If you work for the NHS in England, your salary is almost certainly set by a single national framework called Agenda for Change (AfC). It covers more than a million staff — nurses, healthcare assistants, paramedics, physiotherapists, pharmacists, administrators, cleaners, scientists and managers — everyone except doctors, dentists and very senior managers. Whether you are deciding to join the NHS, weighing up a promotion from Band 5 to Band 6, or simply trying to understand why your take-home pay looks the way it does, the starting point is your band and your pay step.
This guide sets out the full Agenda for Change pay scales for 2026/27, which took effect on 1 April 2026 following the government's pay award. We cover every band from 2 to 9, the extra payments for working in and around London, how the NHS Pension Scheme affects your pay packet, and a worked example showing exactly how a Band 5 nurse's monthly payslip is built up. Every figure below is taken from the official NHS Employers and NHS Business Services Authority (NHSBSA) tables and labelled with its source.
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How Agenda for Change works
Agenda for Change is the national pay system for the bulk of NHS staff, agreed through the NHS Staff Council. Two things decide what you are paid:
- Your band (2 to 9). Every NHS role is matched to a band through a job-evaluation process that scores the job on factors such as knowledge, responsibility, physical effort and working conditions. The band reflects the demands of the job, not the individual doing it.
- Your step point within the band. Each band (other than Band 2) contains two or three step points. You start at the entry step and move up after a fixed number of years, provided you meet the standards in your appraisal. Once you reach the top step, your basic pay only changes when the national pay award is applied.
Band 1 is now closed to new entrants — its work has been absorbed into Band 2 — so in practice the lowest band you will be appointed to is Band 2.
The scales below are the England rates. Scotland, Wales and Northern Ireland negotiate their own Agenda for Change pay scales, which differ in both the headline rates and the timing of awards. If you work outside England, check your country's own published scales (see the action checklist at the end).
NHS pay bands 2026/27: full pay scales
The table below shows the basic full-time annual salary for every Agenda for Change band, from the entry step to the top of the band, for 2026/27 (effective 1 April 2026). These are the standard rates before any London weighting, unsocial-hours enhancements or pension deductions.
| Band | Entry step | Intermediate step | Top of band |
|---|---|---|---|
| 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 |
Source: NHS Employers, "Pay scales for 2026/27". Bands 2 to 4 have entry and top steps only; Bands 5 to 9 have an additional intermediate step. Band 2 has a single rate. Figures effective from 1 April 2026.
For context, the previous year's 2025/26 scales (1 April 2025 to 31 March 2026) ran lower — for example, Band 5 started at £31,049 and topped out at £37,796, and Band 6 ran from £38,682 to £46,580 (Source: NHS Employers, "Pay scales for 2025/26"). The 2026/27 figures above reflect the 3.3% award applied from April 2026 and are the latest officially published scales at the time of writing. There is no further AfC award published beyond 2026/27; the next year's rates will be confirmed once the government responds to the NHS Pay Review Body, usually in spring or summer. We will update this guide when those figures are released — we do not publish unconfirmed numbers.
High Cost Area Supplements (London weighting)
Staff working in and around London receive an extra payment on top of basic pay, called a High Cost Area Supplement (HCAS). There are three zones, each paying a percentage of basic salary within a floor and a ceiling:
| Zone | Percentage of basic pay | Minimum payment | Maximum payment |
|---|---|---|---|
| Inner London | 20% | £5,794 | £8,746 |
| Outer London | 15% | £4,870 | £6,137 |
| Fringe | 5% | £1,346 | £2,270 |
Source: NHS Employers, "Pay scales for 2026/27", HCAS rates effective 1 April 2026.
In practice this means a Band 5 nurse at the entry step (£32,073) working in Inner London receives 20% on top, subject to the minimum and maximum — taking the total to £38,488 a year (Source: NHS Employers, 2026/27 HCAS inner table). A worker at the top of Band 8d in Inner London is capped by the £8,746 maximum, so the supplement does not keep rising indefinitely with salary. Whether your post attracts a supplement depends on where your base is — your contract or HR team can confirm your zone.
Unsocial hours and Section 2 enhancements
Basic pay is only part of the picture for staff who work nights, weekends and bank holidays. Under Section 2 of the NHS terms and conditions, eligible staff in Bands 1 to 9 receive enhanced rates for working unsocial hours. The percentage uplift is applied to your basic hourly rate for the hours that qualify:
- Saturdays (midnight to midnight), and any weekday after 8pm or before 6am: time plus 30% (for most bands).
- Sundays and public holidays (midnight to midnight): time plus 60% (for most bands).
Lower-banded staff (Bands 1 to 3) can receive higher percentages under transitional arrangements in some cases, and the rules on what counts as an unsocial hour are detailed — they are set out in Section 2 of the NHS Terms and Conditions of Service Handbook (Source: NHS Employers, NHS Terms and Conditions of Service Handbook). These enhancements can add a meaningful amount to monthly pay for staff on rotating shift patterns, and they are pensionable and taxable in the normal way.
The NHS Pension Scheme
Almost all AfC staff are automatically enrolled in the NHS Pension Scheme (2015 Scheme), a defined-benefit, career-average revalued earnings (CARE) scheme. Rather than depending on stock-market returns, it builds you a guaranteed pension based on a fraction (1/54th) of your pensionable pay each year, revalued for inflation. It is widely regarded as one of the most valuable parts of NHS reward.
What you pay is tiered — the higher your pensionable pay, the higher the percentage you contribute. The member contribution rates from 1 April 2026 are:
| Pensionable pay range | Member 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% |
Source: NHSBSA, "Cost of being in the Scheme", rates effective 1 April 2026.
