NHS pay in England, 2026/27
Latest pay deal effective 2026-04-01, a 3.3% uplift on the previous year. Pay is negotiated by NHS Employers (on behalf of the Department of Health and Social Care).
England pay scale, 2026/27
| Band | Minimum | Steps | Maximum | Hourly at top |
|---|---|---|---|---|
| Band 1 closed | £25,272 | 1 | Single rate | £12.92 |
| Band 2 | £25,272 | 1 | Single rate | £12.92 |
| Band 3 | £25,760 | 2 | £27,476 | £14.05 |
| Band 4 | £28,392 | 2 | £31,157 | £15.93 |
| Band 5 | £32,073 | 3 | £39,043 | £19.97 |
| Band 6 | £39,959 | 3 | £48,117 | £24.61 |
| Band 7 | £49,387 | 3 | £56,515 | £28.90 |
| Band 8a | £57,528 | 3 | £64,750 | £33.11 |
| Band 8b | £66,582 | 3 | £77,368 | £39.57 |
| Band 8c | £79,504 | 3 | £91,609 | £46.85 |
| Band 8d | £94,356 | 3 | £108,814 | £55.65 |
| Band 9 | £112,782 | 3 | £129,783 | £66.37 |
England pay scales for 2026/27, effective 2026-04-01. Hourly rate uses the 37.5-hour NHS working week. Source: Pay scales for 2026/27 — NHS Employers.
About England NHS pay
England has the largest NHS workforce of the four UK nations and sets the reference pay scale for the Agenda for Change framework. Pay is negotiated by NHS Employers on behalf of the Department of Health and Social Care, following the recommendation of the independent NHS Pay Review Body. Wales and Northern Ireland usually adopt the same recommendation; Scotland negotiates separately and consistently pays more.
How England sets NHS pay
Each year, NHS Employers and the trade unions submit detailed evidence to the NHS Pay Review Body. The Review Body hears the evidence, decides on a recommended uplift, and submits its report to the UK Government in the spring. The government then accepts, modifies or rejects the recommendation. The agreed uplift is published as a Pay Advisory Notice on the NHS Employers website and applied to the AfC scale with effect from 1 April. Between 2021 and 2025 the uplift was always agreed late and backdated, with arrears paid alongside the first new monthly rate. The 2026/27 award broke that pattern: it was accepted on 12 February 2026 and paid on time in April 2026 salaries.
Recent settlements
Three recent settlements give the picture. 2024/25 saw a flat £1,400 uplift to every Band 2 to 8c pay point, plus a 5% rise for Band 8d and Band 9. 2025/26 applied a consolidated 3.6% uplift to every pay point, worth roughly £1,090 at Band 5 entry. The 2026/27 deal is a 3.3% consolidated uplift, recommended by the PRB and accepted by the government in early 2026.
What England staff actually take home
English pay sits below Scotland and now below Wales at most bands. The High Cost Area Supplement (London weighting) adds 5% to 20% for staff working at Trusts in and around London, but this doesn't cover the gap with Scotland for staff outside the capital. Union ballots in 2022 and 2023 led to widespread strike action across England. The picture has been more settled since the 2024/25 award, but the underlying pressure on real-terms pay hasn't gone away.
Jump to a band in England
Pay history
Recent annual pay rounds for England. Each year page shows the full table for every band.
England common questions
- When does the NHS pay rise apply each year?
- The uplift always takes effect from 1 April, but when it reaches your payslip depends on when the Pay Review Body reports, when the government responds, and when NHS Employers issues the new pay scales. From 2021/22 to 2025/26 the award was announced between May and August, so staff saw the new rate plus arrears in a summer or autumn payslip. The 2026/27 award was different: it was accepted on 12 February 2026 and paid on time in April 2026 salaries, with no back pay owed on the basic award. Employers that don't use ESR for payroll may have paid it a month late, with arrears.
- Does England include Wales for pay purposes?
- No. Wales runs its own AfC(W) circulars, even though it usually adopts the same headline uplift percentage as England. Both apply to nurses, midwives, AHPs and support staff, but with separately published pay tables. There can be small cash differences at the bottom of the scale where the Welsh Government has chosen to top up entry rates above the Living Wage Foundation real Living Wage.
- What is the High Cost Area Supplement for English NHS staff?
- English NHS staff working at Trusts inside three defined zones get a pay supplement on top of basic salary. Inner London is 20% (minimum £5,794, maximum £8,746 in 2026/27), Outer London is 15% (£4,870 to £6,137) and Fringe is 5% (£1,346 to £2,270). The supplement is paid as part of normal salary, is pensionable, and is subject to income tax and NI in the usual way. See the London weighting page for more detail.
- Are English NHS pay rises going to keep up with inflation?
- The honest answer is nobody knows yet. Recent settlements have been a few percentage points above the government's CPI inflation target but below actual headline inflation for most of 2022 and 2023. The 2026/27 deal is 3.3%, and if inflation comes in below that level over the year, NHS staff get a real-terms pay rise; if inflation runs higher, they don't. The PRB process doesn't include an automatic inflation guarantee in the way the current Scottish multi-year deal does.