Last Updated On – 03-09-2026
Agenda for Change pay bands determine the basic salaries of most NHS employees, including nurses, midwives, paramedics, healthcare assistants, administrative staff and allied health professionals.
In England, the 2026/27 Agenda for Change rates took effect on 1 April 2026 following a confirmed 3.3% consolidated pay increase. National basic salaries now range from £25,272 at Band 2 to £129,783 at the top of Band 9.
What Is Agenda for Change?
Agenda for Change, commonly shortened to AfC, is the national framework used to determine pay and employment conditions for most NHS staff.
It was introduced to create a more consistent system across different occupations.
Instead of every profession operating under a separate salary structure, jobs are evaluated and placed into bands according to factors such as:
- Required knowledge and experience
- Responsibility for patients or services
- Communication requirements
- Decision-making and problem-solving
- Financial and staff-management responsibilities
- Physical, mental and emotional demands
- Working conditions
- Freedom to act independently
The system covers more than clinical jobs. Finance teams, IT workers, estates staff, receptionists, project managers, scientists and operational leaders may also be paid through Agenda for Change.
Readers looking for a broader comparison of grades and occupations can review the existing overview of NHS pay bands.
What Are the Agenda for Change Pay Bands for 2026/27?
The following figures are the national full-time basic salaries for Agenda for Change employees in England. They apply from 1 April 2026 and are based on a standard 37.5-hour working week.
| Pay band | Entry salary | Intermediate salary | Top salary | Normal progression timeframe |
| Band 2 | £25,272 | — | £25,272 | Single pay point |
| Band 3 | £25,760 | — | £27,476 | Top point after 2 years |
| Band 4 | £28,392 | — | £31,157 | Top point after 3 years |
| Band 5 | £32,073 | £34,592 | £39,043 | Intermediate after 2 years; top after a further 2 years |
| Band 6 | £39,959 | £42,170 | £48,117 | Intermediate after 2 years; top after a further 3 years |
| Band 7 | £49,387 | £51,932 | £56,515 | Intermediate after 2 years; top after a further 3 years |
| Band 8a | £57,528 | £60,417 | £64,750 | Intermediate after 2 years; top after a further 3 years |
| Band 8b | £66,582 | £70,896 | £77,368 | Intermediate after 2 years; top after a further 3 years |
| Band 8c | £79,504 | £84,346 | £91,609 | Intermediate after 2 years; top after a further 3 years |
| Band 8d | £94,356 | £100,140 | £108,814 | Intermediate after 2 years; top after a further 3 years |
| Band 9 | £112,782 | £119,583 | £129,783 | Intermediate after 2 years; top after a further 3 years |
These are basic-pay figures. They do not include London weighting, overtime, unsocial-hours payments, recruitment premiums or other allowances.
Band 1 remains part of the historical structure but is closed to new entrants. Most jobs that were previously placed at Band 1 have moved into Band 2.
Which NHS Jobs Are Found in Each Pay Band?
Job titles can vary between NHS organisations. A title alone does not guarantee a particular band because each post must be assessed against its full job description.
| Band | Examples of roles commonly associated with the band |
| Band 2 | Healthcare assistants, porters, domestic staff, catering assistants, receptionists and clerical support |
| Band 3 | Clinical support workers, therapy assistants, pharmacy assistants and experienced administrative staff |
| Band 4 | Nursing associates, assistant practitioners, pharmacy technicians, medical secretaries and senior administrators |
| Band 5 | Newly registered nurses, midwives, paramedics, physiotherapists, occupational therapists and radiographers |
| Band 6 | Specialist nurses, experienced paramedics, junior charge nurses, senior therapists and team leaders |
| Band 7 | Ward managers, advanced specialists, senior midwives, service managers and highly specialist practitioners |
| Band 8a | Matrons, advanced clinical practitioners, principal specialists and operational managers |
| Band 8b | Senior service managers, lead pharmacists, consultant psychologists and major programme leads |
| Band 8c | Heads of service, senior clinical leaders and organisation-wide professional leads |
| Band 8d | Deputy directors, major service directors and senior strategic leaders |
| Band 9 | Directors, chief professional officers and the most senior Agenda for Change leadership roles |
The differences between lower support grades can be particularly difficult to understand. Separate salary breakdowns are available for Band 3 NHS roles and Band 4 NHS pay.
