What is Agenda for Change?
NHS pay bands are the Agenda for Change salary tiers, running from Band 2 (£25,272) to Band 9 (£129,783) in 2026/27. Agenda for Change is the pay system used by most NHS staff: around 1.56 million across England, Wales and Northern Ireland (NHS Pay Review Body, 2026). Staff are placed into one of nine pay bands, each with a set of pay points that form the national NHS pay scales. Rates are updated every April through the annual pay award process.
Agenda for Change took effect across the NHS in 2004, replacing a patchwork of separate pay systems with a single national framework. The pay-step and promotion rules were later reformed in the 2018 framework agreement.
Your actual take-home pay depends on more than the headline salary. Scotland applies different income tax rates to the rest of the UK, and London staff receive a High Cost Area Supplement (HCAS). Use the chart above to compare bands at a glance, or read on for how pay progression and promotion work.
Pay progression
Each AfC band has a set of pay points. You start at the bottom of the band and move up one point each year at your pay step date. Reaching the top of the band typically takes two to five years depending on the number of points.
Progression is not automatic. Your employer confirms at an annual pay step review that you have met the national standards (a satisfactory appraisal, up-to-date mandatory training, and no live formal sanctions). If you don’t meet them, your step can be deferred.
Moving to a higher pay point can also push you into a higher pension contribution tier, reducing the net gain. Use our take-home and pension calculator to see exactly how a pay step affects your monthly income.
Unsocial hours
Staff working evenings, nights, weekends and public holidays receive percentage uplifts on basic salary under Section 2 of the AfC handbook. Lower bands receive higher percentages to protect take-home pay for the lowest-paid staff.
| Band | Sat & weekday nights | Sun & public holidays |
|---|---|---|
| Band 1 | +47% | +94% |
| Band 2 | +41% | +83% |
| Band 3 | +35% | +69% |
| Bands 4–9 | +30% | +60% |
Percentages are applied to basic hourly salary. Band 1 is closed in England and Northern Ireland but remains active in Scotland.
Pay on promotion
When you move to a higher band, your pay is set at the minimum of the new band. Since the 2018 AfC reform, adjacent bands no longer overlap, so this always gives a pay rise for standard moves.
Basic pay on promotion will be set at the minimum pay step point of the new pay band. The pay step date will reset to the date the employee starts in the new pay band.
On promotion the new starting salary (made up of basic pay and any unsocial hours payment and/or any long-term recruitment and retention premium) should produce an increase in earnings. If it does not, the previous salary will be maintained until the combination in the new band does produce a higher salary.
Source: NHS Terms and Conditions of Service Handbook, Section 1.17–1.18 (England)
Scotland (Section 1.12–1.13) and Wales/Northern Ireland (Section 6.21) use different section numbers but follow the same principle: promotion should always result in a pay increase. For worked examples see the NHS Employers pay on promotion scenarios.
Frequently Asked Questions
Your post is matched to one of nine pay bands (1 to 9) using the NHS Job Evaluation Scheme, which scores the role against 16 factors such as knowledge, responsibility and effort. Your band reflects the job, not the person. Band 1 is closed to new entrants in England and Northern Ireland, so most roles start at Band 2, with Band 5, Band 6 and Band 7 among the most common.
Yes. All four UK nations (England, Wales, Scotland and Northern Ireland) use the Agenda for Change framework, but each sets its own annual pay award. See each nation’s page for its current rates.
You start at the bottom of your band and move up one pay step each year on your pay step date, until you reach the top. Progression is not automatic. Your employer confirms at an annual review that you have met the national standards. Reaching the top of a band typically takes two to five years. Use our calculator to see what a pay step adds to your take-home pay.
Basic pay is only part of it. Staff working nights, weekends and public holidays earn unsocial-hours enhancements, and staff in and around London receive a High Cost Area Supplement (HCAS) on top of basic pay. Both are added before tax and pension, so they affect your take-home pay. Use our calculator to see your own numbers.
Agenda for Change covers most directly employed NHS staff, but not everyone. Doctors and dentists have their own national contracts, and very senior managers (VSM) are paid under a separate executive pay framework rather than AfC bands.
Agenda for Change pay rates are reviewed and updated every April through the national pay award process. Each UK nation confirms its own award, so the timing and amount can vary. See what the latest 2026/27 pay rise means for your band’s take-home pay.