NHS pay rise 2026/27

How the 2026/27 deal landed

The 2026/27 pay round delivered a 3.3% consolidated uplift to every Agenda for Change pay point in England and Wales, paid on time in April 2026 salaries. It was the first on-time Agenda for Change award since 2020. Scotland's two-year deal added a further 3.75% on top of its revised 2025/26 baseline. Northern Ireland staff were still waiting for the 3.3% at the start of October 2026.

The NHS Pay Review Body recommended 3.3% in its 39th report, and the UK Government accepted it in full on 12 February 2026. Because the award was confirmed before the pay year started, NHS Employers published the new pay scales in February and the uplift was paid in April 2026 salaries, in line with ESR lead times. There was no back pay owed on the basic award, unlike every year from 2021/22 to 2025/26. Employers that don't run payroll through ESR may have paid it a month late, with arrears. Wales adopted the same percentage through AfC(W) 02/2026, issued on 12 February 2026 with the new rates applying from 1 April 2026. Any pay structure reforms still being agreed will be backdated to 1 April 2026 once settled. Scotland's separately negotiated two-year settlement delivered 3.75% from 1 April 2026, on top of a 2025/26 baseline that had been revised upwards via the inflation guarantee. In Northern Ireland, the Health Minister said he wanted to pay 3.3%, but the ministerial direction to fund it still needed Executive approval, so HSC staff had not received the uplift by early October 2026.

Cash impact at the most-searched bands

For staff in England, the 2026/27 pay rise translates into the following annual cash increases at entry to the most common bands.

Union response to the 2026/27 deal

Unions welcomed the timing but not the size of the award. The RCN called a below-inflation award 'an insult', UNISON said staff would be 'downright angry' at another below-inflation rise, and the Royal College of Midwives said the government had let down maternity staff again. GMB acknowledged that April payment was progress, the first time this had happened in years. In Northern Ireland, the RCN has notified the Executive and employers of a dispute over the unpaid 2026/27 award and plans a statutory industrial action ballot.

Structural changes

Every pay point on every band moved up by 3.3% on the 2025/26 figures in England and Wales. The structural pay scale (number of steps per band, years to top) is unchanged from 2025/26 while structural reform talks continue. Wales also applied a Real Living Wage floor at the bottom of the scale. Scotland's structure remained two-step from Band 8a upward; England and Wales kept the intermediate steps introduced in the 2024/25 deal.