How Is an NHS Job Placed Into a Pay Band?
Agenda for Change bands apply to jobs rather than individual employees. An employer should create an accurate job description and evaluate the demands of the post against the NHS Job Evaluation Scheme.
This means that having a degree, professional registration or many years of experience does not automatically place someone in a higher band. The duties and responsibilities actually required by the position are the deciding factors.
For example, two employees may have the same professional qualification but work at different bands because one role includes:
- Supervising a department
- Managing a substantial budget
- Making complex independent clinical decisions
- Developing organisation-wide policy
- Leading specialist services
- Holding responsibility for other employees
If a job changes substantially, the employee may be able to request a review through the employer’s local job-evaluation process. Taking on occasional extra duties will not necessarily justify rebanding; the higher-level responsibilities generally need to form a significant and ongoing part of the role.
How Does Pay Progression Work?
Moving through a band is different from receiving an annual NHS pay award.
An annual pay award changes the value of the national pay points. Pay progression moves an eligible employee from one pay point to another within the same band.
Progression is not necessarily an automatic yearly increment. At the relevant pay-step date, the employer will normally check whether the employee has:
- Completed the required period at the current pay point
- Participated in the appraisal process
- Met the expected performance standards
- Completed required statutory and mandatory training
- Demonstrated the necessary knowledge and skills
- Avoided any relevant unresolved formal capability process
The employee remains in the same band after progressing to a higher pay point. Moving from Band 5 to Band 6, for example, normally requires appointment to a Band 6 position or the successful re-evaluation of an existing role.
Years spent elsewhere in the NHS do not automatically count as years within a newly acquired band. The relevant period normally begins from the date the employee starts in that band, although previous equivalent service may be considered under applicable appointment rules.
What Changed in the 2026/27 Pay Award?
The confirmed NHS pay rise for 2026 increased Agenda for Change pay points in England by 3.3%, effective from 1 April 2026.
Examples of the annual increase include:
| Pay point | 2025/26 salary | 2026/27 salary | Annual increase |
| Band 2 | £24,465 | £25,272 | £807 |
| Band 5 entry | £31,049 | £32,073 | £1,024 |
| Band 6 top | £46,580 | £48,117 | £1,537 |
| Band 7 top | £54,710 | £56,515 | £1,805 |
| Band 9 top | £125,637 | £129,783 | £4,146 |
The 3.3% rise is consolidated, which means it forms part of the employee’s ongoing basic salary rather than being paid as a temporary or one-off bonus. The wider debate surrounding the award and workforce affordability is covered in the analysis of the UNISON pay rise response.
How Much Is NHS London Weighting in 2026/27?
Eligible NHS employees in London and certain surrounding areas may receive a High-Cost Area Supplement, often called HCAS or London weighting.
The supplement is based on the workplace location rather than where the employee lives.
| Area | Percentage of basic pay | Minimum annual payment | Maximum annual payment |
| Inner London | 20% | £5,794 | £8,746 |
| Outer London | 15% | £4,870 | £6,137 |
| Fringe | 5% | £1,346 | £2,270 |
The minimum and maximum limits matter. An employee does not always receive the exact percentage of their full basic salary.
For example, a top-of-band Band 6 employee earns basic pay of £48,117. Twenty per cent would equal £9,623.40, but the Inner London supplement is capped.
The employee would therefore receive a maximum HCAS payment of £8,746, producing total gross pay of £56,863 before any other additions.
Part-time employees normally receive the supplement on a pro-rata basis. NHS job adverts should state whether Inner London, Outer London or Fringe HCAS applies.
How Much Is Agenda for Change Pay Per Month?
