Band 5 pay in Northern Ireland, 2025/26

Band 5 in Northern Ireland, what the role involves

Band 5 is the entry point for the registered nursing, midwifery and allied health workforce. Newly qualified nurses, midwives, paramedics, physiotherapists, occupational therapists, radiographers, dietitians, speech and language therapists, and operating department practitioners all start their NHS careers on Band 5. It is the busiest band on the Agenda for Change scale by headcount, with hundreds of thousands of staff across the four UK nations.

Day-to-day work varies hugely by profession, but the common thread is autonomous registered practice. A Band 5 staff nurse takes a patient caseload (typically four to eight patients depending on acuity), leads care for the patients they're allocated, administers medications, and is professionally accountable for their own clinical decisions. A Band 5 physiotherapist runs their own clinic, assesses patients and writes treatment plans. A Band 5 paramedic crews an ambulance, makes clinical calls on scene, and decides whether to convey patients to hospital or treat at home.

How NHS pay is set in Northern Ireland

Health and Social Care (HSC) staff in Northern Ireland sit on the same Agenda for Change framework as the rest of the UK. Pay is set by the Department of Health's Workforce Policy Directorate, which usually adopts the NHS Pay Review Body recommendation. Pay circulars are published as HSC (AfC) letters and apply to staff across the integrated HSC Trusts rather than separate NHS Trusts.

Northern Ireland's health service is integrated with social care, so Agenda for Change covers HSC Trusts rather than NHS Trusts only. The Department of Health takes the PRB recommendation, secures Executive approval (when there is a functioning Executive), and issues an HSC (AfC) pay arrangement circular. Pay is usually applied from 1 April with arrears paid later in the year, often after a delay caused by political processes at Stormont.

How Band 5 pay in Northern Ireland compares to other UK nations

At the top of Band 5 in Northern Ireland, staff earn £37,796 per year for 2025/26. Scotland pays Band 5 more at the top of band: £43,039, a difference of £5,243 per year (13.9% more than Northern Ireland).

Scotland pays Band 5 noticeably more than England, Wales or Northern Ireland at every pay point. On the 2026/27 scales, a Scottish Band 5 entry is £34,544 versus England's £32,073, a gap of around £2,471 a year. The gap widens further at the top step. Welsh Band 5 entry pulled slightly ahead of England in 2025/26 following the Welsh Government's marginal uplift difference. Northern Ireland and England remain at identical rates because they apply the same Pay Review Body recommendation.

Recent NHS pay history in Northern Ireland

The 2025/26 settlement applied a 3.6% consolidated uplift, matching England and Wales in percentage terms. The previous round (2024/25) was delayed by Executive politics but eventually delivered. The 2026/27 settlement is expected later in 2026 following the PRB report and Executive approval. NI HSC pay has consistently tracked England exactly because the Department of Health applies the PRB recommendation in full.