NHS Agenda for Change Pay Scales 2026/27 — England
The following pay scales apply to all NHS Agenda for Change staff in England, Wales, and Northern Ireland from 1 April 2026. These figures include the 3.3% pay rise.
Band 2 — Healthcare Assistants, Porters
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £23,615 | £1,968 |
| Point 2 | £24,336 | £2,028 |
Band 3 — Senior HCAs, Healthcare Support Workers
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £24,336 | £2,028 |
| Point 2 | £25,674 | £2,140 |
Band 4 — Assistant Practitioners
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £26,530 | £2,211 |
| Point 2 | £27,596 | £2,300 |
| Point 3 | £28,407 | £2,367 |
| Point 4 | £29,114 | £2,426 |
Band 5 — Newly Qualified Nurses, AHPs, Midwives
| Spine Point | Annual Salary | Monthly Gross | Approx Take Home* |
|---|---|---|---|
| Point 1 (Starting) | £30,049 | £2,504 | £1,932 |
| Point 2 | £31,049 | £2,587 | £1,989 |
| Point 3 | £32,073 | £2,673 | £2,046 |
| Point 4 | £33,122 | £2,760 | £2,104 |
| Point 5 | £34,196 | £2,850 | £2,163 |
| Point 6 | £35,307 | £2,942 | £2,223 |
| Point 7 | £36,483 | £3,040 | £2,285 |
Band 6 — Senior Nurses, Specialist AHPs
| Spine Point | Annual Salary | Monthly Gross | Approx Take Home* |
|---|---|---|---|
| Point 1 (Starting) | £36,483 | £3,040 | £2,285 |
| Point 2 | £37,846 | £3,154 | £2,362 |
| Point 3 | £39,274 | £3,273 | £2,442 |
| Point 4 | £40,768 | £3,397 | £2,524 |
| Point 5 | £42,121 | £3,510 | £2,601 |
| Point 6 | £43,151 | £3,596 | £2,657 |
| Point 7 | £44,608 | £3,717 | £2,738 |
Band 7 — Advanced Practitioners, Ward Managers
| Spine Point | Annual Salary | Monthly Gross | Approx Take Home* |
|---|---|---|---|
| Point 1 (Starting) | £44,608 | £3,717 | £2,738 |
| Point 2 | £46,187 | £3,849 | £2,827 |
| Point 3 | £47,840 | £3,987 | £2,919 |
| Point 4 | £49,575 | £4,131 | £3,010 |
| Point 5 | £51,418 | £4,285 | £3,104 |
| Point 6 | £53,134 | £4,428 | £3,192 |
Band 8a — Nurse Consultants, Modern Matrons, Senior Managers
| Spine Point | Annual Salary | Monthly Gross | Approx Take Home* |
|---|---|---|---|
| Point 1 (Starting) | £53,134 | £4,428 | £3,192 |
| Point 2 | £55,225 | £4,602 | £3,303 |
| Point 3 | £57,477 | £4,790 | £3,421 |
| Point 4 | £60,504 | £5,042 | £3,582 |
Band 8b — Senior Managers
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £62,970 | £5,248 |
| Point 2 | £66,065 | £5,505 |
| Point 3 | £69,297 | £5,775 |
| Point 4 | £74,098 | £6,175 |
Band 8c — Executive Managers
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £76,702 | £6,392 |
| Point 2 | £81,138 | £6,762 |
| Point 3 | £85,716 | £7,143 |
| Point 4 | £89,253 | £7,438 |
Band 8d — Directors
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £93,385 | £7,782 |
| Point 2 | £100,431 | £8,369 |
| Point 3 | £107,806 | £8,984 |
Band 9 — Executive Directors
| Spine Point | Annual Salary | Monthly Gross |
|---|---|---|
| Point 1 | £111,653 | £9,304 |
| Point 2 | £117,975 | £9,831 |
*Approximate take-home is after tax, NI, and pension (8.3%-9.8% tier). Individual circumstances vary based on tax code and student loans.
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NHS Pay Scales — Scotland 2026/27
Scotland negotiated a 3.75% pay rise for 2026/27, slightly higher than England's 3.3%. Scottish pay scales are marginally higher across all bands.
