NHS pay rise 2018/19
The 2018/19 pay deal applied to all staff on Agenda for Change contracts. Each UK nation publishes its own circular: England and Wales follow the Pay Review Body recommendation, Scotland negotiates separately, and Northern Ireland implements once the Executive has signed off.
How the 2018/19 deal landed
The 2018/19 pay round was the first year of the 2018-2021 three-year deal, the most significant restructuring of NHS Agenda for Change pay since the scheme was introduced in 2004. It raised entry pay, started closing legacy spine points, and committed the UK Government to three years of above-inflation increases.
The 2018-2021 framework deal was negotiated between the UK Government, NHS Employers and the NHS Staff Council (representing the major trade unions) in early 2018 and ratified by union members in a consultative ballot. The deal was published on 27 March 2018 and applied retrospectively to 1 April 2018. It promised £4.2bn of additional funding over three years and committed to raising the lowest NHS pay rates above the National Living Wage, removing legacy spine points and reforming pay progression.
Uplift by nation
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England
Pay scale
Effective 2018-04-01
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Scotland
Not published yet
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Wales
Not published yet
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Northern Ireland
Not published yet
Union response to the 2018/19 deal
The deal followed a sustained pay cap that had held NHS pay growth to 1% per year since 2010, well below inflation, and represented a significant breakthrough. Unions including Unison, the RCN and Unite recommended acceptance, though they noted that the deal would not fully restore the cumulative real-terms losses since 2010. Around 76% of those who voted in the consultative ballot supported acceptance.
Structural changes
Band 1 was closed to new entrants from 1 December 2018, with the entry route redirected to Band 2. Many legacy spine points were marked as transitional with a planned end date. Entry pay at every band moved up substantially. The deal set a clear three-year roadmap to reach the consolidated Entry/Intermediate/Top structure that has been in use since 2021/22.
England
NHS terms and conditions pay poster 2018/19 — NHS Employers
| Band | Minimum | Steps | Maximum | Hourly at top |
|---|---|---|---|---|
| Band 1 closed | £17,460 | 1 | Single rate | £8.93 |
| Band 2 | £17,460 | 3 | £18,702 | £9.56 |
| Band 3 | £17,787 | 6 | £20,448 | £10.46 |
| Band 4 | £20,150 | 6 | £23,363 | £11.95 |
| Band 5 | £23,023 | 7 | £29,608 | £15.14 |
| Band 6 | £28,050 | 8 | £36,644 | £18.74 |
| Band 7 | £33,222 | 8 | £43,041 | £22.01 |
| Band 8a | £42,414 | 5 | £49,969 | £25.55 |
| Band 8b | £49,242 | 5 | £59,964 | £30.67 |
| Band 8c | £59,090 | 5 | £71,243 | £36.43 |
| Band 8d | £70,206 | 5 | £85,333 | £43.64 |
| Band 9 | £84,507 | 5 | £102,506 | £52.42 |
England pay scales for 2018/19, effective 2018-04-01. Hourly rate uses the 37.5-hour NHS working week. Source: NHS terms and conditions pay poster 2018/19 — NHS Employers.
Common questions about the 2018/19 pay rise
- When was the 2018/19 NHS pay rise paid?
- The new England pay rates were backdated to 2018-04-01. In most Trusts the new rate first showed in monthly pay a few months after the official circular was published, with arrears for the backdated period paid alongside the first new monthly rate. Scotland, Wales and Northern Ireland followed their own implementation timetables.
- Did Scotland, Wales and Northern Ireland get the same pay rise in 2018/19?
- Each UK nation negotiates separately. England and Wales usually follow the NHS Pay Review Body recommendation, Scotland negotiates directly with trade unions, and Northern Ireland needs Executive sign-off. The headline percentage and the structural shape of the deal can differ between nations.
- What was the 2018 NHS three-year pay deal?
- The 2018-2021 framework agreement was a three-year NHS pay deal negotiated between the UK Government, NHS Employers and the NHS Staff Council in early 2018. It committed £4.2bn of additional pay funding over three years, restructured the Agenda for Change pay scale, raised entry pay above the National Living Wage and closed Band 1 to new entrants.
- Why was the 2018 NHS pay deal a big change?
- Between 2010 and 2018, NHS pay had been held to a 1% per year cap, well below inflation. The 2018 deal was the first multi-year settlement since then to commit to above-inflation increases and the first major restructure of Agenda for Change since it was introduced in 2004. It also began the consolidation of legacy spine points that completed under the 2021/22 scale.