NHS Pay Rise 2026: Complete Guide to AfC Bands, Take-Home Pay and the 2025/26 Award
By Mustafa Bilgic • Updated
The 2025/26 NHS Agenda for Change (AfC) pay award of 5.5%, effective from 1st April 2025, marks a significant moment for the UK's 1.4 million NHS workers. After years of real-terms pay cuts during the post-pandemic inflation surge, the 5.5% award — above the CPI inflation rate of approximately 2.6% at the time of settlement — delivered a genuine real-terms increase for most AfC staff. This guide covers the full AfC pay scales, real take-home pay examples at key bands, the negotiation history, and what the future holds for NHS pay in 2026/27.
2025/26 NHS Pay Award: Key Facts
The 5.5% Agenda for Change award covers all NHS staff in England on AfC contracts, from Band 2 healthcare assistants to Band 9 directors of nursing.
5.5%
AfC pay increase from April 2025
£23,615
New Band 2 starting salary
£29,970
New Band 5 starting salary
~2.9%
Real-terms increase above CPI
NHS Take-Home Pay Calculator 2025/26
Select your band and pay point to calculate your monthly and annual take-home pay after income tax, National Insurance and NHS pension contributions (2025/26 rates).
Your Take-Home Pay Breakdown
Gross Annual Salary (incl. HCAS)-
NHS Pension Contribution-
Income Tax (PAYE)-
National Insurance (Class 1)-
Annual Take-Home Pay-
Monthly Take-Home-
Weekly Take-Home-
Hourly Rate (37.5hr week)-
Effective Tax Rate (incl. NI)-
Full AfC Pay Scales 2025/26 (After 5.5% Increase)
The following table shows the full Agenda for Change pay scale for England, effective 1st April 2025. The 2024/25 figures are shown for comparison. Note that some bands have only one pay point following previous NHS pay reforms, while others have multiple progression points.
Senior/Specialist Nurse, Team Leader AHP, Senior Scientist
Top
42,618
44,962
+2,344
Band 7
Entry
43,742
46,148
+2,406
Advanced Nurse Practitioner, Service Manager, Principal AHP
Top
50,056
52,809
+2,753
Band 8a
Entry
53,755
56,711
+2,956
Consultant Nurse, Departmental Manager, Lead Scientist
Top
60,504
63,832
+3,328
Band 8b
Entry
62,215
65,637
+3,422
Deputy Director, Head of Specialty, Chief AHP
Top
72,293
76,269
+3,976
Band 8c
Entry
74,290
78,376
+4,086
Associate Director, Head of Nursing Division
Top
85,601
90,309
+4,708
Band 9
Entry
91,787
96,835
+5,048
Director of Nursing, Executive Level Clinical Lead
Top
105,385
111,181
+5,796
Note on London High Cost Area Supplement (HCAS): NHS staff working in London and surrounding areas receive a High Cost Area Supplement (HCAS) in addition to their basic pay. Inner London: 20% of basic pay (minimum £5,132, maximum £8,461). Outer London: 15% (minimum £4,314, maximum £5,436). Fringe: 5% (minimum £1,192, maximum £2,011). These figures for 2025/26 are subject to the same minimums/maximums uplift as base pay.
Real Take-Home Pay Examples: Band 5, 6 and 7 (2025/26)
The following examples show actual take-home pay calculations for three representative AfC roles. All calculations use 2025/26 income tax and National Insurance rates: Personal Allowance £12,570, Basic Rate 20% up to £50,270, Higher Rate 40% up to £125,140. National Insurance: 8% on earnings between £12,570 and £50,270, then 2% above. NHS Pension contributions are applied before tax (salary sacrifice, increasing take-home pay).
Band 5 Staff Nurse (Entry) — England
Gross Salary£29,970
NHS Pension (6.5%)-£1,948
Taxable Pay£28,022
Income Tax (PAYE)-£3,090
National Insurance-£1,956
Annual Take-Home£22,976
Monthly Take-Home£1,915
Band 6 Senior Nurse (Mid) — England
Gross Salary£41,150
NHS Pension (7.2%)-£2,963
Taxable Pay£38,187
Income Tax (PAYE)-£5,123
National Insurance-£2,449
Annual Take-Home£30,615
Monthly Take-Home£2,551
Band 7 ANP / Manager (Entry) — England
Gross Salary£46,148
NHS Pension (7.2%)-£3,323
Taxable Pay£42,825
Income Tax (PAYE)-£6,051
National Insurance-£2,742
Annual Take-Home£34,032
Monthly Take-Home£2,836
Note on NHS Pension Salary Sacrifice: NHS pension contributions are made under a salary sacrifice arrangement in most trusts, meaning the contribution is deducted from gross pay before income tax and National Insurance are applied. This reduces both your income tax and NI liability, effectively giving you tax relief at your marginal rate. The examples above assume salary sacrifice pension deduction, which is the standard arrangement in NHS England.
NHS Pay Rise vs Inflation: The Real Picture 2019 to 2026
Understanding whether NHS pay has kept pace with the cost of living requires looking at the full picture over several years, not just the most recent award.
