Occupational therapist pay in the NHS

A newly qualified NHS occupational therapist is typically paid on Agenda for Change band 5, which is £32,073 a year in England from 1 April 2026, rising to £39,043 at the top of the band. Health Careers does not quote a salary for the role. The bands below are from the NHS Employers 2026/27 pay scales, and the band you are paid depends on the post.

Bands 5 to 7 in England

Band	Entry	Middle	Top
5	£32,073	£34,592	£39,043
6	£39,959	£42,170	£48,117
7	£49,387	£51,932	£56,515

You spend two years on the entry point of band 5 and two on the middle point. Bands 6 and 7 have two years on entry and three on the middle point. Moving up a band normally means applying for a new job. The band 5 guide and pay progression guide explain the steps, and Health Careers says you can specialise (it names elderly care and paediatrics), move into research or education, work overseas or apply for senior and specialist posts with further qualifications and experience.

London trusts add a high cost area supplement. A band 5 OT earns £38,488 in inner London, £36,943 in outer London and £33,677 in the fringe area on the entry point.

Council occupational therapists

Health Careers lists hospitals, clinics, charities, prisons and social services departments as employers, often as part of a multidisciplinary team. Where an OT works for a council’s social care service, the job is normally graded by the council, not on the NHS bands. Councils use job evaluation and spinal points, which are covered in the council job evaluation guide and the NJC pay spine guide.

Rozile has not verified a standard grade for council OTs. Different councils can grade the same job differently, so use the grade and spinal points printed on the advert. If you are moving between the NHS and a council, compare the full package, including pension. Council employees can join the Local Government Pension Scheme, covered in the LGPS guide.

Hours, leave and extra pay

The standard NHS week is about 37.5 hours, with flexible working across a seven-day period. Annual leave is 27 days plus bank holidays. Staff on bands 4 to 9 are paid 30% more for Saturdays and weekday hours from 8pm to 6am, and 60% more for Sundays and public holidays, under the NHS terms and conditions. Whether you work those hours depends on the service, because many community and outpatient teams run weekday patterns. Take the band 5 entry rate of £16.40 an hour: a night or Saturday hour pays about £21.32 and a Sunday hour about £26.24. The enhancement is worked out on basic pay, so it does not include the London supplement.

Getting qualified

The usual route is an occupational therapy degree, which takes three years full time or up to six part time. A master’s is available at postgraduate level in one to two years. Alternatively, a degree apprenticeship lets you earn while you qualify, with your employer and the government paying the fees, so apprentices are not eligible for student grants. Typical entry is two or three A levels and five GCSEs at grades 9 to 4 including science, and equivalents are accepted. You then register with the HCPC before practising, and the HCPC registration guide covers that step. The application asks you to show how you apply the NHS values in everyday work. The occupational therapist profile covers the role.

Pension and tax

In the NHS Pension Scheme in England and Wales, an OT on £32,073 pays 8.3% of pensionable pay, one on £39,043 pays 9.8%, and one on £56,515 pays 10.7%. Income tax, National Insurance and any student loan come off as well. The take-home pay calculator shows the monthly figure for each point. The figures above are for England. Scotland has a separate Agenda for Change scale, which the nurse pay guide sets out for bands 5 to 7.