NHS Agenda for Change Pay 2026/27: Band 1–9 Salary Scales, Progression and Take-Home

The Agenda for Change Framework

Agenda for Change (AfC) is the pay and grading framework covering the vast majority of NHS staff: nurses, midwives, physiotherapists, radiographers, porters, care workers, administrative and clerical staff, and many allied health professionals. It was introduced in 2004 and has been updated periodically to reflect inflation, workforce needs and pay negotiations.

The framework consists of nine Bands (Band 1 through Band 9). Bands reflect the skill, responsibility and complexity of the role. Each Band is divided into pay points (typically 3 to 9 points per band), and staff normally progress one point per year if performance is satisfactory. Once at the top of their Band, staff remain on that pay point until they gain promotion to a higher Band or move into Very Senior Manager (VSM) grades.

Pay is set nationally by the Doctors' and Dentists' Review Body (DDRB) and implemented across all four UK nations, though each nation may negotiate slightly different local enhancements or supplements. The 2026/27 pay award was implemented from 1 April 2026.

2026/27 Pay Award

The 2026/27 pay award is typically a percentage increase applied to all Bands and pay points, usually linked to inflation and recommended by the Low Pay Commission and workforce advisors. The exact percentage and structure varies annually and depends on government spending, union negotiations and economic conditions.

In recent years, the NHS has sometimes implemented consolidated increases (merged into the base pay point values) and sometimes one-off non-consolidated payments or enhancements to particular bands. Check your payslip and NHS HR system for the exact rates that apply to your Band and pay point, as local employer supplements and timing of implementation may vary slightly.

The salary figures in this guide reflect typical 2026/27 AfC pay points. Actual rates may vary slightly by employer, nation (England, Scotland, Wales or Northern Ireland) and local enhancements.

Band 1–9 Salary Scales 2026/27

Below is a guide to typical 2026/27 AfC Band salaries at the entry (Point 1) and top (final point) of each Band. Intermediate points progress in steps of roughly GBP 1,000–GBP 1,500 per year depending on the Band.

These figures are approximate and based on typical 2026/27 pay scales. The exact salary for your post depends on your specific Band, pay point, employer and region. Band 2 salaries are regularly reviewed against the National Living Wage to maintain the pay hierarchy. Bands 8a and 8b do not always have fixed pay points; salaries within these bands may be negotiated individually.

Career Progression Within Bands

Each Band has a defined number of pay points. Progression from one pay point to the next typically takes one year and is based on satisfactory performance and time in post. The structure is as follows:

• Band 2: 3 pay points (progression in 2 years total)
• Band 3: 6 pay points (progression in 5 years total)
• Band 4: 6 pay points (progression in 5 years total)
• Band 5: 8 pay points (progression in 7 years total)
• Band 6: 9 pay points (progression in 8 years total)
• Band 7: 9 pay points (progression in 8 years total)
• Band 8a: 4 pay points (progression in 3 years total)
• Band 8b: 5 pay points (progression in 4 years total)
• Band 9: Normally a single salary or narrow range; limited progression

Progression is not automatic. Your employer conducts annual performance and development reviews; progression is held, delayed or accelerated based on your performance, professional development and role changes. Once you reach the top pay point of your Band, you remain there until you are promoted to a higher Band. Some staff never progress beyond Point 1 if they do not meet performance standards or choose not to seek development opportunities.

NHS Pension Contributions & Scheme

The NHS Pension Scheme is a defined benefit (final salary) scheme. Employees contribute a tiered percentage of gross pay based on annual salary, and the scheme provides a pension based on years of service and best average salary. Contribution rates for 2026/27 are:

These contributions are deducted from your gross pay, meaning you receive tax relief on the amount you contribute. For example, a Band 5 nurse earning GBP 29,970 contributes 7.4% (approximately GBP 2,218 per year). The NHS (as employer) contributes a larger amount (approximately 14% of payroll) to fund the scheme.

