Last Updated: February 2026 | Status: The NHS Pay Review Body is currently reviewing evidence. The UK Government has proposed a 2.5% pay rise for 2026/27. The Welsh Government will make its own final decision, expected by late summer 2026. Any award will be backdated to 1 April 2026.
The NHS Wales pay rise for 2026/27 has not been confirmed yet. The UK Government has put forward a proposed increase of 2.5% for Agenda for Change staff, but this figure is under review and could change before the final award is announced.
This page covers everything NHS Wales staff need to know — from projected pay band tables and payment timelines to what the unions are demanding and how Wales compares with England and Scotland.
What Is the NHS Wales Pay Rise for 2026/27?
The Department of Health and Social Care has submitted written evidence to the NHS Pay Review Body recommending a pay award of up to 2.5% for the 2026/27 financial year. This applies to all Agenda for Change staff across the NHS, including nurses, midwives, paramedics, healthcare assistants, allied health professionals, and administrative workers.
However, this is not the final figure. It is simply the government’s opening proposal. The independent NHS Pay Review Body will assess evidence from the government, NHS Employers, and trade unions before publishing its own recommendation. The Welsh Government then decides separately whether to accept, match, or adjust that recommendation for NHS Wales.
For context, NHS Wales staff received a 5.5% pay increase in 2024/25 and a 3.6% increase in 2025/26. A drop to 2.5% would mark the lowest Agenda for Change pay award since the austerity-era freezes ended in 2018.
NHS Wales Pay Rise 2026/27 Latest News
Here are the most recent developments, listed from newest to oldest:
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February 2026 — Trade unions including UNISON, the Royal College of Nursing, and the Royal College of Midwives are completing their evidence submissions to the NHS Pay Review Body. Several unions have chosen not to participate in the formal review body process and are instead pushing for direct negotiations with ministers.
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January 2026 — The Welsh Government published its Final Budget for 2026/27, allocating £12.6 billion to health and social care — a 3.6% uplift with an extra £180 million secured through the budget agreement with Plaid Cymru.
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January 2026 — The Royal College of Nursing confirmed that an inflation guarantee built into the Scottish pay deal triggered an additional 0.15% increase for 2025/26, taking the total to 4.4% in Scotland. A similar guarantee exists for 2026/27 in Scotland.
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November 2025 — The UK Government submitted written evidence proposing up to 2.5%. Unions immediately rejected it, with UNISON calling it a real-terms pay cut.
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November 2025 — NHS Wales signed a landmark agreement to re-band healthcare support workers from Band 2 to Band 3, delivering a meaningful pay rise for thousands of the lowest-paid staff.
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July 2025 — The Health Secretary issued the remit letter to the NHS Pay Review Body earlier than in previous years, signalling a desire for faster recommendations.
When Will the NHS Wales Pay Rise 2026/27 Be Paid?
The pay rise is expected to be paid in late 2026 or early 2027, with a backdated lump sum covering the months from 1 April 2026 up to the date of payment.
Here is the full timeline:
| Stage | Expected Date | Status |
|---|---|---|
| Government remit letter issued to NHSPRB | July 2025 | ✅ Complete |
| Government and NHS Employers submit evidence | October–November 2025 | ✅ Complete |
| Unions submit evidence to NHSPRB | November 2025 – February 2026 | ✅ In progress |
| NHSPRB publishes recommendation | Spring–Summer 2026 | ⏳ Pending |
| Welsh Government announces final decision | Late Summer 2026 | ⏳ Pending |
| Backdated pay appears in pay packets | Autumn–Winter 2026 | ⏳ Pending |
When the award is finally confirmed, your payslip will show two things: a one-off lump sum covering the backdated months (April onwards) and your new monthly salary going forward. The exact month depends on how quickly the Welsh Government confirms its decision after the Pay Review Body reports.
How Much Could NHS Wales Staff Receive? Predictions for 2026/27
While the government has proposed 2.5%, several indicators suggest the final award could be higher:
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Government position: Up to 2.5%, funded within existing departmental budgets. The DHSC budget for 2026/27 grew by just 2.8%, lower than the 3.6% historical average.
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Union demand: Above-inflation increases. UNISON and the Royal College of Nursing are pushing for at least 3.5% or more, arguing anything less is a real-terms pay cut.
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Scotland benchmark: Scottish NHS staff already have a confirmed 3.75% for 2026/27 as part of a pre-negotiated two-year deal, plus an inflation guarantee. This creates pressure on England and Wales to match or come close.