Year
AfC Pay Award
UK CPI Inflation
Real-Terms Change
Cumulative Real Change (from 2019)
2019/20
+3.0%
+1.8%
+1.2%
baseline
2020/21
+2.8%
+0.9%
+1.9%
+3.1%
2021/22
+3.0%
+2.5%
+0.5%
+3.6%
2022/23
+3.5%
+9.1%
-5.6%
-2.0%
2023/24
+5.0%
+7.9%
-2.9%
-4.9%
2024/25
+5.5%
+3.2%
+2.3%
-2.6%
2025/26
+5.5%
~2.6%
~+2.9%
~+0.3%
CPI figures are approximate annual averages. Real-terms change = pay award minus CPI inflation. Cumulative figures are compounded. Data sources: ONS, NHS Pay Review Body reports.
The table illustrates a challenging picture. While the 5.5% award in 2025/26 represents genuine progress and the first year in which NHS pay has broadly matched or exceeded inflation for consecutive years since 2021, the accumulated real-terms deficit from 2022 and 2023 has not been fully recovered. NHS unions have argued that a single above-inflation year is insufficient to address years of falling purchasing power. The Royal College of Nursing has noted that a Band 5 nurse's real purchasing power in 2025 remains approximately 3 to 4 percent below 2010 levels in real terms, despite numerous nominal pay increases over that period.
NHS Pay Negotiation Timeline: 2023 to 2026
January 2023
Strike action begins — nurses and ambulance workers
RCN, UNISON and GMB members voted for industrial action over the 2022/23 pay award, which unions argued failed to keep pace with inflation running above 10%.
March 2023
Junior doctors begin first strike since 1970s
BMA junior doctors began 72-hour strike action seeking a 35% pay restoration, beginning a protracted dispute that would extend throughout 2023.
May 2023
AfC 2023/24 offer accepted — 5% plus £1,655 lump sum
After intensive negotiations, the Sunak government offered AfC staff a 5% consolidated increase plus a one-off lump sum, equivalent to approximately 5% for most staff. UNISON, GMB and other unions accepted via member ballot.
October 2023
Junior doctors dispute temporarily suspended
BMA junior doctors accepted a phased agreement with the government, pausing industrial action pending a multi-year pay deal.
August 2024
New Labour government announces 5.5% AfC award for 2024/25
Incoming Health Secretary announced acceptance of the Pay Review Body recommendation, with backdated payment from April 2024.
April 2025
2025/26 AfC 5.5% award effective
Second consecutive 5.5% award applied, reflecting the Government's intention to maintain above-inflation increases while managing NHS workforce costs within the Spending Review envelope.
Spring 2026
NHS Pay Review Body recommendations expected for 2026/27
The PRB will submit its 2026/27 recommendations to government. Unions are expected to seek a 4 to 6% increase. Final outcome dependent on Chancellor's Spending Review decisions.
Understanding the NHS Pension Scheme
The NHS Pension Scheme is one of the most valuable elements of NHS employment and is often underestimated in discussions purely about take-home pay. The scheme is a Defined Benefit (DB) arrangement, which means your pension is calculated based on your career average earnings rather than investment performance. In a world where most private sector DB schemes have closed to new entrants, the NHS scheme remains genuinely exceptional.
Employee Contribution Rates (2025/26)
Pensionable Pay Range
Employee Contribution Rate
Monthly Cost (mid-band pay)
Up to £23,030
5.4%
~£104/month
£23,031 to £36,667
6.5%
~£163/month (at £30k)
£36,668 to £62,000
7.2%
~£256/month (at £42k)
£62,001 to £100,000
9.8%
~£657/month (at £80k)
Over £100,000
12.3%
~£1,025/month (at £100k)
Employer contributions to the NHS Pension Scheme stand at 23.7% of pensionable pay — a substantial additional benefit that does not appear in your payslip but represents real value. NHS staff accrue pension at 1/54th of their career average pensionable earnings each year. A Band 6 nurse working 30 years at an average of £40,000 would accrue approximately £22,222 per year in pension (30 × £40,000 / 54).
Frequently Asked Questions: NHS Pay Rise 2026
What is the NHS pay rise for 2025/26? ▲
The NHS Agenda for Change (AfC) pay award for 2025/26 is 5.5%, effective from 1st April 2025. This applies to all NHS England staff on AfC contracts, covering Bands 2 through 9. Doctors and dentists on separate contracts received different uplifts through their own Pay Review Body recommendations. The 5.5% award exceeded CPI inflation of approximately 2.6% at the time of settlement, delivering a real-terms pay increase.
What is the new Band 5 NHS salary for 2025/26? ▼
Following the 5.5% increase, the Band 5 pay range for 2025/26 runs from £29,970 at entry to £36,483 at the top pay point. Band 5 covers newly qualified nurses, newly qualified allied health professionals (physiotherapists, occupational therapists, radiographers), junior clinical scientists and equivalent non-clinical roles. A newly qualified Band 5 nurse in London with Outer London HCAS would earn approximately £34,466 before deductions.
