NHS Sick Pay Guide — Your Entitlements Under AfC
NHS Occupational Sick Pay (OSP) Entitlements
NHS staff receive Occupational Sick Pay — far more generous than Statutory Sick Pay (SSP). Your entitlement depends on your length of continuous NHS service.
Sick Pay Entitlement by Service Length
| NHS Service |
Full Pay |
Half Pay |
Total Paid Period |
| Less than 1 year |
1 month |
1 month (after full pay) |
2 months |
| 1-2 years |
1 month |
2 months |
3 months |
| 2-3 years |
2 months |
2 months |
4 months |
| 3-5 years |
4 months |
4 months |
8 months |
| 5+ years |
5 months |
5 months |
10 months |
How NHS Sick Pay Works
Full Pay Period
During this period, you receive your normal gross salary with standard deductions (tax, NI, pension). It's as if you were working normally.
Half Pay Period
After full pay ends, you receive 50% of your normal salary. Important notes:
- Half pay period starts after full pay exhausted
- If half pay + SSP exceeds full pay, it's capped at full pay
- SSP (£116.75/week) is usually included in half pay, not on top
After Occupational Sick Pay Ends
Once both full and half pay exhausted, you may receive:
- SSP only: £116.75/week for up to 28 weeks total sickness
- No pay: After 28 weeks total sickness (SSP exhausted)
- ESA/Universal Credit: You may be eligible for benefits
Real Examples
Example 1: Band 5 Nurse (3 Years Service) — 6 Weeks Sickness
Monthly salary: £2,673
Service: 3 years = 4 months full pay + 4 months half pay
Sickness: 6 weeks (1.5 months)
Payment:
Full pay: 6 weeks × £617/week = £3,702 gross
Half pay: £0 (still within full pay period)
Total sick pay: £3,702 (before tax/NI/pension)
Example 2: Band 6 (5+ Years Service) — 16 Weeks Sickness
Monthly salary: £3,330
Service: 5+ years = 5 months full pay + 5 months half pay
Sickness: 16 weeks (4 months)
Payment:
Full pay: 5 months × £3,330 = £16,650
Half pay: Not reached yet (16 weeks = 3.7 months)
Total sick pay: ~£12,321 (for 16 weeks)
The Sick Pay Rolling Year
Your sick pay entitlement is measured over a rolling 12-month period. This means:
- Each period of sickness uses up part of your annual entitlement
- If you have multiple absences, they're added together
- Entitlement "resets" as you move through the rolling year
Example:
5+ years service = 5 months full pay entitlement
January: 2 weeks sick (uses 2 weeks full pay)
Remaining: 18 weeks full pay
April: 4 weeks sick (uses 4 weeks full pay)
Remaining: 14 weeks full pay
October: 6 weeks sick (uses 6 weeks full pay)
Remaining: 8 weeks full pay
By January next year, your entitlement starts refreshing
Statutory Sick Pay (SSP)
SSP is the minimum UK employers must pay. For NHS staff, it's usually absorbed into half pay:
- Rate: £116.75/week (2026/27)
- Duration: Up to 28 weeks
- Waiting days: First 3 days unpaid
- Eligibility: Earn at least £123/week, sick for 4+ consecutive days
Fit Notes (Sick Notes)
To receive sick pay beyond 7 calendar days, you need a fit note (formerly "sick note") from your GP:
- Days 1-7: Self-certification (no doctor needed)
- Day 8+: Fit note required
- Fit notes can cover up to 3 months at a time
- You must submit fit notes to your manager promptly
Return to Work Meetings
After sickness absence, your manager should conduct a return to work interview:
- Discuss your wellbeing and fitness to return
- Identify any workplace adjustments needed
- Review sickness absence history if applicable
- Not disciplinary — supportive conversation
Phased Return to Work
After long-term sickness, you may request a phased return:
- Gradually increase hours over several weeks
- Paid at full salary for agreed hours
- Typically 2-6 weeks duration
- Requires OH (Occupational Health) and manager approval
Example Phased Return
| Week |
Hours Worked |
Pay |
| Week 1 |
18.75 hours (50%) |
Full pay |
| Week 2 |
26.25 hours (70%) |
Full pay |
| Week 3 |
33.75 hours (90%) |
Full pay |
| Week 4+ |
37.5 hours (100%) |
Full pay |
Sickness During Annual Leave
If you fall sick during annual leave:
- You can reclaim annual leave days (if you notify manager)
- Requires fit note from GP
