The NHS pay rise for 2026/27 is a confirmed 3.3% consolidated increase for NHS staff in England employed under Agenda for Change terms.
The increase took effect from 1 April 2026 and was implemented in April pay packets, avoiding the long back-pay delays seen in some earlier NHS pay rounds.
The 2026 NHS Pay Review Body report, published on 12 February, recommended the 3.3% increase for Agenda for Change staff in England, Wales and Northern Ireland.
This increased the Band 5 starting salary from £31,049 to £32,073, while the Band 6 starting salary rose from £38,682 to £39,959.
The 3.3% award applies to the basic Agenda for Change pay scales. Doctors, dentists and some very senior managers have separate pay arrangements.
NHS Pay Rise 2026/27 Key Updates
- Pay Award:3% consolidated increase
- Effective Date: 1 April 2026
- Implementation: Included in April 2026 salaries for eligible staff
- Band 5 Starting Pay: £32,073
- Band 6 Starting Pay: £39,959
- Band 7 Starting Pay: £49,387
- London Weighting: Higher Cost Area Supplement rates also increased
- Structural Reform: Separate Agenda for Change reform discussions remain unresolved
- Possible Further Changes: Any structural improvements are separate from the confirmed 3.3% award
Last Updated: 17.09.2026
What Changed From The Earlier 2.5% NHS Pay Proposal?
The 2.5% figure discussed before the 2026/27 award was not the final NHS pay rise.
It reflected an earlier government affordability assumption used during financial planning. The independent NHS Pay Review Body subsequently recommended a 3.3% consolidated increase, which was accepted.
The final increase was therefore 0.8 percentage points higher than the earlier 2.5% assumption.
For employees, the important figure is now 3.3%. The earlier 2.5% figure is only relevant as background to how the pay round developed.
When Was The 2026/27 NHS Pay Rise Paid?
The new rates became effective on 1 April 2026.
Unlike some previous NHS pay settlements, Agenda for Change employees paid through the Electronic Staff Record system generally received the updated rates in their April salary rather than waiting several months for back pay.
Employees who believe their pay was not updated correctly should check their band, pay point and contracted hours before contacting payroll or HR.
Separate structural reforms may still lead to additional changes for some staff. Those should not be confused with the 3.3% award that has already been implemented.
Who Is Covered By The 3.3% NHS Pay Rise?
Agenda for Change covers most directly employed NHS workers in England, including:
- Nurses And Midwives
- Healthcare Assistants
- Clinical Support Workers
- Paramedics And Ambulance Staff
- Physiotherapists And Other Allied Health Professionals
- Pharmacy Staff
- Administrative Employees
- Porters And Domestic Staff
- Estates And Facilities Employees
Doctors and dentists are covered by separate national pay arrangements.
Agency workers do not automatically receive Agenda for Change increases because their pay depends on their agency contract and the rates agreed with the organisation where they work.
Internal NHS bank arrangements can also vary.
NHS Pay Bands 2026/27
The following figures show full-time equivalent basic Agenda for Change pay in England from 1 April 2026.
They do not include overtime, unsocial-hours enhancements, London weighting, recruitment and retention payments or other local additions.
Annual NHS Pay Bands 2026/27
| 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 |
Band 1 remains closed to new entrants, meaning the active recruitment structure normally begins at Band 2.
NHS Hourly Rates 2026/27
| Band | Entry | Intermediate | 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 |
Part-time employees receive basic salary and applicable allowances on a pro-rata basis.
How Much Did Each NHS Pay Band Increase?
The cash increase depends on an employee’s band and pay point.
| Pay Point | 2025/26 | 2026/27 | Annual Increase | Gross Monthly Increase |
| Band 2 | £24,465 | £25,272 | £807 | £67.25 |
| 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 Top | £62,682 | £64,750 | £2,068 | £172.33 |
| Band 9 Top | £125,637 | £129,783 | £4,146 | £345.50 |
These monthly figures are gross amounts. They are not the amount employees will necessarily see added to their bank account.
