NHS Pay Bands

NHS pay rise history

NHS pay reviews usually land in spring and apply from 1 April, often backdated by a month or two. Pick a year for the full uplift breakdown across the four UK nations, or scroll for the recent-history table and an explainer of how the pay round works.

How the NHS pay round works

For England, Wales and Northern Ireland the pay round runs every year through the NHS Pay Review Body. NHS Employers and the Department of Health and Social Care submit written evidence on what is affordable. The trade unions (RCN, Unison, Unite, GMB, BMA Agenda for Change group and others) submit evidence on what is needed to retain staff and keep pace with inflation. The Review Body weighs the evidence, holds oral hearings, and writes a report to the UK Government in early spring.

The UK Government can accept, modify or reject the recommendation. Once accepted, NHS Employers publishes a Pay Advisory Notice with the new pay scale, and individual NHS Trusts apply it to staff pay. Wales and Northern Ireland publish their own implementing circulars on the same headline figure. Scotland runs an entirely separate negotiation between the Scottish Government and the Scottish NHS Staff Council, often agreeing a deal before the rest-of-UK Pay Review Body has reported.

When the pay rise actually hits your payslip

Pay rises notionally apply from 1 April but in most years are not paid until later because the Pay Review Body has not yet reported. A typical year looks like this: the recommendation lands in May, the UK Government responds in June or July, NHS Employers publishes the implementing circular in July or August, and the new rate plus arrears for April to July hits payslips in August or September. Scotland frequently runs a few months earlier; Northern Ireland frequently runs several months later because of Executive sign-off requirements.

Recent pay rounds at a glance

The table below shows headline England figures for every published pay year on this site, including the Band 5 entry rate so you can see the year-on-year cash change.

Year Headline uplift Band 5 entry
2026/27 3.3% £32,073
2025/26 3.6% £31,049
2024/25 5.5% £29,970
2023/24 5% £28,407
2022/23 Bespoke £27,055
2021/22 3% £25,655
2020/21 Bespoke £24,907
2019/20 Bespoke £24,214
2018/19 Bespoke £23,023

England figures only. See the per-year page for the full four-nation breakdown.

Recent industrial action

The combination of a sustained pay cap from 2010 to 2018 followed by sharply rising inflation from 2022 produced the first national NHS strike action since the 1980s. The Royal College of Nursing balloted members for strike action for the first time in its 106-year history in autumn 2022, with strikes running through December 2022, January, February and May 2023. Unison, Unite, the GMB and the British Dietetic Association all ran similar ballots, and ambulance staff struck on multiple dates. The 2024/25 settlement and the addition of intermediate pay points for Bands 8a-9 marked the formal end of the dispute, though underlying real-terms pay pressures remain.

Common questions

When does the NHS pay rise happen each year?
The NHS Pay Review Body normally publishes its recommendation in the spring and the UK Government responds in early summer. England, Wales and Northern Ireland apply the uplift from 1 April, usually backdated by a month or two so staff see arrears alongside their first new monthly payslip. Scotland negotiates on a different timetable and sometimes finalises its deal before the Pay Review Body has even reported.
Is the NHS pay rise above inflation?
It depends on the year. The 2022/23 flat £1,400 uplift was well below inflation, which fed the 2022 and 2023 strike action. The 2024/25 5.5% deal was above inflation when announced. Recent settlements have come in close to the Bank of England's CPI forecast for the year. Scottish multi-year deals include an automatic inflation guarantee that triggers a top-up if CPI exceeds the deal-implied figure.
Who decides how much the NHS pay rise is?
In England, Wales and Northern Ireland the headline recommendation comes from the independent NHS Pay Review Body, which collects evidence from employers, unions and government and reports each spring. The UK Government can accept, modify or reject the recommendation. In Scotland, pay is agreed directly between the Scottish Government and the Scottish NHS Staff Council, without going through the Pay Review Body.
Why was there NHS strike action in 2022 and 2023?
Inflation in 2022 ran at over 10% while the NHS pay award that year was a flat £1,400 (worth roughly 4% in headline terms). Real-terms pay was falling significantly on top of the cumulative effects of the 2010-2018 1% pay cap. Several unions including the Royal College of Nursing, Unison and Unite balloted members for strike action, and a series of national strikes ran through late 2022 and the first half of 2023.
Do nurses, midwives and AHPs get different pay rises?
No. Agenda for Change is a single pay framework for all non-medical NHS staff. The same percentage (or cash) uplift applies to every band, every pay point and every job family. Differences across bands only happen when the deal explicitly includes them, as in 2022/23 (flat £1,400 for Bands 1-8c, percentage for 8d/9) or 2024/25 (5.5% plus new intermediate pay points for Bands 8a-9).