Last checked: 2 July 2026
The NHS pay rise for 2026/27 is a confirmed 3.3% consolidated increase for staff employed under Agenda for Change terms in England. The new rates took effect on 1 April 2026 and replaced the government’s earlier affordability assumption of 2.5%.
The annual, hourly and Higher Cost Area Supplement rates in this article are based on the official Agenda for Change pay scales for England. Separate pay arrangements and salary tables apply in Scotland, Wales and Northern Ireland.
Doctors, dentists and some very senior NHS managers are not covered by the Agenda for Change salary tables because their pay is considered under separate arrangements.
Quick Answer: What Is the Confirmed NHS Pay Rise for 2026/27?
Agenda for Change staff in NHS England received a consolidated 3.3% pay increase from 1 April 2026. The rise was included in April salaries for staff paid through the Electronic Staff Record system, meaning most affected employees did not have to wait several months for back pay.
For example, the Band 5 starting salary increased from £31,049 to £32,073, while the Band 6 starting salary increased from £38,682 to £39,959. The official annual and hourly rates are set out further below.
Key Updates:
- Final pay award: A 3.3% consolidated increase for Agenda for Change staff.
- Effective date: 1 April 2026.
- Payment date: Included in April 2026 salaries for staff paid through ESR.
- Pay scales: All annual and hourly Agenda for Change rates were updated.
- London weighting: Inner London, Outer London and Fringe HCAS rates also increased.
- Article scope: The detailed salary tables below cover NHS England.
- Separate arrangements: Doctors, dentists and NHS staff in the devolved nations may be covered by different pay processes or salary tables.
What Changed From the Earlier 2.5% NHS Pay Proposal?
The 2.5% figure discussed earlier in the 2026/27 pay round was not a confirmed pay award. It represented the amount that the Department of Health and Social Care said had been included in its financial and delivery plans without requiring additional trade-offs against existing health commitments.
The independent NHS Pay Review Body later recommended a 3.3% consolidated increase for Agenda for Change pay points. The government accepted that recommendation and published the revised salary rates on 12 February 2026.
The final award was therefore 0.8 percentage points higher than the earlier affordability assumption. References to a possible or predicted 2.5% rise should now be removed from the article unless they are clearly presented as background to the completed pay-review process.
When Was the NHS Pay Rise Paid?
The 3.3% increase became effective on 1 April 2026. Electronic Staff Record teams received the pay-award information early enough for the new rate to be included in April salaries. UNISON also confirms that the 2026/27 award was paid in April.
This means the headline 3.3% increase did not generally require the delayed implementation and several months of arrears seen in some previous pay rounds.
Employees who believe that their April salary was calculated using the wrong band, pay point or contracted hours should contact their employer’s payroll or human resources department.
Any future additional increases agreed through Agenda for Change structural reform are separate from the headline 3.3% award. NHS Employers has said that some reform-related increases could be backdated to 1 April 2026 if an agreement is reached.
How Was the NHS Pay Rise for 2026/27 Decided?
The 2026/27 award followed the NHS Pay Review Body process. The review body considered written and oral evidence from governments, NHS employers, workforce organisations and other stakeholders before making its recommendation.
The review considered factors including:
- NHS recruitment and retention pressures
- Pay levels across comparable professions
- Inflation and wider economic conditions
- Staff morale and motivation
- Workforce shortages
- Affordability within health budgets
- Problems within the existing Agenda for Change pay structure
The NHS Pay Review Body recommended a 3.3% consolidated increase, which the government accepted. The decision was announced on 12 February 2026, and the new rates became effective from 1 April 2026.
Completed NHS Pay Review Timeline
| Stage | What Happened | Date |
| Pay round launched | Ministers issued remit instructions and requested evidence | 2025 |
| Government evidence submitted | The government outlined workforce and affordability considerations | Late 2025 |
| Evidence assessed | The review body considered submissions from employers and other stakeholders | Late 2025 to early 2026 |
| Recommendation made | A 3.3% consolidated increase was recommended | Early 2026 |
| Government decision | The recommendation was accepted and announced | 12 February 2026 |
| New rates applied | Annual, hourly and HCAS rates became effective | 1 April 2026 |
| Payroll implementation | The increase was included in April salaries through ESR | April 2026 |
The earlier announcement gave NHS employers more time to prepare payroll systems than in several previous pay rounds.
Who Is Covered by the 3.3% NHS Pay Rise?
