Registered nurses in the NHS are paid under Agenda for Change (AfC), a nationally agreed pay structure that runs from Band 5 (newly qualified staff nurse) through Band 7 (Ward Sister, Charge Nurse, Advanced Nurse Practitioner). Working out actual take-home is more involved than most professions because the NHS Pension is a tiered contribution deducted before pay, London High Cost Area Supplements add a significant uplift, and unsocial hours enhancements are pensionable. This guide sets out the 2024/25 AfC pay points (the most recently confirmed scales), the NHS Pension tier rates, and estimated monthly take-home after Income Tax, National Insurance and NHS Pension for 2026/27. For your personal figure, use the calculators linked below.
AfC Pay Scales -- Band 5, 6 and 7 2026/27
Agenda for Change 2024/25 pay points for England. NHS Scotland and NHS Wales use separate scales. Progression is via annual spine point increments within each band.
Band
Typical roles
Pay range
NHS Pension tier
Notes
Band 5 -- entry
Newly Qualified Nurse / Staff Nurse
£29,970 -- £36,483
9.8%
Most NQNs start at GBP29,970; London adds up to 20%
Band 6 -- senior
Senior Staff Nurse / Specialist Nurse
£37,338 -- £44,962
9.8%
Requires demonstrable clinical expertise or team lead responsibility
GBP52,809 top point crosses into 10.7% pension tier
Source: NHS England Agenda for Change 2024/25 pay circulars. The 2025/26 award is subject to the NHS Pay Review Body recommendation and government response, expected spring 2025. Figures on this page use 2024/25 points pending confirmation of any uplift.
Take-Home Pay -- England (Outside London) 2026/27
2026/27 England income tax and NI rates. NHS Pension contribution deducted from gross before income tax (reducing taxable income). No student loan or salary sacrifice applied. All figures are estimates.
Pay point
Gross
NHS Pension
Income tax
NI
Net/year
Net/month
Band 5 entry
£29,970
£2,488
£2,982
£1,392
£23,108
£1,926/mo
Band 5 mid
£33,161
£3,250
£3,468
£1,647
£24,796
£2,066/mo
Band 5 top
£36,483
£3,575
£4,068
£1,913
£26,927
£2,244/mo
Band 6 entry
£37,338
£3,659
£4,222
£1,981
£27,476
£2,290/mo
Band 6 mid
£41,210
£4,039
£4,920
£2,291
£29,960
£2,497/mo
Band 6 top
£44,962
£4,406
£5,597
£2,591
£32,367
£2,697/mo
Band 7 entry
£46,148
£4,523
£5,811
£2,686
£33,128
£2,761/mo
Band 7 top
£52,809
£5,651
£6,918
£3,067
£37,174
£3,098/mo
NI is calculated on gross pay (not post-pension pay), as employee NI is assessed before pension sacrifice in most NHS trust payroll arrangements. Check your payslip for your exact arrangement.
Take-Home Pay -- Inner London (20% Supplement) 2026/27
Inner London High Cost Area Supplement of 20% of basic pay (minimum GBP4,551, maximum GBP7,994 for 2024/25) added before all deductions. The supplement is pensionable under NHS Pension rules.
Pay point
London gross
NHS Pension
Income tax
NI
Net/year
Net/month
Band 5 entry
£35,964
£3,524
£3,974
£1,872
£26,594
£2,216/mo
Band 5 mid
£39,793
£3,900
£4,665
£2,178
£29,051
£2,421/mo
Band 5 top
£43,780
£4,290
£5,384
£2,497
£31,609
£2,634/mo
Band 6 entry
£44,806
£4,391
£5,569
£2,579
£32,267
£2,689/mo
Band 6 mid
£49,452
£5,291
£6,318
£2,951
£34,892
£2,908/mo
Band 6 top
£53,954
£5,773
£7,122
£3,090
£37,969
£3,164/mo
Band 7 entry
£55,378
£5,925
£7,377
£3,118
£38,958
£3,246/mo
Band 7 top
£63,371
£7,921
£9,612
£3,278
£42,560
£3,547/mo
Fringe zone supplement is 5% of basic pay (minimum GBP1,136, maximum GBP2,011). If you are on a fringe contract, apply the calculator below with your actual gross including supplement.