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UK employer average: A Reuters-cited IDR survey found 39% of UK employers are planning pay rises of 3% to 3.49% in 2026. Consultancy firm WTW forecasts an average salary increase budget of 3.6%.
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OBR forecast: The Office for Budget Responsibility projects average weekly earnings growth of 3.2% for 2026.
Putting this together, a realistic prediction for the final NHS Wales award sits somewhere between 2.8% and 3.5%. The government’s 2.5% floor is unlikely to survive intact given the independent Pay Review Body has historically recommended above the government’s opening figure, and union pressure is significant.
Projected NHS Wales Pay Scales 2026/27
Below are the projected Agenda for Change pay scales for NHS Wales, shown at three possible scenarios: 2.5%, 3.0%, and 3.5%. These figures are estimates based on current 2025/26 rates and will be updated once the final award is confirmed.
| Band | 2025/26 Entry | 2025/26 Top | At 2.5% Entry | At 2.5% Top | At 3.0% Entry | At 3.0% Top | At 3.5% Entry | At 3.5% Top |
|---|---|---|---|---|---|---|---|---|
| Band 2 | £23,615 | £24,336 | £24,205 | £24,944 | £24,323 | £25,066 | £24,442 | £25,188 |
| Band 3 | £24,336 | £25,674 | £24,944 | £26,316 | £25,066 | £26,444 | £25,188 | £26,573 |
| Band 4 | £26,598 | £29,114 | £27,263 | £29,842 | £27,396 | £29,987 | £27,529 | £30,133 |
| Band 5 | £29,970 | £36,483 | £30,719 | £37,395 | £30,869 | £37,577 | £31,019 | £37,760 |
| Band 6 | £37,350 | £44,962 | £38,284 | £46,086 | £38,470 | £46,311 | £38,657 | £46,536 |
| Band 7 | £45,996 | £52,809 | £47,146 | £54,129 | £47,376 | £54,393 | £47,606 | £54,657 |
| Band 8a | £50,952 | £57,349 | £52,226 | £58,783 | £52,481 | £59,069 | £52,735 | £59,356 |
| Band 8b | £58,972 | £68,525 | £60,446 | £70,238 | £60,741 | £70,581 | £61,036 | £70,923 |
| Band 8c | £70,417 | £81,138 | £72,177 | £83,166 | £72,530 | £83,572 | £72,882 | £83,978 |
| Band 8d | £83,571 | £96,376 | £85,660 | £98,785 | £86,078 | £99,267 | £86,496 | £99,749 |
| Band 9 | £99,891 | £114,949 | £102,388 | £117,823 | £102,888 | £118,397 | £103,387 | £118,972 |
These figures represent basic full-time equivalent salaries before deductions for tax, National Insurance, and NHS Pension contributions.
Band 2 NHS Wales Pay 2026/27
Band 2 is the entry point for healthcare support workers, porters, domestic staff, and catering assistants. At a 2.5% rise, the entry salary would be £24,205 per year, which works out to roughly £12.41 per hour.
This is a problem. The National Minimum Wage rises to £12.71 per hour from April 2026. Even at 3.5%, Band 2 entry would only reach £12.53 per hour — still below the legal minimum. This means structural reform of the lowest pay band is unavoidable (more on this below).
Band 5 NHS Wales Pay 2026/27
Band 5 is where newly qualified nurses, midwives, and most allied health professionals start. At 2.5%, the starting salary would rise to £30,719, reaching up to £37,395 at the top of the band. At 3.5%, the entry point would be £31,019 with a top of £37,760.
Band 6 NHS Wales Pay 2026/27
Band 6 covers senior staff nurses, specialist practitioners, and experienced allied health professionals. The projected entry salary ranges from £38,284 (at 2.5%) to £38,657 (at 3.5%), with the top of the band reaching between £46,086 and £46,536.
Band 7 NHS Wales Pay 2026/27
Band 7 is typically for advanced practitioners, team leaders, and clinical specialists. At 2.5%, the starting salary would be £47,146 rising to £54,129. At 3.5%, those figures climb to £47,606 and £54,657 respectively.