The 3.3% award applies to employees working under Agenda for Change terms and conditions. Agenda for Change covers most directly employed NHS staff, including:
- Nurses and midwives
- Healthcare assistants and clinical support workers
- Paramedics and ambulance staff
- Allied health professionals
- Therapists
- Pharmacy staff
- Administrative employees
- Estates, catering, domestic and support staff
The award does not use the same pay scales for doctors, dentists or very senior managers. Agency workers are also not automatically entitled to the Agenda for Change increase because their hourly rates depend on their agency agreement and the terms used by the employer.
Bank staff arrangements can differ between NHS organisations. Employees working through an internal staff bank should check whether their rate is linked directly to an Agenda for Change band.
What Are the Confirmed NHS Pay Bands for 2026/27?
The following annual and hourly pay rates apply to Agenda for Change staff in England from 1 April 2026. They show full-time equivalent basic pay before tax, National Insurance, pension contributions, student-loan deductions and other adjustments.
The figures do not include London HCAS payments, overtime, unsocial-hours enhancements, recruitment and retention premia or other local allowances.
Annual NHS Pay Bands 2026/27 (Agenda for Change)
| Band | Entry | Intermediate | Top |
|---|---|---|---|
| Band 2 | £25,272 | – | £25,272 |
| Band 3 | £25,760 | – | £27,476 |
| Band 4 | £28,392 | – | £31,157 |
| Band 5 | £32,073 | £34,592 | £39,043 |
| Band 6 | £39,959 | £42,170 | £48,117 |
| Band 7 | £49,387 | £51,932 | £56,515 |
| Band 8a | £57,528 | £60,417 | £64,750 |
| Band 8b | £66,582 | £70,896 | £77,368 |
| Band 8c | £79,504 | £84,346 | £91,609 |
| Band 8d | £94,356 | £100,140 | £108,814 |
| Band 9 | £112,782 | £119,583 | £129,783 |
How Much Did Each NHS Pay Band Increase?
The table below compares selected 2025/26 and 2026/27 Agenda for Change salaries in England. The monthly increase is the gross annual difference divided by 12 and does not represent the amount an employee will receive after deductions.
| Band | Pay point | 2025/26 salary | 2026/27 salary | Annual increase | Gross monthly increase |
| Band 2 | Standard rate | £24,465 | £25,272 | £807 | £67.25 |
| Band 3 | Entry | £24,937 | £25,760 | £823 | £68.58 |
| Band 3 | Top | £26,598 | £27,476 | £878 | £73.17 |
| Band 4 | Entry | £27,485 | £28,392 | £907 | £75.58 |
| Band 4 | Top | £30,162 | £31,157 | £995 | £82.92 |
| Band 5 | Entry | £31,049 | £32,073 | £1,024 | £85.33 |
| Band 5 | Top | £37,796 | £39,043 | £1,247 | £103.92 |
| Band 6 | Entry | £38,682 | £39,959 | £1,277 | £106.42 |
| Band 6 | Top | £46,580 | £48,117 | £1,537 | £128.08 |
| Band 7 | Entry | £47,810 | £49,387 | £1,577 | £131.42 |
| Band 7 | Top | £54,710 | £56,515 | £1,805 | £150.42 |
| Band 8a | Entry | £55,690 | £57,528 | £1,838 | £153.17 |
| Band 8a | Top | £62,682 | £64,750 | £2,068 | £172.33 |
| Band 8b | Entry | £64,455 | £66,582 | £2,127 | £177.25 |
| Band 8b | Top | £74,896 | £77,368 | £2,472 | £206.00 |
| Band 8c | Entry | £76,965 | £79,504 | £2,539 | £211.58 |
| Band 8c | Top | £88,682 | £91,609 | £2,927 | £243.92 |
| Band 8d | Entry | £91,342 | £94,356 | £3,014 | £251.17 |
| Band 8d | Top | £105,337 | £108,814 | £3,477 | £289.75 |
| Band 9 | Entry | £109,179 | £112,782 | £3,603 | £300.25 |
| Band 9 | Top | £125,637 | £129,783 | £4,146 | £345.50 |
The actual change shown on a payslip will depend on contracted hours, pension membership, tax code, National Insurance, student loans and additional earnings.
How Does NHS Pay Progression Work?
The annual pay award is different from pay progression. The 3.3% award increased the value of every listed pay point, while progression involves moving to another pay point within the employee’s existing band.
Under the published 2026/27 structure:
- Band 3 employees are normally eligible to reach the top point after two years.
- Band 4 employees are normally eligible to reach the top point after three years.
- Band 5 employees become eligible for the intermediate point after two years and the top point after a further two years.