NHS Pay Bands By Role And Years Of Experience
NHS bands reflect the skills, responsibilities and requirements attached to a role rather than simply an employee’s job title.
Typical examples include:
| Band | Examples Of Roles |
| Band 2 | Healthcare assistants, porters, domestic staff |
| Band 3 | Clinical support workers, therapy assistants |
| Band 4 | Nursing associates, assistant practitioners, pharmacy technicians |
| Band 5 | Registered nurses, paramedics, physiotherapists |
| Band 6 | Specialist nurses, experienced clinicians, team leaders |
| Band 7 | Ward managers, senior specialists, service leads |
| Band 8a | Advanced clinical and management roles |
| Band 8b–8d | Senior operational, clinical and management roles |
| Band 9 | Very senior professional and leadership roles |
These are examples rather than fixed classifications. NHS posts are evaluated according to their responsibilities, so similar job titles can sometimes sit at different bands.
How Long Does It Take To Move Through Each Band?
The annual pay award and pay progression are separate.
Under the current structure:
- Band 3: Normally reaches the top point after two years
- Band 4: Normally reaches the top point after three years
- Band 5: Intermediate point after two years and top point after a further two years
- Bands 6 To 9: Intermediate point after two years and top point after a further three years
Employees generally need to satisfy the relevant pay-step requirements. Progression should therefore not automatically be assumed solely because a certain number of years has passed.
How Much Of The NHS Pay Rise Will Staff Actually Take Home?
A 3.3% increase in gross salary does not translate into a 3.3% increase in net pay.
Income Tax, National Insurance and NHS Pension contributions reduce the amount ultimately received.
For illustration, a Band 5 employee moving from £31,049 to £32,073 gains £85.33 a month before deductions.
Using standard tax and National Insurance assumptions and NHS Pension contributions, the increase could be closer to roughly £56 a month in take-home pay for an employee with a standard tax position.
Illustrative examples are:
| Example | Gross Monthly Increase | Approximate Increase After Tax, NI And Pension |
| Band 5 Entry | £85.33 | Around £56 |
| Band 6 Entry | £106.42 | Around £68 |
| Band 7 Entry | £131.42 | Around £84 |
These are estimates rather than payslip calculations. Student loans, overtime, salary sacrifice, tax codes, part-time hours and other deductions can change the result significantly.
Does The NHS Pay Rise Affect Pension Contributions?
Potentially. NHS Pension Scheme contribution percentages did not simply increase by 3.3%. Instead, contribution rates depend on the employee’s actual annual pensionable pay.
The 2026/27 contribution thresholds are: NHS Pension Scheme contribution rates
| Annual Pensionable Pay | Contribution Rate |
| Up To £13,259 | 5.2% |
| £13,260 To £28,854 | 6.5% |
| £28,855 To £35,155 | 8.3% |
| £35,156 To £52,778 | 9.8% |
| £52,779 To £67,668 | 10.7% |
| £67,669 And Above | 12.5% |
An employee whose salary crosses a pension threshold may therefore move into another contribution tier.
For example, a Band 5 starter on £32,073 falls within the 8.3% tier, while a Band 6 starter on £39,959 falls within the 9.8% tier.
How Does NHS Pay Progression Work?
Pay progression means moving to another pay point within the same NHS band.
It is different from receiving the annual NHS pay award.
The 3.3% award increased the value of existing pay points for all eligible staff. Progression can produce an additional increase when the employee becomes eligible to move to the next point.
Employers can apply conditions connected with:
- Appraisals
- Mandatory Training
- Performance Requirements
- Professional Registration Where Relevant
- Local Pay-Step Procedures
Staff approaching a pay-step date should check their employment record and local HR process.
What Happens To Pay When NHS Staff Move To A Higher Band?
Moving to a higher band is a promotion or rebanding issue rather than ordinary pay progression.
