Returning to the NHS After a Career Break: Pay, Pension and Registration

People take career breaks for all sorts of reasons: raising children, caring for relatives, travelling, studying or recovering from illness. Coming back to the NHS afterwards is very common, and much of what you built up before can still count. What you keep depends on how long you were away, whether you used a formal career break scheme, and whether your professional registration stayed active.

Formal career break schemes

Many NHS employers run a career break or employment break scheme. Terms vary between trusts, but schemes typically:

• allow an unpaid break for a set period, often from a few months up to several years
• offer a right to return to a similar job, or support to find one
• ask you to keep in touch, for example with a few days' work or training each year

If you are still planning a break, ask whether your trust has a scheme. Leaving under a formal scheme usually protects more of your rights than resigning.

What counts when you come back

Under the NHS Terms and Conditions of Service Handbook, previous NHS service is called reckonable service. When you return:

• Annual leave: previous NHS service usually counts towards the 5-year and 10-year steps, so you may return on 29 or 33 days rather than 27.
• Sick pay: previous NHS service counts only if the break was 12 months or less. After a longer break, sick pay entitlement starts again from the first-year level.
• Maternity pay: the 12-month continuous service test usually starts again after a break of more than three months.
• Redundancy: continuity for redundancy pay is broken by a gap of more than a week between NHS jobs.

Employers can also choose to recognise relevant experience you gained outside the NHS during your break.

Which pay point will you return on?

There is no automatic rule that you return to your old pay point. In practice:

• if you return to the same band, many employers will match your previous pay point, particularly after a short break
• some will start you at the entry point, especially after a long break
• relevant experience during the break can support a request for a higher starting point

Ask about this before you accept the offer, and get the agreed pay point in writing. The take-home pay calculator shows what each point means in your account.

Your NHS Pension

The pension you built before your break stays in the scheme as deferred benefits if you left NHS employment, or is unaffected if you were on an approved unpaid break. When you return:

• you can rejoin the NHS Pension and start building new pension in the 2015 scheme
• your earlier benefits remain in your record
• in some cases earlier and later service can be linked, depending on the length of the break and which section the earlier service was in

A break of more than five years can affect some protections, including McCloud remedy eligibility for older service. NHS Pensions can explain the effect on your own record.

Getting your registration back

If you are a registered professional, your registration status decides how quickly you can return.

Nurses, midwives and nursing associates (NMC)

To stay on the NMC register you must revalidate every three years, including at least 450 practice hours in that period. If your registration lapsed, or you do not have enough practice hours, you can complete a return to practice programme. In England these courses are usually funded, and many include a bursary or paid placement. Your trust's education team can tell you about local programmes.

Allied health professionals and others (HCPC)

The HCPC sets updating requirements for people returning after more than two years out of practice: typically 30 days of updating for a break of two to five years, and 60 days for more than five years. This can combine supervised practice, formal study and private study.

Practical steps for a smooth return

1. Contact the trust or team you want to join. Many are keen to support returners.
2. Check your registration and start any return to practice steps early.
3. Gather your history: old contracts, payslips, P60s and pension statements.
4. Ask about flexible working. You can request it from day one. See our flexible working guide.
5. Plan a phased return if you have been away for a long time.

Returning part time

Many returners come back on reduced hours. Pay, leave and pension all scale with your hours. Your pension contribution tier is based on actual pay, so part-time hours often mean a lower rate. The part-time pay calculator shows the figures for any pattern.

Common questions

Will I have to repeat all my mandatory training? Usually yes, unless records can be transferred and are still in date.

Does my previous band guarantee I return on it? No. You return on the band of the post you are appointed to.

Can I return through the staff bank first? Yes. Some returners start on the bank to rebuild confidence, although bank work does not usually build continuous service.

Your first payslip back: what to check

The first payslip after a break is where most problems show up. Check these lines:

1. Tax code. Without a P45 you may be on an emergency code ending in M1, W1 or X. It is normally corrected within a month or two, and overpaid tax is refunded through your pay. Our tax code guide explains the codes.
2. Pay point. Make sure it matches what was agreed in your offer letter.
3. Pension. You should be enrolled automatically. Check the contribution rate matches your pay.
4. Student loan. If you have a loan, make sure the right plan is being used.
5. Hours. If you returned part time, check that the hours on the payslip match your contract.

If anything is wrong, contact payroll as soon as possible. Underpayments are usually corrected in the next month's pay.

Work out your pay

Use the take-home pay calculator to see your monthly pay on return.