- Employees in Bands 6 to 9 become eligible for the intermediate point after two years and the top point after a further three years.
Eligibility does not necessarily mean that progression is unconditional. Employers apply the relevant pay-step process, which may include performance, appraisal and mandatory-training requirements.
The employee’s contract and local HR guidance should be checked before assuming that progression will occur automatically.
NHS Hourly Rates for 2026/27
| Band | Entry | Mid | Top |
|---|---|---|---|
| Band 2 | £12.92 | – | £12.92 |
| Band 3 | £13.17 | – | £14.05 |
| Band 4 | £14.52 | – | £15.93 |
| Band 5 | £16.40 | £17.69 | £19.97 |
| Band 6 | £20.44 | £21.57 | £24.61 |
| Band 7 | £25.26 | £26.56 | £28.90 |
| Band 8a | £29.42 | £30.90 | £33.11 |
| Band 8b | £34.05 | £36.26 | £39.57 |
| Band 8c | £40.66 | £43.14 | £46.85 |
| Band 8d | £48.26 | £51.21 | £55.65 |
| Band 9 | £57.68 | £61.16 | £66.37 |
The published hourly figures are based on standard Agenda for Change working arrangements. Actual hourly earnings may be higher where an employee receives overtime, night, weekend, public-holiday or other unsocial-hours enhancements.
Part-time staff receive annual salaries and allowances on a pro-rata basis according to their contracted hours.
How Much Will NHS Staff Earn in London in 2026/27?
NHS staff working in qualifying London and surrounding-area locations can receive a Higher Cost Area Supplement in addition to basic Agenda for Change pay.
The 2026/27 HCAS rules are:
| HCAS area | Percentage of basic salary | Minimum payment | Maximum payment |
| Inner London | 20% | £5,794 | £8,746 |
| Outer London | 15% | £4,870 | £6,137 |
| Fringe | 5% | £1,346 | £2,270 |
These supplements are subject to the stated minimum and maximum limits, so the final payment is not always a straightforward percentage of basic salary.
Selected Salaries Including HCAS
| Example | Inner London | Outer London | Fringe |
| Band 5 entry | £38,488 | £36,943 | £33,677 |
| Band 5 top | £46,852 | £44,900 | £40,996 |
| Band 6 top | £56,863 | £54,254 | £50,387 |
| Band 7 top | £65,261 | £62,652 | £58,785 |
| Band 8a top | £73,496 | £70,887 | £67,020 |
| Band 9 top | £138,529 | £135,920 | £132,053 |
The figures above include basic salary and the applicable HCAS amount. Employees should check their organisation and work location because eligibility depends on the official HCAS geographical rules.
Does the 3.3% NHS Pay Rise Apply Across the UK?
NHS pay is not governed by one identical UK-wide salary table.
England
Agenda for Change staff received a 3.3% consolidated increase from 1 April 2026. The detailed annual, hourly and HCAS tables in this article apply to England.
Wales
The Welsh Government accepted a 3.3% consolidated increase for Agenda for Change pay points from 1 April 2026. Separate Welsh salary and implementation guidance should be checked because some lower-paid staff may receive additional adjustments connected with the Real Living Wage.
Scotland
Scotland is covered by a separate two-year agreement. Agenda for Change rates increased by 3.75% from 1 April 2026, rather than 3.3%. Scottish salary tables should therefore not be calculated from the England rates shown above.
Northern Ireland
The NHS Pay Review Body’s recommendation also covered Health and Social Care Agenda for Change staff in Northern Ireland. However, confirmation, implementation timing and published salary tables are handled through Northern Ireland’s Department of Health.
How Have NHS Unions Responded to the 2026/27 Pay Award?
NHS unions criticised the 3.3% award because they did not consider it sufficient to resolve longer-term problems with pay, progression, recruitment and retention.
The Royal College of Nursing described the England award as below inflation at the time of its announcement and criticised the decision to impose it without direct union involvement.
Fourteen Agenda for Change unions later supported a joint letter challenging the award and stating that NHS employees felt angry and let down.
UNISON has confirmed that the 3.3% rise was paid in April 2026 but continues to argue that the headline award does not address problems within the Agenda for Change structure.
Its concerns include low pay in the lower bands, limited financial rewards for progression and insufficient differences between some pay points.
Union concerns now focus on both the value of the annual award and the outcome of separate pay-structure negotiations.
What Is Happening With Agenda for Change Pay Reform?
The government’s 2026/27 pay announcement included a commitment to hold discussions with unions and employers about funded improvements to the Agenda for Change pay structure.