Part-Time Nursing -- Pro-Rata Pay and Tax
NHS part-time contracts are expressed as a whole-time equivalent (WTE) fraction. A Band 5 nurse on 0.8 WTE (30 hours per week out of 37.5) earns 80% of the full-time pay: GBP29,970 x 0.8 = GBP23,976. The tax and NI calculation uses the actual annual pay, but NHS Pension tier contributions are assessed on the full-time equivalent rate -- so a 0.8 WTE Band 5 nurse still contributes at the 9.8% tier rather than moving into a lower tier.
WTE / Hours
Annual gross
NHS Pension (9.8%)
Income tax
NI
Net/month
1.0 WTE (37.5 hr)
£29,970
£2,937
£2,893
£1,392
£1,896/mo
0.8 WTE (30 hr)
£23,976
£2,350
£1,811
£912
£1,575/mo
0.6 WTE (22.5 hr)
£17,982
£1,762
£730
£433
£1,255/mo
0.5 WTE (18.75 hr)
£14,985
£1,469
£189
£193
£1,094/mo
Based on Band 5 entry point GBP29,970 full-time. Pension assessed at 9.8% on actual pay for simplicity (NHS rules use WTE pensionable pay to determine tier but deduct 9.8% of actual pay received).
Agency Nursing vs Band Employment -- The Tax Reality
Agency nursing often quotes attractive hourly rates -- GBP20--GBP40+ for a registered nurse versus the Band 5 employed rate of roughly GBP15.36/hr. The tax treatment, however, erodes much of the difference:
--PAYE as normal: whether through a recruitment agency or an umbrella company, agency nurses pay income tax and NI at exactly the same rates as directly employed nurses. There is no self-employed tax treatment for nursing locum work.
--Umbrella employer NI: umbrella companies must pay employer NI (15% above GBP5,000 secondary threshold from April 2025) from the rate before passing pay on. On GBP30/hr, this deduction alone reduces what reaches your payslip by roughly GBP3--GBP4/hr.
--No NHS Pension: agency nurses do not accrue NHS Pension benefits. The NHS defined benefit pension is worth a significant percentage of pay in employer value -- often cited at 20%+ of salary. Losing this contribution is a major cost of agency working.
--No AfC increments: Band employment accrues annual spine point progression worth GBP1,000--GBP2,000 per year through the band range. Agency work provides no incremental pay progression.
--Holiday pay included (or not): holiday pay for agency workers is typically rolled up into the hourly rate. A headline rate of GBP30/hr may include 12.07% holiday pay; the effective working rate is therefore closer to GBP26.78/hr. Check whether your rate is inclusive or exclusive.
Rule of thumb: an agency rate needs to be roughly 30--40% higher than the equivalent Band gross rate to match the total remuneration (including NHS Pension value and AfC progression) of directly employed nursing. Many nurses use agency work strategically for flexibility rather than as a route to significantly higher take-home.
NHS Pension -- Member Contribution Tiers for Nurses
The NHS Pension Scheme is a defined benefit (career average revalued earnings) scheme. Member contributions are tiered by whole-time equivalent pensionable pay and are deducted before income tax, reducing your taxable income. The 2025/26 contribution table is:
WTE pensionable pay
Contribution rate
Typical Band
Up to GBP13,246
5.2%
Part-time Band 2/3
GBP13,247 -- GBP26,831
6.5%
Part-time Band 5 / Band 3-4
GBP26,832 -- GBP32,691
8.3%
Band 4 / lower Band 5
GBP32,692 -- GBP49,078
9.8%
Band 5 full / Band 6 / Band 7 entry
GBP49,079 -- GBP62,924
10.7%
Band 7 top / Band 8a
GBP62,925 -- GBP84,798
12.5%
Band 8b/c
Above GBP84,799
13.5%
Band 8d / Band 9
Employer contributions are currently 23.7% of pensionable pay -- a substantial addition to the package cost that is invisible to take-home pay but represents significant pension accrual. The NHS Pension is widely considered one of the most valuable occupational pension schemes in the UK. Opting out removes both the member contribution (increasing immediate take-home) and all pension accrual -- most financial planners strongly advise against opting out unless in severe financial difficulty.
Marginal Tax Rates for Nurses 2026/27
Understanding marginal rates helps when considering overtime, bank shifts or pay rises. The table below shows the combined income tax and NI rate on each additional pound earned (England, excluding pension contributions which are pre-tax).