Key Scottish Differences:
- Pay award: 3.75% (vs 3.3% England)
- Typical difference: £50-200/year more depending on band
- Tax: Scotland has 6 income tax bands vs England's 3
- Take-home: Often similar or slightly lower despite higher gross due to tax
Scotland Band 5 Example (Nurses)
| Spine Point | Scotland Annual | England Annual | Difference |
|---|---|---|---|
| Point 1 | £30,184 | £30,049 | +£135 |
| Point 3 | £32,218 | £32,073 | +£145 |
| Point 7 | £36,651 | £36,483 | +£168 |
How AfC Pay Bands and Spine Points Work
Pay Bands
NHS Agenda for Change uses 9 pay bands (Bands 2-9) organized by role responsibility and skills required:
- Bands 2-4: Support and assistant roles
- Bands 5-7: Registered professionals and specialists
- Bands 8a-9: Advanced practitioners, consultants, and managers
Spine Points (Annual Increments)
Within each band, there are spine points — step increases in pay:
- You move up one spine point each year on your anniversary date
- Each band has 2-9 spine points
- When you reach the top of your band, you stop progressing (unless promoted)
- Increments are automatic (not performance-based in most cases)
Example: Band 5 Nurse Career Progression
Year 1 (2026): Point 1 — £30,049
Year 2 (2027): Point 2 — £31,049 (+£1,000)
Year 3 (2028): Point 3 — £32,073 (+£1,024)
Year 4 (2029): Point 4 — £33,122 (+£1,049)
Year 5 (2030): Point 5 — £34,196 (+£1,074)
Year 6 (2031): Point 6 — £35,307 (+£1,111)
Year 7 (2032): Point 7 — £36,483 (+£1,176)
Total 7-year gain: £6,434 (21.4% increase)
When Do Pay Scales Update?
NHS pay scales are updated annually on 1 April following the NHS Pay Review Body (NHSPRB) recommendation:
Annual Pay Review Timeline
- Autumn: NHS Employers and unions submit evidence to NHSPRB
- Winter: NHSPRB reviews evidence and economic forecasts
- February: NHSPRB publishes pay recommendation
- March: Government accepts/modifies and announces final award
- 1 April: New pay scales effective (if on time)
Recent History (On-Time Payments)
- 2026/27: ✅ On time (announced Feb, effective 1 April)
- 2025/26: ❌ Late (announced May, backdated to April)
- 2024/25: ❌ Late (announced June, backdated)
- 2023/24: ❌ Late (announced July after strikes)
- 2022/23: ❌ Late (announced July)
- 2021/22: ❌ Late (announced July)
- 2020/21: ✅ On time
NHS Pay Scales History (2020-2026)
See how Band 5 starting salary has changed:
| Year | Starting Salary | Pay Award | Cumulative Increase |
|---|---|---|---|
| 2020/21 | £24,907 | 2.8% | — |
| 2021/22 | £25,655 | 3.0% | +£748 |
| 2022/23 | £27,055 | 4.0% + £1,400 | +£2,148 |
| 2023/24 | £28,407 | 5.0% | +£3,500 |
| 2024/25 | £29,970 | 5.5% | +£5,063 |
| 2025/26 | £29,066 | 3.8% | +£4,159 |
| 2026/27 | £30,049 | 3.3% | +£5,142 |
6-year total increase: +£5,142 (20.6% cumulative)
Real terms: When adjusted for inflation (CPI ~20% over same period), real pay has remained roughly flat.
Frequently Asked Questions
What are the NHS pay scales for 2026/27?
▼
Band 2 starts at £23,615, Band 5 at £30,049, Band 6 at £36,483, Band 7 at £44,608. See full tables above for all spine points.
When do NHS pay scales update?
▼
Annually on 1 April following the NHS Pay Review Body recommendation. The 2026/27 scales are effective from 1 April 2026.
What is the difference between England and Scotland pay scales?
▼
Scotland received 3.75% pay rise vs England's 3.3%, making Scottish scales £50-200/year higher per band. However, higher Scottish tax rates mean take-home pay is often similar.
How do spine points work?
▼
Spine points are annual pay increments within a band. You automatically move up one point each year on your anniversary until reaching the top of your band.
How much does a Band 5 nurse earn in 2026/27?
▼
Band 5 starting salary is £30,049 (£2,504/month gross, ~£1,932/month take-home). With experience, this rises to £36,483 at the top spine point.
Are NHS pay scales the same across the UK?
▼
No — England, Scotland, Wales, and Northern Ireland negotiate separately. Scotland typically has slightly higher scales but also higher taxes. Pay structures are the same (Bands 2-9).
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