NHS Wales vs England vs Scotland: Pay Comparison 2026/27
Health is a devolved matter, which means the Welsh Government, Scottish Government, and UK Government each make their own decisions on NHS pay. Here is how the three nations compare:
| Factor | Wales | England | Scotland |
|---|---|---|---|
| 2025/26 Agenda for Change award | 3.6% | 3.6% | 3.75% (year 1 of 2-year deal) |
| 2026/27 proposal | TBC — follows NHSPRB | 2.5% proposed | 3.75% confirmed |
| Decision maker | Welsh Government | UK Government | Scottish Government |
| Pay review body | NHSPRB (shared) | NHSPRB | NHSPRB (separate negotiation) |
| Inflation guarantee | Not confirmed | Not confirmed | Yes — built into deal |
| Band 2 reform | Re-banding to Band 3 agreed | No equivalent agreement | N/A |
| Health budget uplift | 3.6% (+£180M) | 2.8% | Separate settlement |
The key takeaway is that Scotland has already locked in 3.75% with an inflation safety net, putting Wales and England under pressure to deliver something competitive. Wales has the advantage of its landmark healthcare support worker re-banding agreement, which goes further than anything offered in England. For more on the England NHS pay rise 2026 position, see our dedicated guide.
Band 2 and the Minimum Wage Crisis
This is one of the most urgent issues in the 2026/27 pay round, and it affects thousands of the lowest-paid NHS Wales workers.
From April 2026, the National Minimum Wage for workers aged 21 and over rises to £12.71 per hour. But Band 2 entry-level staff on the Agenda for Change pay scale currently earn £12.11 per hour.
Here is the problem at every proposed pay rise level:
| Scenario | Band 2 Entry Salary | Hourly Rate | vs NMW (£12.71) |
|---|---|---|---|
| At 2.5% | £24,205 | £12.41/hr | ❌ Below |
| At 3.0% | £24,323 | £12.47/hr | ❌ Below |
| At 3.5% | £24,442 | £12.53/hr | ❌ Below |
Even at 3.5%, Band 2 staff would earn 18p less per hour than the legal minimum wage. This means a simple percentage pay rise cannot fix this — the Agenda for Change pay structure itself needs reform at the bottom end.
Wales is ahead of the curve here. In November 2025, the Welsh Partnership Forum signed a historic agreement to re-band healthcare support workers from Band 2 to Band 3, delivering an immediate pay increase for thousands of porters, domestic staff, and healthcare assistants. The Royal College of Nursing called it a “landmark” deal. Implementation is expected by mid-2026.
The UK Government has also acknowledged the structural issue and asked the NHS Staff Council to begin exploratory talks on reforming the Agenda for Change pay structure for 2026/27.
How Is NHS Wales Pay Decided?
NHS pay in Wales follows a specific process that is similar to England but with one important difference — the Welsh Government has the final say for Welsh staff.
Here is how it works, step by step:
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The Health Secretary sends a remit letter to the NHS Pay Review Body, setting out the scope of the review and any financial constraints.
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The government, NHS Employers, and trade unions each submit written evidence covering recruitment data, inflation, workforce pressures, and affordability.
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The NHS Pay Review Body evaluates all evidence independently and publishes a recommended pay increase.
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The UK Government decides whether to accept the recommendation for England.
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The Welsh Government decides separately whether to accept, match, or adjust the recommendation for NHS Wales.
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The pay award is implemented and backdated to 1 April of the relevant financial year.
For doctors and dentists, a separate body called the Doctors’ and Dentists’ Review Body handles the process. GP contract uplifts follow yet another route.
A notable development this year is that several major unions — including UNISON and the GMB — have refused to participate in the formal Pay Review Body process for 2026/27, arguing the system is broken and calling for direct negotiations with ministers instead.
What Unions Are Saying About the 2026/27 Proposal
The reaction from NHS trade unions has been overwhelmingly negative:
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UNISON — The largest health union has rejected the 2.5% proposal and pulled out of the Pay Review Body process entirely, demanding direct negotiations. They argue 2.5% amounts to a real-terms pay cut when inflation is running above that figure.
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Royal College of Nursing (RCN) — RCN Wales continues to push for above-inflation pay rises. In Scotland, the RCN secured an inflation guarantee as part of a two-year deal, and they want something similar for Wales.
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Royal College of Midwives (RCM) — The RCM has warned that the National Minimum Wage will overtake the lowest NHS pay bands, making it harder to recruit and retain support staff.
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British Medical Association (BMA) — Doctors’ pay is handled separately through the Doctors’ and Dentists’ Review Body. The BMA continues to campaign for pay restoration following years of below-inflation awards.
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GMB — Like UNISON, the GMB has announced it will not participate in the Pay Review Body process for 2026/27.
Whether this leads to industrial action depends on the final offer. If the award comes in at or near 2.5%, ballot activity becomes much more likely. If it lands closer to 3% or above, unions may accept it, albeit reluctantly.
NHS Wales Workforce: Why Pay Matters
Pay is not just about the number on a payslip — it directly affects whether the NHS in Wales can attract and keep the staff it needs.