Income range
IT rate
Employee NI
Combined marginal
Relevant for nurses
Up to GBP12,570
0%
0%
0%
Part-time only
GBP12,570 -- GBP50,270
20%
8%
28%
Band 5 / 6 / 7 entry
GBP50,270 -- GBP100,000
40%
2%
42%
Band 7 top w/ London / Band 8+
GBP100,000 -- GBP125,140
40% + PA taper
2%
62%
Band 8c/d and above
Above GBP125,140
45%
2%
47%
Very senior nursing leadership
The 62% effective marginal rate between GBP100,000 and GBP125,140 arises because the Personal Allowance (GBP12,570) is tapered away at GBP1 per GBP2 of income above GBP100,000. Few nurses encounter this trap unless they have multiple income sources, but Band 8c/d roles with London supplements can approach it. Pension contributions are one of the most efficient tools to bring income below GBP100,000.
NHS Scotland -- Different Pay and Different Tax
Nurses employed by NHS Scotland face a double difference from their English counterparts: NHS Scotland AfC pay scales have been set above England rates following separate pay negotiations, and Scottish Income Tax has six bands compared with three in England and Wales.
Scottish IT for 2026/27: Starter 19% (GBP12,570--GBP16,536); Basic 20% (GBP16,537--GBP29,525); Intermediate 21% (GBP29,526--GBP43,661); Higher 42% (GBP43,662--GBP75,000); Advanced 45% (GBP75,001--GBP125,140); Top 48% above GBP125,140. A Band 5 nurse on GBP30,000 in Scotland pays approximately GBP3,490 income tax versus GBP2,886 in England (difference of around GBP600/yr) due to the 21% Intermediate rate applying to income above GBP29,525. Use our Scottish Income Tax calculator for Scottish figures.
Student Loan Repayments for Nurses
Most registered nurses in England qualified after 2017 and are on Plan 2 student loans (threshold GBP28,470, repayment 9% of income above). The nursing bursary was reintroduced from 2020 alongside loans, so many nurses have both a maintenance loan and a tuition fee loan. A Band 5 entry nurse on GBP29,970 repays 9% of (GBP29,970 - GBP28,470) = GBP135 per year (GBP11/month). At Band 6 top (GBP44,962), repayments are 9% of (GBP44,962 - GBP28,470) = GBP1,484/yr (GBP124/month).
Nurses who started their degree before 2012 may be on Plan 1 (threshold currently GBP24,990). Post-2023 starters are likely on Plan 5 (threshold GBP25,000, 40-year repayment window). Check your Welcome to Repayment letter for your plan type. Use the student loan repayment calculator to model your repayments alongside take-home.
Frequently Asked Questions
Frequently Asked Questions
How much does a registered nurse take home per month in 2026/27?
A Band 5 newly qualified nurse on the entry point of GBP29,970 takes home approximately GBP1,928 per month after income tax, employee NI and the 7.1% NHS Pension contribution. At the top of Band 5 (GBP36,483), monthly take-home rises to around GBP2,312. A Band 7 Ward Sister on GBP46,148 takes home approximately GBP2,833 per month with the 10.7% NHS Pension contribution. All figures are estimates for England -- use the linked calculators for your own circumstances.
What is the NHS Pension contribution for Band 5, 6 and 7 nurses?
NHS Pension member contributions are tiered by whole-time equivalent pensionable pay. For 2025/26 and 2026/27 the relevant tiers are: up to GBP13,246 -- 5.2%; GBP13,247-GBP26,831 -- 6.5%; GBP26,832-GBP32,691 -- 8.3%; GBP32,692-GBP49,078 -- 9.8%; GBP49,079-GBP62,924 -- 10.7%; GBP62,925-GBP84,798 -- 12.5%; above GBP84,799 -- 13.5%. A Band 5 entry nurse on GBP29,970 falls in the 9.8% tier. Band 6 mid-range (GBP40,000) is also in the 9.8% tier. Band 7 entry (GBP46,148) is in the 9.8% tier; Band 7 top (GBP52,809) moves into the 10.7% tier. Contributions are made from gross pay, reducing your taxable income slightly and cutting your income tax bill.
Does the London High Cost Area Supplement make a big difference to take-home?
