What Agenda for Change actually is
Agenda for Change (AfC) is the national pay and grading framework used for most NHS staff: nurses, healthcare assistants, porters, paramedics, administrators, allied health professionals and more. It doesn't cover doctors, dentists or very senior managers, who sit on separate contracts with their own pay arrangements.
Every AfC post sits in one of nine bands (Band 8 splits into 8a to 8d), decided by job evaluation, which scores the role against factors like knowledge, responsibility and physical demands, not the person doing it. Within a band, staff sit at a pay point; most bands have an entry rate, sometimes an intermediate rate, and a top rate. Moving up those points over time is progression, not promotion: a higher band normally means a different, separately evaluated role.
The terms blur easily, so it's worth being precise. Band is the pay range; pay point is where you sit in it; basic salary is what that point pays before anything is added or removed; total earnings can include shift pay, overtime or a location supplement on top; take-home pay is what's left after deductions. Two people on the same band and point can still take home very different amounts.
England's 2026/27 pay scale
This is the basic full-time annual salary table for England, effective from 1 April 2026, as published by NHS Employers on 12 February 2026.
| Band | Entry | Intermediate | Top | Time to top |
|---|---|---|---|---|
| 1 (closed to new entrants) | £25,272 | — | — | n/a |
| 2 | £25,272 | — | £25,272 | Flat rate |
| 3 | £25,760 | — | £27,476 | 2 years |
| 4 | £28,392 | — | £31,157 | 3 years |
| 5 | £32,073 | £34,592 | £39,043 | 4 years (2 + 2) |
| 6 | £39,959 | £42,170 | £48,117 | 5 years (2 + 3) |
| 7 | £49,387 | £51,932 | £56,515 | 5 years (2 + 3) |
| 8a | £57,528 | £60,417 | £64,750 | 5 years (2 + 3) |
| 8b | £66,582 | £70,896 | £77,368 | 5 years (2 + 3) |
| 8c | £79,504 | £84,346 | £91,609 | 5 years (2 + 3) |
| 8d | £94,356 | £100,140 | £108,814 | 5 years (2 + 3) |
| 9 | £112,782 | £119,583 | £129,783 | 5 years (2 + 3) |
Two things worth flagging. Band 1 is closed to new starters and its single rate now matches Band 2's exactly: years of above-inflation rises at the bottom have pushed the two together. Band 2 is now a flat rate, so staff there are paid the same regardless of service. Neither is a typo. To see what these figures mean once deductions apply, estimate your NHS take-home pay.
What this table leaves out
Every figure above is contracted basic pay for a standard full-time post, before tax, National Insurance and pension deductions, and before anything is added for the specifics of a role. It excludes High Cost Area Supplements, unsocial-hours and weekend enhancements, overtime, on-call payments, recruitment and retention premia some employers attach to hard-to-fill posts, bank or agency earnings, and one-off arrears payments. Depending on where you work and what shifts you do, those additions can move your actual pay well beyond the band figure, which is why a pay table is never a promise of what lands in your account.
High Cost Area Supplements
Staff working in and around London receive a High Cost Area Supplement (HCAS) on top of basic pay, as a percentage of salary capped by a minimum and maximum cash amount. For 2026/27 in England: Inner London gets 20% (minimum £5,794, maximum £8,746 a year), Outer London 15% (minimum £4,870, maximum £6,137), and the Fringe zone 5% (minimum £1,346, maximum £2,270). It only applies within those designated zones; "London weighting" is a slightly loose label, since the Fringe reaches into the Home Counties and nothing is paid outside them. The NHS pay and take-home guide covers how the supplement interacts with your band and part-time hours.
Scotland, Wales and Northern Ireland compared
England's Pay Review Body route isn't the only one. Scotland negotiates its Agenda for Change pay directly with health unions, on a separate two-year deal running to 2026/27; Wales and Northern Ireland sit within the same Pay Review Body process as England but don't automatically inherit its exact figures. All four awards are effective, or intended to be, from 1 April 2026.
