NHS Pay Scales 2026/27: Annual, Hourly and HCAS Rates for Every Band

The NHS pay scales for 2026/27 run from £25,272 at Band 2 to £129,783 at the top of Band 9. They apply to staff on NHS terms and conditions (Agenda for Change) in England from 1 April 2026, after a 3.3% pay award. This guide sets out every pay point with its annual, monthly and hourly rate, and the high cost area supplement (HCAS) paid in and around London.

What changed for 2026/27

The government accepted the NHS Pay Review Body's recommendation for 2026/27, giving Agenda for Change staff in England a 3.3% pay rise. NHS Employers confirmed that the new rates take effect from 1 April 2026 and would be paid in April salaries, so most staff did not have to wait for back pay this year.

The structure of the pay bands is the same as in 2025/26:

• Band 1 is closed to new staff
• Band 2 has a single pay point
• Bands 3 and 4 have two pay points
• Bands 5 to 9 have three pay points

The figures in this guide are the England pay scales. Wales, Scotland and Northern Ireland set their own NHS pay, which we cover in separate guides linked further down.

Annual pay scales 2026/27

These are the full-time annual salaries for a 37.5-hour week, as published by NHS Employers. The monthly figure is the annual salary divided by 12, before tax, National Insurance, pension and any other deductions.

"After 2 years" and similar labels show how long you normally spend at the previous point before moving up. For example, a Band 5 nurse moves from £32,073 to £34,592 after two years, and to £39,043 after four years in the band.

How to read the bands

Each band covers jobs of a similar level of responsibility, knowledge and skill, decided through the NHS job evaluation scheme. Your band depends on your job, not your qualifications or length of service. Our guide to NHS pay bands explained lists typical jobs in each band, and our guide to how NHS jobs are banded explains how to ask for a review if you think your role is in the wrong band.

Hourly pay rates 2026/27

Agenda for Change works out an hourly rate by dividing the annual salary by 52.143 weeks and then by 37.5 hours. The 52.143 figure is the average number of weeks in a year, allowing for leap years. Hourly rates matter for bank shifts, overtime, unsocial hours and part-time pay.

Figures are rounded to the nearest penny. Payroll systems may round slightly differently.

Part-time pay

If you work part time, your pay is worked out pro rata. For example, a Band 5 at entry working 30 hours a week earns 30/37.5 of £32,073, which is £25,658 a year. Our part-time pay guide explains how leave and pension work for part-time staff, and the hourly rate calculator works out your figure for any hours.

Overtime and unsocial hours

Unsocial hours enhancements for nights, weekends and bank holidays are paid as a percentage of your hourly rate, with different rates depending on your band. Overtime for staff in Bands 1 to 7 is usually paid at time and a half, or double time on bank holidays. Staff in Band 8a and above are not normally paid overtime. Our unsocial hours and overtime guide gives the rates for each band, and our hourly rates guide shows worked examples.

HCAS (London weighting) 2026/27

Staff working in and around London get a high cost area supplement (HCAS) on top of their basic pay. It is a percentage of basic salary, with a minimum and maximum amount for each of the three zones:

Which zone you are in depends on where your workplace is, not where you live. Your employer will tell you which applies.

HCAS at each band's entry point

Applying the percentage, minimum and maximum to the entry point of each band gives these full-time annual supplements:

From Band 7 upwards, every pay point reaches the maximum in all three zones, so the supplement is the same cash amount whatever your salary.

Two examples

• Band 5 at the top point (£39,043) in Inner London: 20% is £7,809, which is between the minimum and maximum, so the supplement is £7,809. Total pay is £46,852 a year.
• Band 2 in Outer London (£25,272): 15% would be £3,791, which is below the £4,870 minimum, so the minimum applies. Total pay is £30,142 a year.

HCAS is paid pro rata for part-time staff, counts as pensionable pay and is taxed in the normal way. Our London weighting guide has more examples, and the London weighting calculator works out your supplement.

How you move up the pay points

You move to the next pay point in your band once you have spent the required time at your current point and met the expected standards. This is checked at a pay step review with your manager. When you reach the top point of your band, your pay only rises with future pay awards, unless you move to a higher-band job.

New starters usually begin at the entry point of their band. If you have relevant previous NHS service in the same band, your employer should take it into account. Our pay progression guide explains the rules in detail, and the pay progression calculator shows when your next step is due.

What you actually take home

The pay scales show gross pay. From it, your employer deducts:

• income tax, based on your tax code
• National Insurance
• NHS Pension contributions, at a rate that depends on your pensionable pay
• student loan repayments, if you have a loan
• any salary sacrifice schemes, such as a lease car or cycle to work

For example, a full-time Band 5 at entry on £32,073 takes home noticeably less than the £2,673 monthly gross figure once these deductions are made. Use our take-home pay calculator to see your own figure for 2026/27, or read our NHS take-home pay guide for a band-by-band breakdown.

Pay in Wales, Scotland and Northern Ireland

The figures above are for England. Each of the other UK nations sets its own NHS pay:

• Wales uses Agenda for Change, with its own pay scales. See our guide to NHS pay in Wales vs England.
• Scotland has its own pay deal and a shorter working week. See NHS Scotland pay vs England.
• Northern Ireland health and social care pay is set separately. See HSC pay in Northern Ireland vs England.

Doctors and dentists are not on Agenda for Change. Resident doctors have their own pay scales, covered in our resident doctor pay guide.

Checking your own pay is right

It is worth checking your payslip against these scales, especially after the April pay award, a promotion or a move between trusts:

1. Find your band and pay point on your contract or payslip.
2. Check your annual salary matches the table above for a full-time post, or the pro rata figure if you work part time.
3. If you work in London or the fringe, check your HCAS is included and correct for your zone.
4. Check your pay point moved up on time if you were due a pay step.

If something looks wrong, contact your payroll or HR team. Our guide on how to read your NHS payslip explains each line.

Questions about the 2026/27 pay scales

When did the 2026/27 pay scales start?

They took effect from 1 April 2026, the start of the NHS pay year.

How much did NHS pay go up in 2026/27?

Agenda for Change pay in England rose by 3.3%.

What is the lowest NHS salary in 2026/27?

The lowest open pay point is Band 2, at £25,272 a year for full-time staff, or £12.92 an hour. Band 1 is closed to new staff.

Is HCAS included in the pay scales?

No. HCAS is paid on top of the basic salaries in the pay scales, if you work in an eligible area.

Where can I find the official tables?

NHS Employers publishes the official annual, hourly and HCAS pay scales on its pay scales for 2026/27 page.

Sources

Checked on 14 October 2026:

• NHS Employers: Pay scales for 2026/27
• NHS Employers: NHS PRB pay award announcement 2026
• NHS Employers: 2026/27 Agenda for Change pay scales (PDF)