Trust. If you work through NHS Professionals or a trust staff bank, check with your bank coordinator for confirmation of when the new rates will apply.

I am on maternity leave or long-term sick — do I still get the pay rise?

Yes. The pay award applies to your substantive pay band and spine point. Your salary will increase by 3.3% regardless of whether you are currently on leave. This will be reflected in your pay when you return, or in any maternity or sick pay calculations based on your substantive salary.

Is the 2026/27 NHS pay rise backdated?

No backdating is needed — for the first time in six years, the pay award will be paid on time in April 2026. However, if you are in Northern Ireland, the timing depends on the NI Executive budget settlement. Additionally, structural pay reforms (once agreed) will be backdated to 1 April 2026, so any improvements from those discussions will include back pay.

Does the 3.3% pay rise apply to practice nurses in GP surgeries?

Most practice nurses employed directly by GP surgeries are not on Agenda for Change contracts, so this specific pay award does not automatically apply to them. Practice nurse pay is typically informed by separate recommendations. However, many GP practices use AfC rates as a benchmark. Check with your employer whether they will apply the 3.3% uplift.

When will Northern Ireland HSCNI staff receive the 2026/27 pay rise?

Health Minister Mike Nesbitt has confirmed his intention to proceed with a 3.3% pay award for HSCNI AfC staff and has committed to an interim “downpayment” from 1 April 2026. However, final confirmation depends on the NI Executive agreeing a budget. The Department of Health’s 2026-27 funding settlement represents just a 0.9% increase to £8.5 billion, creating significant financial pressure.

Will my pension contributions increase with the pay rise?

The NHS pension contribution tier thresholds are adjusted each year — first by CPI inflation, then by the pay award if it exceeds CPI. This two-step mechanism is specifically designed so that staff do not move into a higher contribution tier solely because of the national pay award. In most cases, your contribution percentage will remain the same after the 3.3% uplift. The NHSBSA will publish confirmed 2026/27 tier boundaries before April.

Why Trust Our Figures?

All salary data is verified against the official NHS Employers pay circular published 12 February 2026. Some competitor sites display significantly incorrect rates:

These errors understate NHS salaries by £2,000–£5,000. Our figures are sourced directly from NHS Employers and verified against the NHS Pay Review Body Thirty-Ninth Report.