Yes, materially. Nurses working in inner London receive a supplement of 20% of basic salary (minimum GBP4,551, maximum GBP7,994 for 2024/25). Fringe zones carry a 5% supplement. For a Band 5 nurse on GBP29,970, inner London adds roughly GBP5,994, bringing total pay to approximately GBP35,964. After tax, NI and NHS Pension, this adds around GBP300-GBP350 per month to take-home compared with the same Band 5 role outside London. The supplement moves some nurses into a higher NHS Pension tier too.
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What are the AfC pay scales for Band 5, 6 and 7 in 2026/27?
The 2024/25 Agenda for Change pay scales (the most recently confirmed) are: Band 5 GBP29,970-GBP36,483; Band 6 GBP37,338-GBP44,962; Band 7 GBP46,148-GBP52,809. NHS England typically announces the following year award in spring; the 2025/26 and 2026/27 awards were not yet confirmed at the time of writing. Progression within a band is via spine point increments, usually one point per year until the ceiling is reached.
How does agency nursing affect take-home pay compared with Band employment?
Agency nurses (whether supplied through a recruitment agency or working via an umbrella company) are taxed as employees through PAYE -- there is no self-employed tax advantage. The headline hourly rate is typically higher than the equivalent Band rate, often GBP20-GBP40/hr or more, but agency workers receive no NHS Pension, no NHS sick pay and no AfC increments. Umbrella companies deduct employer NI (15% above GBP5,000 secondary threshold) from the rate before calculating take-home, reducing net pay significantly. Many nurses find the NHS Band employment more valuable once pension accrual is factored in.
Do nurses pay income tax on their NHS Pension contributions?
No. NHS Pension contributions are made from gross pay before income tax is applied (salary sacrifice or net pay arrangement depending on trust). This means a Band 5 nurse contributing 9.8% of GBP29,970 (about GBP2,937) reduces their taxable income to roughly GBP27,033. The income tax saving is therefore GBP2,937 at 20% = GBP587 per year compared with saving the same amount in a non-tax-advantaged account. The NHS Pension is a defined benefit (career average) scheme -- extremely valuable compared with the typical defined contribution workplace pension.
Is nurse pay different in Scotland?
Yes, in two ways. First, NHS Scotland AfC pay scales are set separately and have generally been above England rates in recent years after separate pay deals. Second, Scottish Income Tax rates differ: there are six bands from 19% Starter up to 48% Top, compared with three in England/Wales. For Band 6 and Band 7 nurses, the Intermediate rate of 21% applies to a slice of income (GBP29,526-GBP43,661), which is higher than the 20% basic rate in England. This means Scottish nurses in Band 6/7 may have slightly lower net take-home on the same gross than their English counterparts.
How does part-time nursing affect pay and tax?
Part-time nurses are paid on a pro-rata basis: a Band 5 nurse working 22.5 hours per week (0.6 WTE) on GBP29,970 full-time receives GBP17,982 per year. NHS Pension tier contributions are assessed on the full-time equivalent pay (whole-time equivalent pensionable pay), not actual hours pay, which matters when determining contribution percentages. At GBP17,982 gross, this nurse would pay no income tax (below the GBP12,570 Personal Allowance) but would pay employee NI at 8% on the slice above GBP12,570.
Can nurses reduce their tax bill through salary sacrifice?
Yes. NHS trusts often offer salary sacrifice schemes for childcare vouchers (legacy schemes), cycle to work and lease cars. Salary sacrifice reduces gross pay before income tax and NI are calculated, saving both. For example, a Band 6 nurse on GBP40,000 who sacrifices GBP1,000 for a cycle scheme saves GBP200 income tax plus GBP80 employee NI -- a GBP280 saving on a GBP1,000 bike. The NHS Pension contribution is typically assessed on post-sacrifice pay, so the pension saving slightly reduces the pension benefit but increases monthly take-home.
What is the NHS unsocial hours uplift and is it taxable?
NHS AfC includes enhanced rates for unsocial hours: Saturday plain time, evening and night enhancements, and Sunday/bank holiday double time (rates vary by band). These enhancements are part of contracted pay and are fully taxable as earnings -- they are not exempt allowances. However, they increase gross pay and therefore NHS Pension contributions (which are calculated on all pensionable pay, including enhancements). For many Band 5 nurses working shifts, unsocial hours enhancements can add GBP2,000-GBP5,000 per year to gross pay, meaningfully boosting both take-home and pension accrual.
