NHS band 9

Band 9 is the highest band in Agenda for Change. In England it pays £112,782 a year from 1 April 2026, rising to £119,583 after two years and £129,783 after three more. Few posts are graded this high. It covers the most senior professional and operational roles below the trust board, and in some organisations director posts.

The three pay points

Step	England 2026/27	With Inner London supplement
Entry	£112,782	£121,528
After 2 years	£119,583	£128,329
After 5 years	£129,783	£138,529

The England rates include the 3.3% consolidated award paid from 1 April 2026. London supplements at band 9 are always at the cap: £8,746 for Inner London, £6,137 for Outer London and £2,270 for the fringe. The high cost area supplement guide explains the zones.

Scotland’s band 9 runs from £127,338 to £132,853 in 2026/27, under its separate deal giving 3.75% this year. Wales has announced 3.3% (reported by the RCN), and Northern Ireland’s 2026/27 award had not been confirmed as of 16 October 2026.

Who is on band 9

Band 9 posts usually lead a whole professional group or a large operational area across an organisation. Examples include a chief nurse or director of nursing in some trusts, a director of operations, a chief pharmacist in a large trust, a director of estates, or a head of a regional or national clinical service. Whether a role is band 9 or on a very senior manager contract varies: executive directors who sit on the board are usually employed outside Agenda for Change, with pay set separately.

Job evaluation drives banding, so the same title can be 8d at one organisation and band 9 at another. Larger trusts and national bodies are more likely to use band 9.

Steps and promotion

The pattern matches the other senior bands: two years at the entry point, then three at the middle step before the top. Each step depends on meeting your employer’s pay progression standards. For bands 8c and above these often include having met agreed objectives at appraisal. The pay progression guide covers the rules.

The step from the top of 8d (£108,814) to the band 9 entry point (£112,782) is just under £4,000.

Tax on band 9 pay

Every band 9 point is over £100,000, so your Personal Allowance is reduced: you lose £1 of the £12,570 allowance for every £2 of adjusted net income above £100,000. At £125,140 the allowance is gone. The top point of £129,783 is above that, so the additional rate of 45% applies to income over £125,140 in England, Wales and Northern Ireland, and you have no tax-free allowance at all.

Pension contributions and some salary sacrifice arrangements reduce adjusted net income, which can change how much of the allowance you keep. The £100,000 tax trap guide shows the effect with a worked example. In Scotland, the 45% advanced rate applies from £75,001 and the 48% top rate above £125,140.

If you claim Child Benefit, the High Income Child Benefit Charge applies in full at adjusted net income of £80,000 or more. The Child Benefit charge guide explains the options.

Leave, sick pay and other terms

Band 9 staff are on the same national terms as the rest of Agenda for Change. Annual leave is 27 days on appointment, 29 after five years and 33 after ten years of NHS service, plus 8 public holidays. Occupational sick pay rises with service until it reaches six months on full pay and six months on half pay after five years.

That matters for senior appointments from outside the NHS. If you join from the private sector, your sick pay and leave start at the lower levels, while someone who has spent a career in the NHS brings their entitlement with them. You can ask during the offer stage whether the employer will recognise previous service, although it is not obliged to.

Pension at band 9

You pay 12.5% of pensionable pay into the NHS Pension Scheme, the top tier, which starts at £67,669. Pension growth for senior staff can exceed the annual allowance, particularly in the year of a promotion or a big pay step. The annual allowance guide explains the test. For your own position, NHS Business Services Authority provides statements and a regulated financial adviser can give personal advice.

Band 9 vacancies are rare and are often handled by executive search firms as well as through NHS Jobs. The NHS Jobs guide covers setting up alerts by band, and the take-home pay calculator shows net pay at each point.