- Sick leave replaces annual leave for those days
- You can take the annual leave later
Sickness Absence Management
Trigger Points (Varies by Trust)
Most Trusts use Bradford Factor or similar systems to monitor absence:
- 3+ episodes of sickness in 6 months (may trigger review)
- 10+ days total sickness in rolling year (may trigger review)
- Patterns (e.g., always sick on Mondays/Fridays)
Formal Sickness Review
If absence exceeds triggers:
- Meeting with manager to discuss concerns
- Occupational Health referral may be required
- Support plan developed (not automatic discipline)
- Reasonable adjustments considered
Occupational Health (OH)
Your Trust may refer you to OH:
- Long-term sickness (usually 4+ weeks)
- Frequent short-term absences
- Work-related health concerns
- To assess fitness to return
- To recommend workplace adjustments
OH is supportive, not disciplinary. They advise on health, adjustments, and return-to-work plans.
Disability Considerations
If your sickness is related to a disability (Equality Act 2010 definition):
- You're protected from disability discrimination
- Your Trust must make reasonable adjustments
- Sickness absence related to disability may be treated differently in absence reviews
- Cannot be dismissed solely due to disability-related absence (without reasonable adjustments explored)
Long-Term Sickness & Dismissal
In rare cases, long-term sickness may lead to dismissal if:
- No prospect of return to work (supported by medical evidence)
- All reasonable adjustments explored
- Alternative redeployment considered and not suitable
- Full consultation process followed
You have rights:
- Fair consultation process
- Occupational Health assessment
- Consideration of adjustments and redeployment
- Right to appeal
Mental Health & Stress-Related Absence
Mental health absences are treated the same as physical health:
- Fit notes from GP for stress/anxiety/depression accepted
- Same sick pay entitlements apply
- OH can support mental health return-to-work plans
- Adjustments may include reduced hours, role changes, or supportive measures
What Happens to Pension During Sick Leave?
During paid sick leave (full or half pay)
- Pension contributions continue on the pay you receive
- Counts as pensionable service
During unpaid sick leave
- No contributions paid
- First 3 years unpaid still count as pensionable service (you get credit)
- After 3 years: unpaid leave doesn't count (service break)
Frequently Asked Questions
How much sick pay will I get?
▼
Depends on your NHS service: Less than 1 year = 1 month full + 1 month half pay. 5+ years = 5 months full + 5 months half pay. See table above for full breakdown.
Do I need a sick note from day 1?
▼
No — first 7 days are self-certification (no doctor needed). From day 8 onwards, you need a fit note from your GP to receive sick pay.
Is sick pay taxed?
▼
Yes — sick pay is taxable income. You pay normal tax, NI, pension, and student loan deductions on sick pay received.
Can I be dismissed for being sick?
▼
Only in exceptional cases after long-term sickness with no prospect of return, all adjustments explored, full consultation, and OH assessment. Short-term sickness alone rarely leads to dismissal.
What if I'm sick during annual leave?
▼
You can reclaim annual leave days if you notify your manager and get a fit note from your GP. Those days count as sick leave instead, and you can take the annual leave later.
What happens when my sick pay runs out?
▼
After occupational sick pay ends, you may receive SSP (£116.75/week) for up to 28 weeks total. After that, you may be eligible for ESA (Employment Support Allowance) or Universal Credit.
Can I work elsewhere while on sick leave?
▼
No — working elsewhere while on sick leave is gross misconduct and can lead to dismissal. Your fit note confirms you're unfit for your NHS role, which means you're unfit for any work.
Does my pension continue during sick leave?
▼
Yes during paid sick leave — you continue paying pension on the pay you receive. During unpaid sick leave, the first 3 years still count as pensionable service (no cost to you).
