NHS Pay Rise 2026/27: What Staff in England and Wales Will Receive?

Most NHS staff in England and Wales on Agenda for Change contracts will receive a 3.3% consolidated pay rise from 1 April 2026.

This NHS pay rise 2026/27 applies to many healthcare workers, including nurses, midwives, paramedics, healthcare assistants, administrative teams and other staff covered by NHS terms and conditions.

The award updates annual pay scales, hourly rates and London Higher Cost Area Supplements. Doctors and dentists are not usually covered by Agenda for Change, so their pay increases are handled separately.

Resident doctors were projected to receive an average increase of around 4.9%, while other doctor and dentist groups were expected to receive increases of around 3.5% to 3.75%.

Key points include:

• The main Agenda for Change uplift is 3.3%.
• The new rates are effective from 1 April 2026.
• The rise applies to most NHS staff in England and Wales under Agenda for Change.
• London staff may receive HCAS depending on location.
• Some pay structure discussions may continue, especially for lower bands.

What Is the NHS Pay Rise 2026/27 for England and Wales?

The NHS pay rise 2026/27 is a 3.3% consolidated uplift for most Agenda for Change staff in England and Wales. A consolidated increase means the rise becomes part of basic salary, rather than being paid as a one-off amount.

This is important because basic pay affects pensionable earnings, overtime calculations and future salary increases. For NHS workers, the confirmed award gives a clearer idea of expected income for the 2026/27 financial year.

Pay detail	2026/27 position
Main award	3.3% consolidated uplift
Effective date	1 April 2026
Main coverage	Agenda for Change staff
Countries covered	England and Wales
Estimated staff affected	Around 1.5 million
Further review	Pay structure discussions may continue

Who Will Receive the NHS Staff Pay Increase in 2026/27?

The 3.3% pay rise mainly applies to NHS employees on Agenda for Change contracts. These contracts cover a large part of the NHS workforce, both clinical and non-clinical.

Agenda for Change Staff

Agenda for Change staff can include:

• Nurses and midwives
• Paramedics and ambulance staff
• Healthcare assistants
• Porters and domestic staff
• Administrative and clerical workers
• Allied health professionals
• Pharmacy, theatre and technical staff

The amount each person receives depends on their band, pay step and working hours. A full-time Band 5 nurse, for example, will have a different salary from a part-time Band 3 administrator or a Band 7 specialist practitioner.

Staff Groups Outside Agenda for Change

Doctors and dentists normally have separate pay arrangements. This means the 3.3% Agenda for Change award should not be automatically applied to medical and dental staff.

For 2026/27, resident doctors were projected to receive an average uplift of around 4.9%. Other doctor and dentist groups were expected to receive increases between 3.5% and 3.75%, depending on their specific arrangements.

How Much Will NHS Agenda for Change Staff Be Paid from April 2026?

The updated NHS Agenda for Change pay scales set out what staff will earn from 1 April 2026. Band 1 is closed to new entrants, while Band 2 is the starting point for many support roles.

Entry, Intermediate and Top Step Points

Some NHS bands have only an entry and top step. Higher bands usually include entry, intermediate and top step points. Staff progress through these points after set periods, provided they meet the relevant progression criteria.

A hospital payroll adviser described the issue clearly: “I often see staff focus on the headline percentage, but the final salary depends on band, step point, hours and location. I always advise staff to compare the new figure with their own payslip rather than using a general estimate.”

NHS Band	Entry Step	Intermediate Step	Top Step
Band 2	£25,272	—	£25,272
Band 3	£25,760	—	£27,476
Band 4	£28,392	—	£31,157
Band 5	£32,073	£34,592	£39,043
Band 6	£39,959	£42,170	£48,117
Band 7	£49,387	£51,932	£56,515
Band 8a	£57,528	£60,417	£64,750
Band 8b	£66,582	£70,896	£77,368
Band 8c	£79,504	£84,346	£91,609
Band 8d	£94,356	£100,140	£108,814
Band 9	£112,782	£119,583	£129,783

Salary note

These figures show gross annual salary before tax, National Insurance, pension contributions and any other deductions.

What Are the NHS Hourly Pay Rates for 2026/27?

The NHS pay rise 2026/27 also updates hourly pay rates. These are useful for part-time staff, bank workers and employees who want to understand the value of each working hour.

NHS Band	Entry Hourly Rate	Intermediate Hourly Rate	Top Hourly Rate
Band 2	£12.92	—	£12.92
Band 3	£13.17	—	£14.05
Band 4	£14.52	—	£15.93
Band 5	£16.40	£17.69	£19.97
Band 6	£20.44	£21.57	£24.61
Band 7	£25.26	£26.56	£28.90
Band 8a	£29.42	£30.90	£33.11
Band 8b	£34.05	£36.26	£39.57
Band 8c	£40.66	£43.14	£46.85
Band 8d	£48.26	£51.21	£55.65
Band 9	£57.68	£61.16	£66.37

Hourly rates help staff compare earnings across bands, but actual take-home pay still depends on contracted hours, deductions and any local supplement.

How Does the 2026/27 NHS Pay Rise Affect Nurses, Midwives and Paramedics?

The 3.3% uplift will be especially relevant for nurses, midwives and paramedics because many of these roles sit in Bands 5, 6 and 7.