For example, the top of Band 5 is £39,043, while Band 6 starts at £39,959.
Employees should not assume that promotion always means simply moving from their current salary to the first listed point in the higher band. Agenda for Change promotion rules and the employee’s existing salary position can affect how the new rate is calculated.
This is particularly important where neighbouring pay bands have relatively small differences between their upper and lower pay points.
Does the 3.3% Rise Increase Overtime And Unsocial-Hours Pay?
The pay award increases basic Agenda for Change rates.
Where overtime or an unsocial-hours enhancement is calculated using an employee’s basic hourly rate, an increase in that underlying rate can also raise the cash amount received for qualifying shifts.
Staff may receive additional payments for:
- Night Shifts
- Saturday Work
- Sunday Work
- Bank Holidays
- Overtime
- On-Call Arrangements
The exact enhancement depends on Agenda for Change terms and the employee’s working arrangements.
How Much Will NHS Staff Earn In London In 2026/27?
Qualifying NHS employees working in London and some surrounding areas can receive a Higher Cost Area Supplement on top of their basic salary.
The 2026/27 rates are:
| Area | Rate | Minimum | Maximum |
| Inner London | 20% | £5,794 | £8,746 |
| Outer London | 15% | £4,870 | £6,137 |
| Fringe | 5% | £1,346 | £2,270 |
The minimum and maximum caps mean the supplement cannot always be calculated simply by multiplying the employee’s salary by 20%, 15% or 5%.
For example, a Band 5 starter can receive total basic salary plus HCAS of approximately:
- Inner London: £38,488
- Outer London: £36,943
- Fringe: £33,677
Eligibility depends on the employee’s work location and the official geographical boundaries.
Does The NHS Pay Rise Apply Across The UK?
No. NHS salary arrangements are not identical across all four nations.
England
Agenda for Change staff in England received the 3.3% consolidated increase from 1 April 2026.
The salary tables above are England rates.
Wales
Wales also accepted a 3.3% consolidated uplift from 1 April 2026.
However, additional arrangements for lower-paid employees connected with Real Living Wage commitments mean some staff may receive a different effective increase.
Scotland
Scotland has a separate two-year NHS pay settlement.
Agenda for Change pay increased by 3.75% from 1 April 2026, so employees should use the Scottish pay tables rather than applying 3.3% to England’s figures.
Northern Ireland
Northern Ireland operates its own Health and Social Care implementation process.
The NHS Pay Review Body recommended the same core 3.3% uplift for Agenda for Change staff, but employees should use current Department of Health guidance rather than assuming England’s salary table applies automatically.
How Does The 2026/27 NHS Pay Rise Compare With Previous Years?
The headline Agenda for Change award has reduced from the larger percentage increases made during the previous two pay rounds.
| Pay Year | Headline Agenda For Change Award In England |
| 2024/25 | 5.5% |
| 2025/26 | 3.6% |
| 2026/27 | 3.3% |
However, percentages alone do not show the full effect of NHS pay changes.
Employees may also be affected by progression, promotions, pension thresholds, local allowances and potential future structural reforms.
How Have NHS Unions Responded To The 2026/27 Pay Award?
Health unions have argued that the headline pay award does not resolve deeper problems within Agenda for Change.
Concerns raised during the 2026 pay debate have included:
- Pay Compression Between Bands
- Low Pay At The Bottom Of The Structure
- Limited Financial Rewards For Progression
- Recruitment And Retention Pressures
- Graduate Starting Pay
- Longer-Term Pay Erosion
The focus has increasingly moved from the 3.3% headline award, which has already been implemented, to the promised reform of the wider salary structure.
Latest Agenda For Change Pay Reform Update – September 2026
Agenda for Change reform remains one of the most important outstanding NHS pay issues.
Discussions were intended to consider improvements such as higher pay for the lowest-paid employees, better graduate starting salaries and larger differences between pay points.
