Is Band 9 the highest NHS pay band?

Band 9 is the top of the Agenda for Change scale, but it's not the highest-paid NHS role. Consultant doctors and dentists can earn more on their separate medical pay scales, particularly once Clinical Excellence Awards are added. Very Senior Manager roles like Chief Executive and Chief Operating Officer sit above Band 9 on a separate framework, with annual pay typically in the £140,000 to £250,000 range depending on Trust size.

How many Band 9 staff does a typical NHS Trust have?

Typically just two or three: a Director of Nursing, a Chief Allied Health Professional, and sometimes a Director of Pharmacy. Some specialist Trusts also have a Director of Midwifery at Band 9. Smaller Trusts and community providers may have only one Band 9 post, with allied health professions covered by a Band 8d.

Do Band 9 directors get pensions, bonuses or shares?

Band 9 staff are members of the NHS Pension Scheme on the same tiered contribution rate as everyone else (capped at 12.5% on the 2025/26 scale). There are no NHS bonuses or shares for Agenda for Change staff: pay is set by the published scale and that's it. Performance is recognised through career progression to VSM rather than annual variable pay.

NHS Band 9 salary, England 2026/27

Trust-level directors of profession. Senior medical staff and very senior managers are paid separately.

Minimum

£112,782

Maximum

£129,783

Hourly at entry

£57.68

Hourly at top

£66.37

Calculate your Band 9 take-home pay

Band 9 pay scale, England 2026/27

Step	Years from entry	Annual	Hourly (37.5h)
Entry	From day one	£112,782	£57.68
Intermediate	After 2 years	£119,583	£61.16
Top	After 5 years	£129,783	£66.37
Full range		£112,782 to £129,783	£57.68 to £66.37

England, 2026/27, effective 2026-04-01. Source: Pay scales for 2026/27 — NHS Employers.

About Band 9

Band 9 is the top of the Agenda for Change pay scale. It covers Trust-level directors of profession: directors of nursing, chief allied health professionals, and directors of pharmacy. Doctors, dentists and Very Senior Managers (chief executives and other executive directors) sit on separate pay arrangements outside the Agenda for Change framework entirely.

What Band 9 staff actually do

Board-level executive work. A director of nursing leads the entire nursing workforce of a Trust, sits on the Trust Board with full voting rights, holds professional accountability for nursing standards across the whole organisation, and contributes to executive-level decisions on strategy, performance and finance. There is no clinical caseload at Band 9.

How to get on Band 9

Director-level appointments are made through formal executive recruitment, usually with external search firm support. Most appointees have been Band 8d for several years and have substantial executive board experience. Director of Nursing roles typically require active NMC registration; equivalent rules apply for other professional director roles.

Moving up from Band 9

From Band 9, the next step is a Very Senior Manager role outside the Agenda for Change framework: Chief Nursing Officer at NHS England or one of the devolved health departments, or moving into a Chief Executive role. VSM pay is set on a separate national framework with significantly higher upper limits and bespoke benefits packages.

Band 9 across the four UK nations

Band 9 pay across all four nations is broadly aligned in the £105,000 to £133,000 range on the 2026/27 scales. Scottish Band 9 is structured with two pay points rather than three.

Nation	Minimum	Maximum
England	£112,782	£129,783	View pay scale
Scotland	£127,521	£133,044	View pay scale
Wales	£114,475	£131,732	View pay scale
Northern Ireland	£109,179	£125,637	View pay scale

Example Band 9 roles

Band 9 covers a range of NHS jobs. The roles below are typical of this band.

Band 9 pay over time

Band 9 pay rose from £109,179 to £112,782 at entry between 2025/26 and 2026/27, a 3.3% change. Top of band moved from £125,637 to £129,783.

Band 9 common questions

Is Band 9 the highest NHS pay band?: Band 9 is the top of the Agenda for Change scale, but it's not the highest-paid NHS role. Consultant doctors and dentists can earn more on their separate medical pay scales, particularly once Clinical Excellence Awards are added. Very Senior Manager roles like Chief Executive and Chief Operating Officer sit above Band 9 on a separate framework, with annual pay typically in the £140,000 to £250,000 range depending on Trust size.
How many Band 9 staff does a typical NHS Trust have?: Typically just two or three: a Director of Nursing, a Chief Allied Health Professional, and sometimes a Director of Pharmacy. Some specialist Trusts also have a Director of Midwifery at Band 9. Smaller Trusts and community providers may have only one Band 9 post, with allied health professions covered by a Band 8d.
Do Band 9 directors get pensions, bonuses or shares?: Band 9 staff are members of the NHS Pension Scheme on the same tiered contribution rate as everyone else (capped at 12.5% on the 2025/26 scale). There are no NHS bonuses or shares for Agenda for Change staff: pay is set by the published scale and that's it. Performance is recognised through career progression to VSM rather than annual variable pay.