NHS Occupational Therapist Salary 2026/27: Band 5 to Band 8

Occupational therapists help people do the everyday things that matter to them after illness, injury or disability. In the NHS you will find them on acute wards, in community rehab teams, in mental health services and in specialist areas such as hand therapy and paediatrics. Most are paid on Agenda for Change, but OTs are unusual in that many also work for local councils, which use different pay scales.

NHS OT pay by band for 2026/27

Occupational therapy support workers are usually on Band 3, and senior support workers or assistant practitioners on Band 4.

Take-home pay at the main OT stages

Full time, with the NHS Pension and tax code 1257L, no student loan:

Most newly qualified OTs repay a student loan. On Plan 2 that is about £20 a month at Band 5 entry, and on Plan 5 it is more because repayments start at £25,000.

The first few years

Many trusts offer Band 5 rotational posts, where you spend several months in each of a few areas, such as acute medicine, orthopaedics, neurology and community. It is a good way to find your specialism. Others recruit directly into a single team.

Moving to Band 6 typically happens after 18 months to three years, once you have broad experience and can work more independently. Each move to a new band starts you at its entry point, and the pay progression calculator shows when your next step on the current band is due.

NHS or council: does it matter?

OTs in adult social care, who assess for equipment, adaptations and care at home, are often employed by local councils. Council pay scales are set locally, usually on the national local government pay spine, and differ from Agenda for Change. Before you compare salaries, check three things:

1. Pension. Council staff are in the Local Government Pension Scheme, which has different contribution rates and benefits from the NHS Pension.
2. Leave and sick pay. These are set by each council and are often less generous than the NHS scheme of up to 33 days of leave plus bank holidays.
3. Hours. Many councils work a 37-hour week rather than 37.5.

Some OTs move between the two sectors. Previous local authority service does not automatically count towards NHS leave and sick pay, although some employers recognise it.

Weekend and seven-day working

More acute therapy services now run at weekends. Weekend hours on Bands 5 to 7 are enhanced: Saturdays by 30% and Sundays by 60% of the basic hourly rate. At Band 5 entry, that turns £16.40 an hour into £21.32 on a Saturday and £26.24 on a Sunday.

Professional costs you can claim back

Your HCPC registration fee and membership of the Royal College of Occupational Therapists are both on HMRC's approved list, so you can claim tax relief on them. Our guide to tax rebates for NHS staff explains how to claim, including for uniform laundering.

Student OTs

Occupational therapy students in England can usually apply for the NHS Learning Support Fund, which pays at least £5,000 a year and does not need to be repaid. Degree apprenticeships are also available in many areas, where you are paid while you train.

Common questions

Is OT paid the same as physiotherapy? Yes. Both are on the same bands for equivalent roles. See our physiotherapist salary guide for comparison.

Do OTs in mental health earn more? Not on basic pay. The band depends on the job, but some mental health roles include more unsocial hours.

Can I work as an OT privately? Yes, many experienced OTs do case management or private assessments, often alongside an NHS post.

Work out your pay

Use the take-home pay calculator with your band, hours and student loan plan.