NHS pay award 2026/27: what we know

NHS staff on Agenda for Change in England received a 3.3% consolidated pay rise from 1 April 2026. It was announced on 12 February 2026 and paid in April salaries, so there are no arrears to wait for. Scotland has its own, larger deal, Wales has announced 3.3%, and Northern Ireland’s award was still unconfirmed on 16 October 2026.

Where each nation stands

Nation	2026/27 award	Status on 16 October 2026
England	3.3% from 1 April 2026	Confirmed and paid in April salaries
Scotland	3.75% from 1 April 2026 (second year of a two-year deal)	Confirmed, with an inflation guarantee
Wales	3.3%	Announced, reported by the RCN
Northern Ireland	3.3% recommended	Not confirmed; depends on the Executive’s budget

England: confirmed and paid

The NHS Pay Review Body recommended 3.3% and the government accepted it. The announcement came in February, before the start of the financial year, so employers could pay the new rates from April without backdating. Band 5 entry pay, for example, is now £32,073 and band 2 is £25,272. The full set of rates is in the Agenda for Change pay bands guide.

The bottom of the scale had an extra stage. From 1 April 2026, bands 1 and 2 were first lifted to £24,853 (£12.71 an hour) to match the new National Living Wage. The 3.3% award then replaced that adjustment, taking both to £25,272. The band 2 guide explains what that means in practice.

The talks that could still change pay

Separately from the award, the NHS Staff Council has a mandate from England, Wales and Northern Ireland to negotiate reform of the pay structure for the lowest bands and for graduate entry roles. Talks began at the end of April 2026. The Staff Council statement says that if agreement is reached, backdating to 1 April 2026 will apply.

No deal had been announced as of 16 October 2026, so any figures you see for a restructured band 2, band 3 or band 5 are proposals. If a deal is reached and backdated, affected staff would receive arrears from April. Your union will tell members if there is an offer to vote on.

Scotland: 3.75% and an inflation guarantee

NHS Scotland has a two-year agreement: 4.25% for 2025/26 and 3.75% for 2026/27, from 1 April 2026. It includes an inflation guarantee. If average CPI inflation for January to December 2026 is above 2.75%, a top-up will be paid in March 2027. Scotland’s bands have fewer points and higher values than England’s; band 5, for example, runs £34,494, £36,857 and £42,977. The guide to the NHS in Scotland, Wales and Northern Ireland covers the wider differences.

Wales and Northern Ireland

The Welsh Government announced 3.3% for 2026/27, matching England. That figure comes from the RCN’s report of the announcement, so check the payment date and any arrears with your health board or union.

In Northern Ireland, the Pay Review Body recommendation of 3.3% has not been confirmed as of mid-October 2026. The Health Minister wants to pay it, but it depends on the Northern Ireland Executive’s budget, and no payment date has been found. Whether any eventual award would be backdated to April depends on the decision when it comes. UNISON NI and other unions publish updates as the position changes.

Doctors and dentists are separate

Doctors and dentists are not on Agenda for Change. In England, the DDRB award of 3.5% from 1 April 2026 applies to resident doctors, SAS doctors, consultants and salaried GPs, and it was accepted on 25 March 2026. Resident doctors also voted to accept a further offer in June 2026, which adds pay-scale reform on top of the 3.5%. The doctors’ pay guide has the details.

How the award is decided

For Agenda for Change staff in England, Wales and Northern Ireland, the NHS Pay Review Body takes evidence from the government, employers and unions and recommends a pay rise. The government then decides whether to accept it. In 2026 the announcement came in February, which is why the rise could be paid on time.

Scotland does not use the review body for Agenda for Change. Pay is negotiated directly between the Scottish Government, NHS employers and unions, which is how the two-year deal for 2025/26 and 2026/27 came about.

Unions can reject an award and ballot for industrial action, but an award the government has accepted is paid whether or not unions agree with it.

What the rise means for your pay

A 3.3% rise on your basic pay also lifts anything calculated from it: unsocial hours enhancements, overtime rates and, below the cap, the High Cost Area Supplement. It can also move you into a higher NHS Pension Scheme contribution tier if your pay crosses a threshold. To see what a rise leaves after tax, National Insurance and pension, use the take-home pay calculator or read how much of a pay rise you actually keep.