Two points worth noting. First, your contribution percentage is based on your actual annual pensionable pay, so a pay rise or a promotion that pushes you into a higher band may also move you into a higher contribution tier. Second, your contributions attract tax relief, so the real cost to you is lower than the headline percentage.
What your employer pays is far more. The employer contribution rate is 23.7% of pensionable pay (with a further amount collected centrally), so for every pound you contribute, your trust contributes a great deal more on your behalf (Source: NHSBSA, NHS Pension Scheme employer contributions).
How an NHS payslip reads: a worked Band 5 nurse example
Let us walk through a realistic monthly payslip for a Band 5 nurse at the entry step, on the 2026/27 scale of £32,073 a year, working outside London (no HCAS) and ignoring any unsocial-hours enhancements for simplicity. The figures below are illustrative, rounded, and based on standard 2025/26 income-tax and National Insurance thresholds for England; your own payslip will vary with your tax code, overtime and shift premia.
Annual basic pay of £32,073 is £2,672.75 a month gross. From that:
- Pension contribution. At £32,073, this nurse falls in the 8.3% tier, so the monthly pension deduction is roughly £32,073 × 8.3% ÷ 12 ≈ £221.84. This is taken before tax, reducing taxable pay.
- Income tax. With the standard 1257L tax code, the first £12,570 of annual pay is tax-free. Because pension contributions are deducted before tax, tax is charged on roughly £32,073 − £12,570 personal allowance − £2,662 pension ≈ £16,841 at 20%, giving about £3,368 a year, or roughly £280.70 a month.
- National Insurance. Employee NI is charged at 8% on earnings between the primary threshold (£12,570 a year) and the upper earnings limit. On £32,073 that is about 8% of £19,503 ≈ £1,560 a year, or roughly £130.03 a month.
Putting it together:
| Item | Monthly amount |
|---|---|
| Gross basic pay | £2,672.75 |
| Less: NHS pension (8.3%) | −£221.84 |
| Less: Income tax (code 1257L) | −£280.70 |
| Less: National Insurance | −£130.03 |
| Net (take-home) pay | ≈ £2,040.18 |
Illustrative only. Basic-pay figure from NHS Employers 2026/27 scales; pension tier from NHSBSA; tax and NI based on standard UK thresholds. Use the PayslipIQ checker with your own payslip to confirm your exact figures.
Tax code notes
Most NHS staff with a single job and no taxable benefits have the standard tax code 1257L, which gives the full £12,570 personal allowance spread evenly across the year. Watch for these common situations:
- A code ending in W1 or M1 (week 1 / month 1) means tax is calculated on each pay period in isolation — common when you start a new NHS post. It usually corrects itself once your full record reaches the trust's payroll.
- A BR code taxes all of that income at the basic rate with no personal allowance — normal for a second job or bank shifts paid under a separate assignment.
- A K code means deductions exceed your allowance (for example, an underpayment being collected), increasing the tax taken.
If your code looks wrong, check your Personal Tax Account on GOV.UK and contact HMRC — your trust's payroll team applies whatever code HMRC issues but cannot change it themselves.
Pay progression: Band 5 to Band 6 to Band 7
Career progression in the NHS usually means moving up a band, and the financial step can be significant. Using the 2026/27 entry-step rates:
| Move | From (entry) | To (entry) | Annual uplift |
|---|---|---|---|
| Band 5 → Band 6 | £32,073 | £39,959 | +£7,886 |
| Band 6 → Band 7 | £39,959 | £49,387 | +£9,428 |
| Band 5 → Band 7 | £32,073 | £49,387 | +£17,314 |
Source: NHS Employers, "Pay scales for 2026/27".
A nurse who joins at Band 5, develops into a senior or specialist Band 6 role, and then progresses to a Band 7 team-leader or advanced-practice post would see basic pay rise by more than £17,000 a year over that journey — before counting step progression within each band, London weighting or unsocial-hours pay. Remember that each move may also change your pension contribution tier.
Action checklist
- Confirm your band and step. Check your contract or payslip, and ask HR if you are unsure which step you are on or when you are due to progress.
- Use the official 2026/27 tables. Compare your basic pay against the NHS Employers pay scales — the only definitive source for England.
- Check your London zone. If you work in or near London, confirm whether you qualify for Inner, Outer or Fringe HCAS.
- Review your pension tier. A pay rise can move you into a higher contribution band — see the NHSBSA contributions page.
- Verify your tax code in your GOV.UK Personal Tax Account.
- If you work in Scotland, Wales or NI, use your nation's own published Agenda for Change scales rather than the England figures here.
- Run your payslip through the PayslipIQ checker to confirm your deductions line up.
Disclaimer
This guide is for general educational purposes only and is not regulated financial, tax or pensions advice. Pay scales, pension rules and tax thresholds change, and individual circumstances vary. The worked example uses rounded, illustrative figures and standard assumptions. For decisions about your own pay, pension or tax, refer to the official sources — NHS Employers, NHS Pensions / NHSBSA, GOV.UK and your trust's payroll or HR team — and consider speaking to your trade union or a qualified adviser.
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Check My Payslip FreePayslipIQ provides educational information and estimated calculations only. It does not provide tax, legal, financial, payroll, accounting, pension, benefits or employment advice. Always verify your payslip, tax code, deductions and take-home pay with your employer's payroll department, HMRC, your pension provider, a qualified accountant, tax adviser or another appropriately qualified professional.
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