When does the 2025/26 NHS pay rise take effect and when is it paid? ▼
The 5.5% award is effective from 1st April 2025. The timeline for actual payment varies by NHS Trust. Most Trusts issued backdated payments (covering April, May, June 2025) as a lump sum in July or August 2025, with the new higher monthly rate applying from the following month. Some Trusts were slower, with payments arriving as late as September or October 2025. If you are unsure whether your backdated payment has been issued, check your payslip or contact your Trust's payroll department.
How does the NHS pay rise compare to inflation? ▼
The 5.5% award for 2025/26 compares favourably to UK CPI inflation, which fell to approximately 2.6% by early 2025 and RPI at around 3.2%. This means NHS AfC staff received a real-terms pay increase of approximately 2.9% above CPI. This is the second consecutive year of real-terms increases after two years (2022/23 and 2023/24) in which NHS pay rose significantly below the inflation rate, which at its peak exceeded 10% in late 2022. The cumulative real-terms position from 2019 to 2026 remains broadly flat, with the gains in 2024/25 and 2025/26 largely offsetting the real-terms losses of the 2022 to 2023 inflation surge.
Does the NHS pay rise affect NHS pension contributions? ▼
Yes, it can. The NHS Pension Scheme uses tiered contribution rates based on pensionable pay. If your salary increase moves you from one tier to the next, your pension contribution rate will increase. For example, if a pay rise moves your salary from below £36,667 to above £36,667, your employee contribution rises from 6.5% to 7.2% of pensionable pay. This slightly reduces the net take-home pay benefit of the pay award for staff near a tier boundary. However, higher contributions mean a proportionally larger pension at retirement.
Is the NHS pay rise the same in Scotland and Wales? ▼
No. Pay negotiations are handled separately for each UK nation. NHS Scotland and NHS Wales operate under their own AfC negotiating frameworks. In recent years, Scotland has sometimes offered higher percentage increases (NHS Scotland awarded 6.0% for 2025/26) while Wales has broadly matched England. NHS Northern Ireland negotiates independently and has historically faced delays in implementing awards due to devolved budget constraints. Always check the specific award from your employer rather than assuming the England figure applies to you.
What will the NHS pay rise be in 2026/27? ▼
The 2026/27 NHS pay award has not been confirmed as of February 2026. The NHS Pay Review Body is expected to submit recommendations to the Government in spring 2026. NHS unions (RCN, UNISON, GMB, Unite, BMA) have indicated they will seek an above-inflation increase, with some citing a 4 to 6% target. The outcome depends significantly on the Government's public sector pay policy following the autumn 2025 Spending Review. Given the current trajectory of CPI inflation (approximately 2.5 to 3% forecast for 2026), an award in the 4 to 5% range would deliver a real-terms increase and avoid industrial action.
What is London Weighting in the NHS and how is it calculated? ▼
NHS London Weighting, formally called the High Cost Area Supplement (HCAS), is paid to staff working in high-cost areas to reflect the higher cost of living. For 2025/26: Inner London pays an additional 20% of basic salary (minimum £5,132, maximum £8,461 per year), Outer London pays 15% (minimum £4,314, maximum £5,436), and the Fringe zone pays 5% (minimum £1,192, maximum £2,011). The fringe zone covers parts of the Home Counties adjacent to Greater London. HCAS is fully taxable and subject to NI, but is pensionable, which increases your pension accrual.
What to Expect for NHS Pay in 2026/27
As the NHS enters the 2026/27 pay round, the context is significantly more stable than in the turbulent 2022 to 2024 period. CPI inflation has returned to a more manageable level, reducing the urgency of catch-up demands. However, NHS unions are acutely aware that the real-terms value of NHS pay remains below its 2010 peak when measured against a consumer price index — and they will press that case in Pay Review Body submissions.
Several factors will shape the 2026/27 outcome: the Government's desire to avoid a repeat of the 2023 strike action, the NHS workforce plan's recruitment targets (which require competitive pay to attract and retain nurses and allied health professionals), the overall fiscal envelope set in the 2025 Spending Review, and private sector pay trends. At the time of writing, a 4 to 5.5% award for 2026/27 appears the most likely outcome based on current trajectory.
For NHS staff, the key practical action is to use our calculator above to understand your exact take-home pay at your current band and progression point, factor in any HCAS entitlement, and plan your personal finances accordingly. The NHS pension scheme remains highly valuable — our calculator accounts for salary sacrifice pension deductions, which reduce your taxable income and therefore your income tax and NI liability.
Data Sources and Accuracy: Pay scale figures are based on NHS Employers published Agenda for Change pay scales for England, effective April 2025. Tax calculations use HMRC 2025/26 rates: Personal Allowance £12,570, Basic Rate 20% on £12,571 to £50,270, Higher Rate 40% on £50,271 to £125,140. National Insurance Class 1: 8% on £12,570 to £50,270, 2% above. NHS Pension contribution tiers are per the NHS Pension Scheme employer guidance for 2025/26. London HCAS rates are per NHS Employers guidance. All calculations are for illustrative purposes — your actual take-home pay may vary based on your specific tax code, student loan deductions, salary sacrifice arrangements and other payroll deductions.