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Last Updated: 13 February 2026 | Status: Confirmed — 3.3% pay rise from 1 April 2026
The NHS Wales pay rise for 2026/27 has been confirmed at 3.3%. Cabinet Secretary for Health and Social Care Jeremy Miles MS announced acceptance of the NHS Pay Review Body recommendation on 12 February 2026. For the first time in years, the pay rise will be paid on time in April 2026 payslips.
NHS Wales Pay Rise CalculatorThe Welsh Government has confirmed a 3.3% consolidated pay uplift for all Agenda for Change staff in NHS Wales, effective from 1 April 2026. This covers nurses, midwives, healthcare assistants, porters, cleaners, and allied health professionals.
Jeremy Miles MS, Cabinet Secretary for Health and Social Care, announced:
“I am pleased to announce I am today accepting the recommendations made by the NHS Pay Review Body from 1 April 2026. The NHSPRB recommended a 3.3% consolidated uplift effective from 1 April 2026 for all Agenda for Change pay points.”
“In accepting these NHSPRB recommendations, we are committed to:
— Jeremy Miles MS, Cabinet Secretary for Health and Social Care, 12 February 2026
Key Wales-specific detail: The Welsh Government has already announced its intention to pay the real living wage (Living Wage Foundation rate) from 1 April 2026. This means the increase for the lowest-paid NHS staff will range from 3.8% to 5.9%, significantly above inflation.
Here are the most recent developments, listed from newest to oldest:
12 February 2026 — Cabinet Secretary Jeremy Miles MS confirmed Wales will accept the 3.3% NHSPRB recommendation in full. The Welsh Government reiterated its commitment to paying the Living Wage Foundation rate from 1 April 2026, meaning the lowest-paid staff receive increases of 3.8% to 5.9%
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.
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.
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.
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.
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.
April 2026. Staff will see the 3.3% increase in their April pay packets
Here is the full timeline:
| Stage | Date | Status |
|---|---|---|
| Government remit letter issued | July 2025 | ✅ Complete |
| Evidence submissions | November 2025 | ✅ Complete |
| NHSPRB report submitted | 5 February 2026 | ✅ Complete |
| Welsh Government decision | 12 February 2026 | ✅ Confirmed |
| Implementation | April 2026 payslips | ✅ On time |
Key point: For the first time in years, NHS Wales staff will receive their pay uplift on time in April. No backdating lump sum is required because the award will be implemented at the start of the pay year.
The confirmed 3.3% pay award fell between the government’s initial proposal and union demands. Here is how the final figure compared to what different parties expected:
| Position | Expected/Demanded | Final Outcome |
|---|---|---|
| UK Government proposal | 2.5% | ❌ Not accepted |
| OBR inflation forecast (2026/27) | 2.2% | Award exceeds this |
| Current RPI inflation | 4.2% | Award below this |
| Union demand | Above inflation (3.5%+) | ❌ Not met |
| Scotland benchmark | 3.75% confirmed | Wales lower |
| Final NHS Wales award | — | 3.3% confirmed |
Government perspective: The Welsh Government states the 3.3% uplift is above the Office for Budget Responsibility’s forecast inflation of 2.2% for 2026/27, describing it as a real-terms pay increase.
Union perspective: With RPI inflation currently at 4.2%, unions including UNISON Cymru Wales and RCN Wales argue the 3.3% rise amounts to another real-terms pay cut. Health workers’ pay in Wales already lags behind Scotland, where staff secured 3.75% through direct negotiations.
NHSPRB reasoning: The NHS Pay Review Body noted that pay settlements across the wider economy were expected to be at or slightly above 3% for 2026. The 3.3% recommendation balanced affordability concerns against recruitment and retention pressures.
Key context: The Department of Health and Social Care’s evidence stated it could only afford 2.5% without making trade-offs against headline health commitments. The Welsh Government did not provide a specific affordability figure, but its draft budget allowed for a 2.2% public sector pay uplift. The NHSPRB recommended 0.8 percentage points above the government’s opening position.
The NHSPRB’s 39th Report noted that the Welsh Government did not provide a specific affordability figure, but its Outline Draft Budget indicated each Main Expenditure Group was being provided with a 2.2% uplift for public sector pay for 2026/27.
The Review Body stated: “An uplift somewhat in excess of the affordability figures provided to us will be necessary to sustain recent improvements to recruitment and retention and to protect the engagement and motivation of the workforce.”
The NHSPRB also noted that pay settlements across the wider economy were expected to be “at or slightly above 3%” for calendar year 2026, supporting their 3.3% recommendation.
Alongside the pay award, the Welsh Government committed to continuing tri-nation discussions with the NHS Staff Council to implement improvements to the Agenda for Change pay structure.
