Last updated 22 May 2026
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NHS England Pay and HCAS 2026/27
Check your Agenda for Change pay in England and see the effect of the High Cost Area Supplement (HCAS) — a percentage top-up for NHS staff working in and around London.
Pay Bands
| Band | Entry | Top |
|---|---|---|
| £25,272 | £25,272 | |
| £25,760 | £27,476 | |
| £28,392 | £31,157 | |
| £32,073 | £39,043 | |
| £39,959 | £48,117 | |
| £49,387 | £56,515 | |
| £57,528 | £64,750 | |
| £66,582 | £77,368 | |
| £79,504 | £91,609 | |
| £94,356 | £108,814 | |
| £112,782 | £129,783 |
Gross annual salaries for each Agenda for Change band in England, entry to top of band. These are base rates before HCAS. Click a band to open it in our pay and pension calculator. Source: NHS Employers — AfC pay scales 2026/27.
See your pay and pension
Build a personalised scenario with your band, pay point, region, and pension options then see the monthly breakdown in the calculator.
HCAS Zones
The cost of living in and around London is significantly higher than the rest of England — particularly housing and transport. HCAS is a percentage top-up on basic salary designed to help the NHS recruit and retain staff in these areas. It is subject to minimum and maximum annual caps. Eligibility depends on where your employer is located, not where you live. Zones are defined using 2005 PCT geographical boundaries. PCTs were abolished in April 2013 under the Health and Social Care Act 2012, but their boundaries are still used for HCAS. The award is broken into three tiers — check the table below for your numbers.
| Zone | Rate | Min | Max |
|---|---|---|---|
| Inner London | 20.0% | £5,794 | £8,746 |
| Outer London | 15.0% | £4,870 | £6,137 |
| Fringe | 5.0% | £1,346 | £2,270 |
Rates and caps are from the 2026/27 AfC pay scales. If the percentage of basic salary falls below the minimum, the minimum is paid. If it exceeds the maximum, the maximum is paid.
How Pay Is Negotiated
In England, AfC pay is set following recommendations from the NHS Pay Review Body (NHSPRB), an independent body that takes evidence from the government, NHS employers, and unions. The Secretary of State for Health decides whether to accept, modify, or reject the recommendation.
3.3%
Consolidated pay rise for NHS England AfC staff from 1 April 2026