As of June 2025, NHS Wales had 5,335 full-time equivalent vacancies, representing a 5.4% vacancy rate. Medical and dental roles have the highest gap at 8.8%, while registered nursing vacancies stood at around 1,481 posts.
There is some good news. The latest NHS Wales workforce trends report from Health Education and Improvement Wales shows that the workforce has been growing and vacancy rates are gradually improving. Agency spending has also started to come down.
The Welsh Government’s Final Budget for 2026/27 allocated £12.6 billion to health and social care — more than 55% of its entire day-to-day spending. An extra £180 million was secured through the budget deal with Plaid Cymru. Whether this is enough to fund a competitive pay rise above 2.5% remains to be seen.
NHS Wales Pay Rise History: 2018 to 2026
Understanding where the 2026/27 proposal sits in context helps make sense of why unions are frustrated:
| Year | Agenda for Change Increase | What Happened |
|---|---|---|
| 2018/19 | 3.0% | Multi-year deal began after years of 1% caps |
| 2019/20 | 1.7% | Year two of the three-year agreement |
| 2020/21 | 1.57% | COVID year — a separate cash lump sum was also paid |
| 2021/22 | 3.0% | Post-pandemic recovery award |
| 2022/23 | 4.75% | Awarded amid widespread strike action |
| 2023/24 | 5.0% | Followed further industrial action ballots |
| 2024/25 | 5.5% | Highest single-year increase in over a decade |
| 2025/26 | 3.6% | Current year |
| 2026/27 | TBC (2.5% proposed) | Under review by NHSPRB |
If the final award lands at 2.5%, it would be the lowest increase since before the 2018 multi-year deal — a sharp reversal from the generous settlements of 2023–2025.
Doctor and Dentist Pay in NHS Wales 2026/27
Doctors and dentists sit outside the Agenda for Change framework. Their pay is reviewed by the Doctors’ and Dentists’ Review Body, which covers consultants, specialty doctors, SAS grades, and resident doctors (formerly known as junior doctors).
For 2025/26, all medical and dental groups in Wales received a 4% pay increase. The government has submitted evidence to the DDRB for 2026/27, again proposing awards within the 2.5% affordability envelope.
The BMA has consistently argued that doctors’ pay has fallen significantly in real terms over the past 15 years and that above-inflation increases are needed to restore it. GP pay follows a separate mechanism through the GP contract, and the Health Secretary has indicated there will be no additional funding specifically for GP pay uplifts in 2026/27.
Frequently Asked Questions
What is the NHS pay deal for 2026?
The UK Government has proposed a 2.5% pay rise for 2026/27, but this is not final. The NHS Pay Review Body will publish an independent recommendation, and the Welsh Government will make its own decision for NHS Wales. The final award is expected by late summer 2026.
Will the NHS Wales pay rise be backdated?
Yes. NHS pay awards are always backdated to 1 April of the relevant financial year. Staff typically receive a lump sum covering the backdated months alongside their updated monthly salary once the award is processed.
Are NHS Wales staff getting a pay rise in 2025?
Yes. For the 2025/26 financial year, NHS Wales Agenda for Change staff received a 3.6% pay increase, which was implemented during 2025.
What is the average pay increase in the UK for 2026?
Private sector employers are planning average increases of 3% to 3.49% according to IDR surveys, while WTW forecasts an average salary increase budget of 3.6%. The OBR projects average earnings growth of 3.2%.
How does NHS Wales pay compare to England?
Wales and England use the same Agenda for Change pay framework and have historically received the same percentage increase. However, the Welsh Government makes its own decision and can choose to diverge. Wales currently has a separate re-banding agreement for healthcare support workers that England does not.
Will there be NHS strikes in 2026?
It depends on the final offer. If the award comes in at or near 2.5%, unions have signalled they may ballot for industrial action. If it lands closer to 3% or above, strike action is less likely but not ruled out. Several unions have already pulled out of the formal Pay Review Body process in protest.
What is Agenda for Change?
Agenda for Change is the pay system used for all NHS staff except doctors, dentists, and some senior managers. It groups roles into nine pay bands based on job responsibilities, with staff progressing through pay points within their band each year.
How can I calculate my new NHS Wales salary?
Use the projected pay tables in this article to find your band and see estimated figures at 2.5%, 3.0%, and 3.5%. For a more detailed take-home pay calculation, including tax, National Insurance, and pension deductions, NHS pay calculator tools are available online.
⚠️ Disclaimer: Pay negotiations for 2026/27 are ongoing. The figures and projections in this article are based on the best available information as of February 2026. The final award may differ from the government’s initial 2.5% proposal. This page will be updated as new developments emerge.