Jeremy Miles MS stated: “These will build on the constructive discussions to date with unions about a multi-year, funded mandate for Agenda for Change structural reforms in England, Wales and Northern Ireland. Our priorities for structural reform include improving pay for the lowest paid staff and graduate pay. Once agreed, these reforms will be effective from, and backdated to, April 2026.”
The NHSPRB specifically noted it was “not making recommendations that change the AfC pay structure” to allow these discussions to progress without interference.
| Band | 2025/26 Entry | 2026/27 Entry | 2025/26 Top | 2026/27 Top |
|---|---|---|---|---|
| Band 2 | £24,465 | £26,300 | £24,465 | £26,228 |
| Band 3 | £24,937 | £25,760 ✓ | £26,598 | £27,476 |
| Band 4 | £27,485 | £28,392 ✓ | £30,162 | £31,157 |
| Band 5 | £31,049 | £32,073 ✓ | £37,796 | £39,043 |
| Band 6 | £38,682 | £39,959 | £46,580 | £48,117 |
| Band 7 | £47,810 | £49,387 | £54,710 | £56,515 |
Bands 1, 2 and the entry point of Band 3 have already received a real living wage top-up. As the 3.3% recommendation is lower than that uplift, these staff will see no additional increase beyond what was already announced.
Wales has made a unique commitment that differentiates it from England. The Welsh Government will pay the Living Wage Foundation’s real living wage from 1 April 2026.
This means:
This addresses minimum wage compression more aggressively than England.
Band 2 is the entry point for healthcare support workers, porters, domestic staff, and catering assistants.
| Pay Point | 2025/26 | 2026/27 (Confirmed) |
|---|---|---|
| Entry/Top | £24,465 | £26,300 |
| Hourly rate | £12.51 | £13.45 |
Important for Wales: Band 2 staff will receive the real living wage (Living Wage Foundation rate) from 1 April 2026. This means the actual increase for Band 2 ranges from 3.8% to 5.9% — significantly higher than the headline 3.3%. The Welsh Government’s real living wage commitment ensures Band 2 pay exceeds statutory minimums.
Wales has also signed a landmark agreement to re-band healthcare support workers from Band 2 to Band 3, delivering a meaningful pay rise for thousands of porters, domestic staff, and healthcare assistants. Implementation is expected by mid-2026.
Band 5 is where newly qualified nurses, midwives, and most allied health professionals start.
| Pay Point | 2025/26 | 2026/27 (Confirmed) |
|---|---|---|
| Entry | £31,049 | £32,073 |
| Intermediate (after 2 years) | £33,487 | £34,592 |
| Top (after 4 years) | £37,796 | £39,043 |
| Entry hourly rate | £15.88 | £16.40 |
| Top hourly rate | £19.33 | £19.97 |
A Band 5 nurse starting in April 2026 will earn £32,073 per year, progressing to £39,043 at the top of the band after approximately four years.
Band 6 covers senior staff nurses, specialist practitioners, and experienced allied health professionals.
| Pay Point | 2025/26 | 2026/27 (Confirmed) |
|---|---|---|
| Entry | £38,682 | £39,959 |
| Intermediate (after 2 years) | £40,823 | £42,170 |
| Top (after 5 years) | £46,580 | £48,117 |
| Entry hourly rate | £19.78 | £20.44 |
| Top hourly rate | £23.82 | £24.61 |
Staff at Band 6 can expect to earn between £39,959 and £48,117, depending on their position within the pay band.
Band 7 is typically for advanced practitioners, team leaders, and clinical specialists.
| Pay Point | 2025/26 | 2026/27 (Confirmed) |
|---|---|---|
| Entry | £47,810 | £49,387 |
| Intermediate (after 2 years) | £50,273 | £51,932 |
| Top (after 5 years) | £54,710 | £56,515 |
| Entry hourly rate | £24.45 | £25.26 |
| Top hourly rate | £27.98 | £28.91 |
A Band 7 team leader or advanced practitioner will earn between £49,387 at entry and £56,515 at the top of the band.
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:
Here is the updated table, with only the Wales column changed as you requested. England and Scotland remain exactly the same.
| Factor | Wales | England | Scotland |
|---|---|---|---|
| 2025/26 Agenda for Change award | 3.6% | 3.6% | 3.75% (year 1 of 2-year deal) |
| 2026/27 award/proposal | 3.3% confirmed | 3.3% confirmed | 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 the 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 |
| Real Living Wage | Yes — 3.8% to 5.9% for lowest bands | — | — |
| Payment timing | April 2026 — on time | — | — |
| Career progression measures | Demanded to match England | — | — |
Northern Ireland note: The NHSPRB Report revealed that the Northern Ireland Department of Health stated there was “no capacity in budgets for a pay uplift for 2026/27 without making corresponding cuts to expenditure.” The Minister of Health indicated he would implement an interim “downpayment” from 1 April 2026 to signal intent, but the full award remains budget-dependent
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.