The annual salary can be divided by 12 to find basic monthly gross pay.
Examples include:
- Band 2: £25,272 a year or £2,106 gross per month
- Band 5 entry: £32,073 a year or £2,672.75 gross per month
- Band 6 top: £48,117 a year or £4,009.75 gross per month
- Band 7 top: £56,515 a year or approximately £4,709.58 gross per month
- Band 8a entry: £57,528 a year or £4,794 gross per month
- Band 9 top: £129,783 a year or approximately £10,815.25 gross per month
These figures are not take-home pay. The actual amount reaching an employee’s bank account depends on personal deductions and additional earnings. More detail about the difference between gross and net earnings is available in the Band 7 take-home pay breakdown.
What Is Deducted From NHS Pay?
A typical NHS payslip may include deductions for:
- PAYE income tax
- National Insurance
- NHS Pension Scheme contributions
- Student or postgraduate loan repayments
- Salary-sacrifice arrangements
- Trade union subscriptions
- Parking or workplace schemes
- Court orders or other authorised deductions
Pension contribution rates are tiered, so employees at different salary levels may contribute different percentages. A promotion or national pay increase can move an employee into another contribution tier.
For that reason, a 3.3% increase in gross salary will not normally produce a 3.3% increase in take-home pay. The result depends on the employee’s tax code, pension status, student loan plan and other circumstances.
Do NHS Staff Receive Extra Pay for Nights and Weekends?
Eligible Agenda for Change employees can receive enhancements for working specified unsocial hours, including certain:
- Night shifts
- Saturdays
- Sundays
- Public holidays
The percentage depends on the employee’s band and when the hours are worked. On-call duties, overtime and unsocial-hours payments can be governed by different rules, so they should not be treated as interchangeable.
Some roles may also attract:
- Recruitment and retention premia
- Overtime payments
- On-call allowances
- Standby payments
- Mileage expenses
- Acting-up payments
- Additional responsibility payments
Not every employee receives these additions. Eligibility depends on the contract, work pattern and local arrangements.
How Is Part-Time NHS Pay Calculated?
Agenda for Change salaries in job adverts are generally quoted as full-time figures. Part-time basic pay is usually calculated in proportion to contracted weekly hours.
For example, a Band 4 employee at the top of the band earning £31,157 on a 37.5-hour contract would receive the following basic salary for 30 hours a week:
£31,157 × 30 ÷ 37.5 = £24,925.60 a year
Any eligible HCAS, annual leave and other contractual entitlements are also normally adjusted proportionately. Unsocial-hours payments are then calculated according to the shifts actually worked.
Do England, Scotland, Wales and Northern Ireland Use the Same Rates?
Agenda for Change operates across the UK, but the four nations do not necessarily apply identical salary figures or introduce pay awards at the same time.
The table in this article covers England for 2026/27. Someone considering a role in Scotland, Wales or Northern Ireland should check the salary stated in the relevant job advert rather than applying the English figure.
Regional differences do not mean that the job-evaluation principles are completely different. However, annual pay settlements, individual pay points and certain employment conditions may vary.
Is Bank or Agency Pay the Same as Agenda for Change Pay?
Not always.
A substantive NHS employee is normally appointed to an Agenda for Change band and pay point. An NHS staff-bank worker may receive an hourly rate linked to a band, but the employer can operate separate bank arrangements.
Agency workers are employed or supplied through an outside organisation. Their hourly rate may look higher, but their pension arrangements, paid leave, sick pay, job security and other benefits can differ from those of substantive NHS employees.
Candidates should compare the complete employment package rather than focusing only on the advertised hourly amount.
Can a New Employee Start Above the Bottom of a Band?
The normal expectation is that a new employee starts at the entry point of the advertised band. Starting at a higher pay point may be possible in limited circumstances, particularly where relevant equivalent experience can be recognised.
It should not be assumed that several years in a similar private-sector role will automatically result in appointment at the top of the band. Any variation should be discussed and confirmed before accepting the position.