However, the process has not yet produced a final new pay structure.
On 11 September 2026, fourteen NHS unions representing more than 1.2 million health workers called for the discussions to regain momentum, saying progress had stalled.
That is the unions’ assessment of negotiations rather than confirmation that an additional pay settlement has been agreed.
Could Further NHS Pay Increases Be Backdated?
Potentially. The structural reform process has included proposals for agreed improvements to take effect from 1 April 2026, meaning some staff could eventually receive additional backdated pay if a settlement is reached.
However, employees should distinguish between:
Confirmed Pay: The 3.3% headline award already implemented.
Possible Additional Pay: Changes resulting from Agenda for Change restructuring.
No specific additional percentage or new salary table should be treated as guaranteed until a formal agreement is published.
What Should NHS Staff Check On Their Payslip?
Employees checking whether their 2026/27 pay is correct should review:
- Agenda For Change Band
- Current Pay Point
- Basic Salary
- Contracted Hours
- Hourly Rate
- London Weighting Where Applicable
- Overtime Payments
- Unsocial-Hours Enhancements
- Pension Contributions
- Income Tax
- National Insurance
- Student Loan Deductions
- Salary Sacrifice
- Local Allowances
- Recruitment And Retention Payments
The basic salary should be compared with the relevant official pay point rather than simply comparing total monthly take-home pay.
Additional shifts and deductions can make two payslips look very different even when the correct 3.3% basic-pay increase has been applied.
What Happens Next For NHS Pay After 2026/27?
The main NHS pay rise 2026/27 has already been decided and implemented.
The major unresolved issue is Agenda for Change structural reform.
Future developments could include changes intended to:
- Increase Pay At Lower Bands
- Improve Graduate Starting Salaries
- Reduce Pay Compression
- Make Progression More Valuable
- Support Recruitment And Retention
The next annual pay round will also determine the headline Agenda for Change award for 2027/28.
Until either process produces a formal announcement, employees should be cautious about reports suggesting that another specific NHS pay rise has already been agreed.
Conclusion
The confirmed NHS pay rise 2026/27 for Agenda for Change staff in England is 3.3%, effective from 1 April 2026.
That puts basic annual salaries at £25,272 for Band 2, £32,073 for a Band 5 starter, £39,959 for a Band 6 starter and up to £129,783 at the top of Band 9.
The headline increase has already been implemented, but that is not the end of the NHS pay story for 2026.
Agenda for Change structural reform remains unresolved, with unions calling in September for negotiations to regain momentum.
Any resulting improvement could potentially affect some employees retrospectively from April 2026, but no additional salary increase should be treated as confirmed until a final agreement is published.
Frequently Asked Questions
What Is The Confirmed NHS Pay Rise For 2026/27?
Agenda for Change staff in England received a 3.3% consolidated increase from 1 April 2026.
Was The NHS Pay Rise Paid In April 2026?
Yes. Eligible Agenda for Change staff paid through the standard NHS payroll system generally received the updated rates in April 2026.
Will The NHS Pay Rise Be Backdated?
The headline 3.3% award applied from 1 April and was implemented in April. Separate Agenda for Change structural reforms could potentially produce further backdated changes if an agreement is reached.
What Is The Band 5 NHS Salary For 2026/27?
Band 5 pay in England ranges from £32,073 at entry to £39,043 at the top pay point.
What Is The Band 6 NHS Salary For 2026/27?
Band 6 pay ranges from £39,959 at entry to £48,117 at the top pay point in England.
Does The NHS Pay Rise Affect Pension Contributions?
It can. NHS Pension contributions depend on actual annual pensionable pay, so a salary increase can move an employee into another contribution threshold.
Will NHS Staff Receive Another Pay Increase In 2026/27?
No additional universal percentage increase has been confirmed. Separate Agenda for Change structural reform could produce further changes for some staff, but negotiations have not yet produced a final settlement.
