NHS Job Offer Checklist: What to Check Before You Accept

You have had the call to say you got the job. Before you accept, it is worth slowing down for a moment. Some details in an NHS offer are easy to agree at the start and hard to change later, especially your starting pay point and how your previous service is counted.

1. The band and pay point

Check the band matches the advert, and ask which pay point you will start on. Most people start at the entry point, but:

• employers can agree a higher starting point for relevant experience, at their discretion
• if you are moving from another NHS employer on the same band, you should normally keep your pay point and step date

Ask for the agreed pay point in writing. The pay progression calculator shows when your next step would be due.

2. Hours, base and working pattern

Check:

• contracted hours and whether the post is full time, part time or annualised
• your base, which matters for mileage claims and London weighting
• the shift pattern, including whether nights, weekends or on-call are expected

If you need flexible working, you can ask before you start. Our flexible working guide explains the process.

3. Previous NHS service

Your previous NHS service can affect your annual leave and sick pay entitlements:

• Annual leave: previous NHS service usually counts towards the 5-year and 10-year steps, taking you from 27 days to 29 and then 33.
• Sick pay: previous NHS service usually counts, provided there is no break of more than 12 months.

Some employers also recognise relevant non-NHS service at their discretion. Ask HR to confirm how your service will be counted, and keep evidence of past NHS employment.

4. Pre-employment checks

NHS offers are usually conditional on checks, including:

• identity and right to work in the UK
• references, usually covering the last three years
• a DBS check for the right level of the role
• occupational health clearance
• professional registration, if needed

Do not hand in notice to your current employer until your offer is unconditional, or until you are comfortable with the risk.

5. Start date and notice period

Agree a start date that works with your current notice period. NHS notice periods are usually set by band, often four weeks for many posts and longer for senior roles. If you are moving between NHS employers, a smooth start date helps keep your service continuous.

6. Relocation and training commitments

If the offer includes relocation support or funded training, check any repayment clauses carefully. See our relocation expenses guide.

7. Pension and payroll details

Most new starters are enrolled in the NHS Pension automatically. If you already have NHS service, make sure your new employer has your previous details so your record joins up. Bring your P45 from your last job to avoid an emergency tax code.

Questions to ask before accepting

• Which pay point will I start on, and when is my next step due?
• How will my previous service count for leave and sick pay?
• What is the shift pattern, and is on-call expected?
• Are there any repayment clauses in my offer?

Common questions

Can I negotiate my band? No. Bands are set by job evaluation. You can sometimes negotiate the starting pay point.

Does a break between NHS jobs matter? For sick pay, breaks over 12 months can reset your entitlement. Check the rules for your situation.

Is an offer final once I accept? A conditional offer can be withdrawn if checks are not satisfactory.

Moving between NHS employers on the same band

If you move to another NHS employer on the same band, you should normally:

• keep your current pay point
• keep your pay step date, so your next step arrives on time
• keep your service for annual leave and sick pay, if there is no long break

Give your new employer your previous employment details early, and check your first payslip carefully. A common mistake is being placed on the entry point of the band by default. If that happens, raise it with HR straight away and provide evidence of your previous pay point.

See your new take-home

Use the take-home pay calculator to see your monthly pay in the new role.