Existing NHS employees who are promoted are covered by specific pay-on-promotion rules. Their new salary should be calculated under those rules rather than negotiated informally.
Does Professional Registration Decide the Band?
Professional registration can be an essential requirement for a role, but it does not determine the pay band by itself.
A newly qualified registered nurse or midwife commonly enters Band 5, while an experienced specialist, team leader or advanced practitioner may hold a Band 6 or Band 7 post. The site’s detailed midwife salary comparison illustrates how one profession can span several bands.
The same principle applies to mental health nursing pay and different groups of allied health professionals. Professional experience can help someone qualify for a senior vacancy, but the responsibilities of the post determine its band.
How Can NHS Staff Check Whether Their Pay Is Correct?
Employees should compare their contract, payslip and current national pay table.
Important details include:
- The correct Agenda for Change band
- The correct pay point within that band
- The pay-step date
- Contracted weekly hours
- Full-time or part-time status
- HCAS eligibility and zone
- Unsocial hours worked
- Overtime or on-call payments
- Pension contribution rate
- Tax code and other deductions
A change in gross pay does not always mean that the basic salary is wrong. Differences may result from a tax-code update, pension contribution change, unpaid absence, salary sacrifice or a different shift pattern.
If a discrepancy remains, the employee should contact payroll or HR with the relevant payslips, rota records and employment documents.
Why Do Agenda for Change Bands Matter to Employers?
For NHS organisations and external businesses supplying workforce services, banding affects more than an employee’s headline salary.
It also influences:
- Pension and National Insurance costs
- Overtime and enhancement calculations
- Recruitment budgets
- Temporary staffing comparisons
- Workforce planning
- Promotion and retention decisions
- Equal-pay risks
- Service redesign costs
An incorrectly banded job can create recruitment problems and employee-relations disputes. Employers should therefore review the actual responsibilities of a role whenever services are redesigned or substantial new duties are introduced.
Final Analysis
Agenda for Change provides a transparent structure for comparing NHS roles, but the band number is only one part of total earnings. Pay point, contracted hours, location, shift pattern, pension membership and personal deductions can all change the final amount.
For 2026/27, national basic pay in England starts at £25,272 for Band 2 and reaches £129,783 at the top of Band 9. Employees assessing a vacancy or checking a payslip should confirm the exact pay point, progression date and any applicable London supplement instead of relying on the band’s headline range alone.
Frequently Asked Questions
What is the lowest Agenda for Change band?
Band 1 is closed to new entrants, so Band 2 is normally the lowest band used for new substantive NHS appointments.
How much is NHS Band 5 pay in 2026/27?
Band 5 basic pay in England ranges from £32,073 to £39,043. The intermediate point is £34,592. The Band 5 hourly-rate information provides further context for shift-based earnings.
What is the highest Agenda for Change salary?
The top of Band 9 is £129,783 in England for 2026/27, before any eligible allowances or additions.
Does everyone move up a pay point every year?
No. Bands have specified progression periods, and employees normally need to satisfy the applicable pay-progression requirements.
Does a pay rise move an employee into the next band?
No. A national pay award increases the value of the existing pay point. Moving into a higher band normally requires a promotion or job-evaluation outcome.
Is London weighting included in the national salary table?
No. HCAS is added separately for eligible workplaces in Inner London, Outer London and designated Fringe areas.
Are Agenda for Change salaries before tax?
Yes. Published pay-band figures show gross basic salary before tax, National Insurance, pension contributions and other deductions.
Are doctors paid under Agenda for Change?
Doctors and dentists are generally covered by separate national contracts and pay scales rather than Agenda for Change.
Do NHS apprentices receive standard band pay?
Apprentice pay can follow separate arrangements depending on the programme, stage and employer. Candidates should check the exact salary and progression terms in the vacancy information.
Can two employees with similar job titles be in different bands?
Yes. Their responsibilities, decision-making authority, required skills and working demands may differ, even when the job titles sound similar.
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