Band 5 Nurses and Newly Qualified Staff

Many newly qualified nurses start in Band 5. From April 2026, Band 5 pay starts at £32,073 and rises to £39,043 at the top step. Other Band 5 roles may include paramedics, operating department practitioners and some allied health professionals.

Senior Clinical Staff in Bands 6 and 7

Band 6 and Band 7 roles often include senior nurses, midwives, paramedics, ward managers, team leaders and specialist practitioners. From April 2026, Band 6 pay ranges from £39,959 to £48,117, while Band 7 pay ranges from £49,387 to £56,515.

This means staff moving from Band 5 to Band 6, or from Band 6 to Band 7, may see a larger salary change than the headline pay rise alone.

What Will NHS Staff in London Receive with HCAS in 2026/27?

NHS staff working in London and certain surrounding areas may receive Higher Cost Area Supplements, known as HCAS. These payments recognise the higher cost of living in those locations.

Inner London HCAS

Inner London HCAS is 20% of basic salary, subject to a minimum payment of £5,794 and a maximum payment of £8,746.

Outer London and Fringe HCAS

Outer London HCAS is 15% of basic salary, with a minimum payment of £4,870 and a maximum payment of £6,137. Fringe HCAS is 5% of basic salary, with a minimum payment of £1,346 and a maximum payment of £2,270.

HCAS area	Supplement	Minimum payment	Maximum payment
Inner London	20%	£5,794	£8,746
Outer London	15%	£4,870	£6,137
Fringe	5%	£1,346	£2,270

A senior NHS recruitment adviser explained this clearly: “I always tell candidates to check whether the role includes HCAS. I have seen people compare only the national salary and miss the London supplement, which can make a noticeable difference to the final offer.”

What Pay Rise Will Doctors and Dentists Receive in 2026/27?

Doctors and dentists are generally outside Agenda for Change. Their pay is agreed through separate structures, so their increases are not the same as the 3.3% NHS staff pay award.

Resident doctors were projected to receive an average increase of around 4.9%. Other doctor and dentist groups were expected to receive around 3.5% to 3.75%, depending on the group and final arrangements.

Medical and dental staff should check their own pay circulars, employer updates and professional body guidance rather than relying on Agenda for Change pay scales.

Will the NHS Pay Rise 2026/27 Be Backdated?

The new rates are effective from 1 April 2026. If payroll systems are updated in time, eligible staff should see the new pay rate applied from that date.

If there is a payroll delay, backdated pay may be processed later. This usually depends on the employer’s payroll timetable and local implementation process.

Staff should check:

• Basic pay
• Band and step point
• Contracted hours
• Tax code
• Pension contribution
• National Insurance deduction
• HCAS eligibility, where relevant
• Any backdated payment line

Payroll note

Gross salary may rise by 3.3%, but take-home pay may increase by a smaller amount after deductions.

Why Is the NHS Pay Award Important for Staff and the Health Service?

The NHS pay rise 2026/27 matters because pay affects staff morale, recruitment and retention. NHS workers have faced rising living costs, high demand and workforce pressure, so a consolidated uplift gives a permanent increase to basic salary.

For NHS employers, fair pay can help reduce vacancies, support staff retention and encourage experienced workers to remain in the health service.

However, debate may continue. Some staff and unions may feel the award does not fully reflect inflation, workload or long-term pay pressures.

What Could Change After the Initial NHS Pay Rise Announcement?

Further discussions are taking place around improvements to the NHS pay structure. These may be especially important for lower bands, where pay compression and progression concerns are often discussed.

This means some staff could see additional changes later, depending on the outcome of further reviews. NHS workers should monitor official employer updates, union statements and NHS pay guidance.

Conclusion

The NHS pay rise 2026/27 gives most Agenda for Change staff in England and Wales a 3.3% consolidated uplift from 1 April 2026. The updated pay scales affect annual salaries, hourly rates and HCAS payments. Staff should check their band, step point, hours and payslip carefully to understand their actual pay.

FAQs About the NHS Pay Rise 2026/27

When does the NHS pay rise 2026/27 start?

The NHS pay rise 2026/27 starts from 1 April 2026 for eligible Agenda for Change staff in England and Wales.

Is the NHS pay rise 2026/27 only for nurses?

No. The pay rise applies to most Agenda for Change staff, including nurses, midwives, paramedics, healthcare assistants, admin staff and many other NHS workers.

Does the 3.3% NHS pay rise apply in Wales?

Yes. Based on the confirmed information, the 3.3% Agenda for Change uplift applies to NHS staff in both England and Wales.

What is the new Band 5 NHS salary from April 2026?

From April 2026, Band 5 pay starts at £32,073. The intermediate step is £34,592, and the top step is £39,043.

Are doctors included in the Agenda for Change pay rise?

Doctors are generally not included in Agenda for Change. They have separate pay arrangements and may receive different increases.

Will NHS staff in London receive extra pay in 2026/27?

Yes. Eligible staff in inner London, outer London and fringe areas may receive HCAS in addition to their basic salary.

Can NHS staff receive more than the 3.3% uplift?

Some staff may see a higher overall change if they move up a pay step, change band, increase hours or qualify for HCAS. Further pay structure changes may also affect some workers.