This was one of the most urgent issues in the 2026/27 pay round. Wales has taken decisive action.
The problem: From April 2026, the National Living Wage for workers aged 21 and over rises to £12.71 per hour. A standard 3.3% uplift would have left Band 2 entry staff earning approximately £13.45 per hour — barely above the legal minimum.
Wales’s solution: The Welsh Government committed to paying the real living wage (Living Wage Foundation rate) from 1 April 2026.
| Rate Type | Hourly Rate | Annual Equivalent |
|---|---|---|
| National Living Wage (statutory minimum) | £12.71 | £24,831 |
| Standard 3.3% uplift (Band 2) | £13.45 | £26,228 |
| Wales Real Living Wage | £13.45 | £26,228 |
What this means for the lowest-paid staff:
Re-banding agreement: In addition to the real living wage commitment, NHS Wales signed a landmark agreement in November 2025 to re-band healthcare support workers from Band 2 to Band 3, delivering further pay increases 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.
This combination of real living wage and re-banding addresses minimum wage compression more aggressively than England.
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:
The Health Secretary sends a remit letter to the NHS Pay Review Body, setting out the scope of the review and any financial constraints.
The government, NHS Employers, and trade unions each submit written evidence covering recruitment data, inflation, workforce pressures, and affordability.
The NHS Pay Review Body evaluates all evidence independently and publishes a recommended pay increase.
The UK Government decides whether to accept the recommendation for England.
The Welsh Government decides separately whether to accept, match, or adjust the recommendation for NHS Wales.
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.
The reaction from NHS trade unions has been overwhelmingly negative:
The largest health union has criticised the confirmed 3.3% award as another below-inflation pay rise. UNISON head of health Helga Pile said: “Hard-pressed NHS staff will be downright angry at another below-inflation pay award.
Yet again, they’re expected to keep delivering more while effectively being given less, as pay slides behind living costs.” UNISON had previously pulled out of the Pay Review Body process entirely, demanding direct negotiations. The union described the government’s return to the Pay Review Body system as “a handbrake turn” after ministers had initially indicated they would negotiate directly with unions.
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.
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.
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.
GMB — Like UNISON, the GMB has announced it will not participate in the Pay Review Body process for 2026/27.
“A 3.3% pay award is very disappointing and shows a failure to grasp the reality facing nursing staff in Wales. At a time when costs of living remain high another real term pay cut is being imposed again on a workforce already stretched to its limits.”
“The Welsh government has made a commitment to pay restoration back to 2008, and this award falls well short of that pledge.”
“The Welsh government must also match the career progression measures announced for NHS nursing staff in England yesterday. Our members in Wales will not accept being left behind.”
With inflation at 4.2%, the 3.3% rise will leave nurses, healthcare assistants, porters and catering staff worse off in real terms. Health workers’ pay in Wales already lags behind Scotland, where staff negotiate pay directly with government.
UNISON wants ministers to open direct pay negotiations after the Senedd election.
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.
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 | 3.3% confirmed | First April payslip implementation in years |
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.
The Welsh Government has confirmed a 3.3% pay rise for 2026/27, announced on 12 February 2026. This applies to all Agenda for Change staff from 1 April 2026.
No backdating required. For the first time in years, the pay rise will be implemented on time in April 2026 payslips.
Yes. For the 2025/26 financial year, NHS Wales Agenda for Change staff received a 3.6% pay increase, which was implemented during 2025.
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%.
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.
Possible but not certain. Unions have criticised the confirmed 3.3% pay award as a real-terms pay cut, with CPI inflation currently at 4.2%.
Welsh Ambulance Services NHS Trust (WAST) staff are already being balloted for industrial action. UNISON’s ballot papers were sent out in October 2025, with the union recommending members vote yes to strike action.
RCN Wales’ Helen Whyley said the award was “very disappointing” and that nursing staff “were led to believe a different approach was coming. Instead, they have been handed more of the same.”
GMB’s Rachel Harrison said the award is “just not enough” and that GMB will “fight for more” at the promised Agenda for Change structural reform talks.
Unions are reviewing the award before deciding next steps. UNISON Cymru Wales wants ministers to open direct pay negotiations after the Senedd election.
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.
Multiply your current 2025/26 salary by 1.033 to calculate your 2026/27 salary.
Formula: Current salary × 1.033 = 2026/27 salary
Example: A Band 5 nurse atthe entry point
Alternatively, use the confirmed pay scales table in this article to find your band and pay point directly. The figures reflect the official 3.3% uplift effective from 1 April 2026.
Important: If you are also due incremental progression (moving up a pay point within your band), apply the 3.3% increase to your new pay point figure, not your current one.
For a detailed take-home pay calculation including tax, National Insurance, and NHS Pension deductions, use our NHS pay calculator tool.
