NHS staff benefits

The NHS Pension Scheme, annual leave that grows with service, and occupational sick pay of up to six months’ full pay and six months’ half pay make up the bulk of what NHS staff get. All three come from the Agenda for Change (AfC) terms, so they apply to almost every NHS employee except doctors, dentists and very senior managers, who have their own contracts. Most trusts and health boards add salary sacrifice schemes, staff discount portals and wellbeing services, and these differ from one employer to the next.

The NHS Pension Scheme

The pension is the largest single part of the package. In England and Wales the employer contribution is 23.7% of pay: employers pay 14.38% directly in 2026/27 and NHS England pays the remaining 9.4% centrally. You pay a tiered rate on the whole of your pensionable pay, from 5.2% up to 12.5%.

Your pensionable pay (2026/27)	Your contribution
up to £13,259	5.2%
£13,260 to £28,854	6.5%
£28,855 to £35,155	8.3%
£35,156 to £52,778	9.8%
£52,779 to £67,668	10.7%
£67,669 and over	12.5%

A band 5 nurse on the entry point of £32,073 in England falls in the 8.3% tier. Contributions come off before Income Tax, so the cost after tax relief is lower. Scotland runs its own scheme with different tiers, starting at 5.7%. The NHS Pension Scheme guide covers how the pension builds up and when you can take it.

Your contributions also buy cover if you die in service or have to retire through ill health.

Annual leave

Full-time AfC staff get 27 days’ annual leave when they start, 29 days after five years’ NHS service and 33 days after ten years, plus 8 public holidays. Part-time staff get the same pro rata, usually worked out in hours.

NHS service counts, wherever you earned it. If you move from one trust to another, your previous NHS years normally count towards your leave entitlement. Some employers also count relevant service outside the NHS, for example in local government or a housing association, at their discretion.

Sick pay

AfC occupational sick pay rises with service:

• First year: 1 month full pay and (after four months’ service) 2 months half pay
• Second year: 2 months full pay and 2 months half pay
• Third year: 4 months full pay and 4 months half pay
• Fourth and fifth years: 5 months full pay and 5 months half pay
• After five years: 6 months full pay and 6 months half pay

Statutory Sick Pay sits underneath this and is counted as part of what you receive. NHS sick pay explains how the entitlement is counted over a rolling 12 months.

Pay enhancements

Basic pay comes from the AfC band, with points set out in the AfC pay bands guide. Staff in and around London get a high cost area supplement on top: 20% of basic pay in inner London (minimum £5,794, maximum £8,746), 15% in outer London and 5% in the fringe. Work in the evenings, at night, at weekends and on public holidays attracts unsocial hours payments, which can add a lot to the pay of ward and ambulance staff.

Salary sacrifice schemes

Most NHS employers run several salary sacrifice schemes. Part of your gross pay is swapped for a benefit, which cuts the Income Tax and National Insurance you pay. The common ones are:

• Cycle to work, for a bike and safety equipment
• Lease cars, often limited to electric or low-emission models
• Home electronics and white goods
• Childcare vouchers for people who joined before the scheme closed to new entrants
• Additional voluntary contributions in some trusts

Salary sacrifice cannot take your pay below the National Living Wage (£12.71 an hour from 1 April 2026). It reduces the pay used for pension and some statutory payments, so ask the scheme provider about the knock-on effects before you sign.

Discounts and perks

NHS staff qualify for the Blue Light Card and for Health Service Discounts. Many trusts also run a staff benefits portal with local deals, discounted gym membership and cashback cards. Staff car parking schemes are common, some larger hospitals have on-site nurseries, and most have staff restaurants. See Blue Light Card and discounts for the eligibility rules.

Wellbeing, learning and flexibility

Every NHS employer has an occupational health service and an employee assistance programme with confidential counselling. Some regions also run staff mental health and wellbeing hubs. Details are in staff wellbeing support in the NHS.

As in any job, you can make a flexible working request from day one. Many NHS employers also use flexible patterns such as self-rostering, annualised hours and term-time working. Funded training is common, including apprenticeships, support for registration fees in some roles, and further study through the employer’s education budget.

When you compare an NHS post with a job elsewhere, add up the whole package. A private sector job with higher basic pay may come with a much smaller pension contribution and statutory-only sick pay. Current NHS and other public sector vacancies are listed by role on the jobs hub.