The stated priorities include:
- Increasing pay for employees in the lowest bands
- Improving graduate-level pay
- Addressing pay compression between bands and pay points
- Making career progression more financially worthwhile
- Improving recruitment and retention
- Considering how the salary structure should operate in future years
Formal negotiations on the structure began in April 2026. However, no additional increase should be treated as guaranteed until a final proposal has been agreed and published.
NHS Employers has stated that agreed structural reforms could provide some staff with additional pay increases backdated to 1 April 2026. This possible backdating is separate from the main 3.3% award, which was already paid in April.
What Should NHS Staff Check on Their Payslip?
Employees can check whether the 2026/27 increase has been applied correctly by reviewing the following details on their payslip:
- Agenda for Change band
- Entry, intermediate or top pay point
- Full-time or part-time contracted hours
- New basic salary or hourly rate
- London HCAS payment, where applicable
- Overtime and unsocial-hours enhancements
- government’s 2026/27 pay announcement
- Income-tax code
- National Insurance deduction
- Student-loan or postgraduate-loan deductions
- Salary-sacrifice arrangements
- Any local allowance or recruitment and retention premium
The basic rate should be compared with the official 2026/27 pay table rather than with total monthly earnings, because additional shifts and deductions can make the final payslip amount difficult to compare.
Where the band, pay point or basic rate appears incorrect, the employee should contact payroll or HR and retain copies of the relevant payslips and employment documents.
Conclusion
The confirmed NHS pay rise for 2026/27 is a 3.3% consolidated increase for Agenda for Change staff in England, effective from 1 April 2026. The rise was announced in February and included in April salaries for employees paid through ESR.
The new England rates range from £25,272 at Band 2 to £129,783 at the top of Band 9 before HCAS and other additions. The award also increased hourly rates and London weighting payments.
The main salary award has therefore been completed, but discussions about the wider Agenda for Change structure remain important. Any further pay changes will depend on the outcome of negotiations and should not be treated as confirmed until official guidance is published.
Frequently Asked Questions
What is the confirmed NHS pay rise for 2026/27?
The confirmed increase for Agenda for Change staff in England is 3.3%. It became effective on 1 April 2026.
Was the NHS pay rise paid in April 2026?
Yes. NHS Employers said the increase would be included in April salaries through ESR, and UNISON subsequently confirmed that the award was paid in April.
Will the 3.3% NHS pay rise be backdated?
The main 3.3% rise was paid from the start of the pay year, so most affected employees did not require several months of back pay. Separate structural reforms could produce additional increases for some staff that may be backdated to 1 April 2026.
What is the Band 5 NHS salary for 2026/27?
Band 5 salaries in England are £32,073 at entry, £34,592 at the intermediate point and £39,043 at the top point.
What is the Band 6 NHS salary for 2026/27?
Band 6 salaries in England are £39,959 at entry, £42,170 at the intermediate point and £48,117 at the top point.
Are doctors included in the 3.3% Agenda for Change award?
No. Doctors and dentists are covered by separate pay-review and contractual arrangements rather than the Agenda for Change salary table.
Is the NHS pay rise the same throughout the UK?
No. England and Wales implemented a 3.3% Agenda for Change increase, while Scotland applied a separate 3.75% increase for 2026/27. Northern Ireland follows its own HSC implementation process.
How We Checked This Information?
This article was checked against:
- Official NHS Employers annual and hourly pay scales for 2026/27
- Official NHS Employers pay-award implementation guidance
- The NHS Pay Review Body’s Thirty-Ninth Report
- Department of Health and Social Care evidence
- Welsh Government pay guidance
- Scottish Government NHS pay guidance
- Northern Ireland Department of Health announcements
- Published responses from the Royal College of Nursing and UNISON
Salary differences were calculated by comparing the official 2025/26 and 2026/27 Agenda for Change pay tables. Gross monthly increases were calculated by dividing the annual salary difference by 12.
Information notice: This article provides general information about published NHS pay rates. It is not personal employment, tax, legal or financial advice.
Source links
https://www.nhsemployers.org/articles/pay-scales-202627
https://www.nhsemployers.org/system/files/2026-02/2026%20AfC%20pay%20scales.pdf
https://www.nhsemployers.org/articles/pay-scales-202526
https://www.nhsemployers.org/news/nhs-prb-pay-award-announcement-2026
https://www.gov.uk/government/publications/nhs-pay-review-body-thirty-ninth-report-2026
https://assets.publishing.service.gov.uk/media/698df41175466636847f6a93/NHSPRB_39th_Report_2026.pdf