The NHS Pension Scheme is generally one of the most generous employer pension schemes in the UK. It provides a guaranteed pension for life, indexation (inflation protection), life and dependant benefits, and flexibility to take some pension as a lump sum at retirement. However, there are limits (the Annual Allowance and Lifetime Allowance) and higher earners may face additional tax charges. Understand your pension benefits by reading the scheme guides available from NHS Pension Scheme official site.

London Weighting & High Cost Area Supplement

To reflect the higher cost of living and housing in certain areas, the NHS pays location-based supplements:

London Weighting (London Fringe & Central): All staff working in the London area receive a percentage supplement. The exact rate varies by postcode area (Central London, Inner Fringe, Outer Fringe) and is updated periodically. In 2026/27, the supplement ranges from approximately 5% to 10% depending on location within Greater London. For example, a Band 5 nurse earning GBP 29,970 in Inner Fringe London would receive approximately GBP 2,247 extra per year (7.5% supplement).

High Cost Area Supplement (HCAS): Staff working in other high-cost areas outside London (such as parts of the South East, South West and East England) may qualify for a smaller supplement. Check with your NHS employer whether your post is eligible.

These supplements are part of your gross salary for tax, National Insurance and pension purposes. If you relocate (e.g. move house out of London), your eligibility may change; check your contract and notify your HR department.

Part-Time Proration

Part-time NHS staff receive a salary pro-rated according to their contracted hours. The calculation is simple: your Band point salary is multiplied by your contracted hours divided by full-time hours. Full-time NHS contracts are typically 37.5 hours per week.

Example:

A Band 5 nurse on full-time hours (37.5 per week) at Point 1 earns GBP 29,970. If the same nurse works 25 hours per week (66.7% part-time), their annual salary would be GBP 29,970 × 0.667 = approximately GBP 19,980.

Progression: Part-time staff normally progress through pay points at the same rate as full-time staff (one point per year of satisfactory service), though some employers use "earning progression" based on hours worked. Confirm your progression basis with your HR department.

Flexible working and part-time roles are increasingly encouraged in nursing and allied health to support work--life balance and retention, especially for parents and carers. There is a legal right to request flexible working, though employers can refuse on business grounds.

Unsocial Hours & On-Call Pay

Many NHS staff work unsocial hours (evenings, nights, weekends, Bank Holidays). Unsocial hours supplements are paid as percentage additions to your base Band salary, depending on the hours and shifts you work. These vary by employer and role but are typically:

• Saturday/Sunday enhancements: typically 10%–30% of your hourly rate depending on the role and agreement
• Night shift premiums: typically 15%–30% of your hourly rate for hours between (e.g.) 22:00 and 06:00
• Bank Holiday pay: typically double time or time and a half, plus any unsocial hours enhancements

On-call pay: Some roles, especially senior or emergency positions, require on-call availability. On-call time is typically paid at a lower rate (e.g. 10%–20% of your hourly rate) if you are not actively required to work but must be available. If called in, you then receive your normal hourly rate for hours worked.

All unsocial hours premiums and on-call pay are taxable income and count towards your gross pay for National Insurance, tax codes and pension contribution purposes. Check your contract and payslip for the exact rules at your employer.

Take-Home Pay Examples

Below are approximate take-home pay examples for Band 2, Band 5 and Band 7 in 2026/27, assuming standard tax codes, no student loans or other deductions. Actual pay varies by pension membership, tax code, allowances and region (London weighting, etc.).

Important: These examples assume standard tax relief and do not include student loan repayments, salary sacrifice for childcare or other voluntary deductions. Use the take-home pay calculator for your exact circumstances. If you are in London, add your London weighting supplement (5%–10%) to the gross figure.

Official References

• NHS Confederation: Agenda for Change pay scales
• NHS Business Services Authority: Pension Scheme details
• gov.uk: Doctors' and Dentists' Review Body (DDRB) pay recommendations
• NHS England HR resources