| Nation | 2026/27 award | Band 5 range | Band 6 range | Status |
|---|---|---|---|---|
| England | 3.3% consolidated | £32,073–£39,043 | £39,959–£48,117 | Confirmed, funded |
| Scotland | 3.75% (year 2 of a two-year deal, plus adjustment) | £34,544–£43,039 | £43,231–£52,679 | Confirmed, funded |
| Wales | 3.3%, applied to Wales's own base | £32,557–£39,631 | £40,559–£48,841 | Confirmed; verify against the circular |
| Northern Ireland | 3.3% proposed | Not yet published | Not yet published | Unresolved, unfunded |
Scotland's higher headline award puts its scale above England's at every band shown. Wales accepted the same 3.3% as England but applied it to its own existing scale, so the AfC(W) 02/2026 circular's cash figures come out a little higher; worth checking directly, since some sites still describe Wales as identical to England. Northern Ireland is the outlier: the Department of Health said in February 2026 it wanted to match the 3.3% award, but called this an ambition dependent on Executive budget approval, not a confirmed award, and unions were still reporting it unfunded going into autumn, with fresh pay tension reported among nursing staff in late August. If you work in Northern Ireland's health and social care system, treat any England figure as a reference point only.
How progression through a band actually works
Moving from one pay point to the next runs from your organisation's pay-progression date, not your work anniversary, and depends on satisfactory performance with no live conduct or capability issues, so it can be delayed, even if that's the exception. Band 5 moves entry to intermediate after two years, then to top after two more; Band 6 and everything above follows a two-then-three-year pattern. None of this is automatic: your actual pay-step date sits on your Electronic Staff Record (ESR), which is what to check, not this table.
Band 5 in practice
Band 5 is where a large share of newly qualified nurses and other clinical roles begin, so it's worth a closer look. A hypothetical full-time Band 5 employee in England starting on 1 April 2026 would enter on £32,073, move to £34,592 after two years' progression, and reach £39,043 after two more, all basic salary, before deductions or any HCAS and unsocial-hours payments their rota might attract. Actual take-home depends on location, shifts and circumstances, so treat this as an illustration, not a forecast. The NHS pay and take-home guide works a Band 5 example through Income Tax, National Insurance and the pension contribution.
Part-time and variable hours
Part-time basic salary is calculated pro rata: annual full-time salary multiplied by contracted hours, divided by full-time hours. A Band 3 employee in England on the £25,760 entry point, contracted for 22.5 hours against a 37.5-hour full-time week, gets £25,760 × 22.5 ÷ 37.5 = £15,456 a year. Job shares split the same way. Not every employer uses 37.5 hours as standard, so check your own contract. Overtime and any night, weekend or bank shifts sit outside this calculation and are paid separately.
Two more worked examples
A full-time Band 2 healthcare support worker in England on the flat 2026/27 rate earns £25,272 basic, before any unsocial-hours pay for shifts actually worked, a fixed figure that doesn't grow with service. A part-time Band 6 nurse on the top point (£48,117 full-time equivalent), contracted for 22.5 hours a week, has a pro-rata basic salary of roughly £28,870 (£48,117 × 22.5 ÷ 37.5); any HCAS or unsocial-hours pay would be added by their employer, not folded into the banded figure. Both use verified England rates and are hypothetical, not a prediction for any specific payslip.
Why your payslip won't match the table
Even on the correct band and point, several things separate the annual table from what reaches your account. Pay runs monthly, so a rise, a change of hours or a pay-step move partway through the year can generate arrears that show up later. Income Tax, National Insurance, NHS Pension Scheme contributions (themselves banded by pay), and any student loan or salary sacrifice arrangement are deducted before you see the money. Unpaid leave, statutory sick pay rules, a tax-code change, part-time hours, and any overtime or unsocial-hours payments actually worked shift the figure further. None of that can be worked out from a salary table alone; see how deductions affect your monthly pay using your own band, location and hours.
What a pay table can't tell you
A table like this is a reference point, not a full picture of what working for the NHS is worth. It won't tell you your pension benefits, exact take-home pay, recruitment-premium eligibility, tax code, or sick pay and maternity entitlements, and it says nothing about annual leave, a meaningful part of the wider package; calculate your NHS annual leave entitlement separately. For anything specific to your own employment, your contract, ESR record or payroll team will have the answer this article can't.
This is general information, not personalised financial, tax or employment advice, and NHS pay rules can change. It doesn't replace your employer's official pay confirmation, particularly in Northern Ireland, where the 2026/27 position remained unresolved at the time of writing.