Do NHS enhancements count in holiday pay?

Yes. Paragraph 13.9 of the NHS handbook says pay during annual leave includes regularly paid supplements, including recruitment and retention premia, payments for work outside normal hours and high cost area supplements. It is calculated on what you would have received had you been at work. If you regularly work nights, weekends or public holidays, your holiday pay should reflect that.

How the calculation works

The handbook sets different reference periods depending on your pattern.

• For regular hours, the previous three months at work, or another period agreed locally.
• For irregular hours, from 6 April 2020, the last 52 weeks, limited to the previous 104 weeks from the date your leave begins, calculating 52 full weeks of pay.

Gov.uk says normal pay includes commission and regular overtime, and does not usually include bonus payments. For irregular hours it uses an average of the previous 52 weeks, counting only weeks in which you were paid. If you have fewer than 52 weeks of work, the average of the full weeks worked is used. Our guide to holiday entitlement covers the general rules.

A hypothetical example

Say a full-time member of staff works a regular pattern with some Sunday shifts each month. Over the previous three months they received their basic pay plus unsocial hours payments for those Sundays. When they take a week of leave, the handbook rule is that the week’s pay should include a typical amount of that Sunday enhancement, not only basic pay. If the payslip for a leave week shows basic pay alone, ask payroll how the reference period was applied.

The figures here are illustrative. The handbook does not give a worked example.

Which payments are included

Paragraph 13.9 names four groups: regularly paid supplements generally, recruitment and retention premia, payments for work outside normal hours, and high cost area supplements. Our guides to unsocial hours and night shift pay show how those payments are built. Because the paragraph says “regularly”, a one-off or occasional payment may not count. Ask your employer how the trust decides what is regular.

Unsocial hours during sick leave

Sick leave follows different rules in England. Paragraph 2.13 says that from 1 July 2018 unsocial hours payments are not payable during sickness absence for staff who first started under the handbook on or after that date, or whose basic pay is above £18,160, whatever their start date.

They are payable for staff employed under the handbook at 30 June 2018 with basic salary of £18,160 or less, for ambulance staff employed before 1 September 2018 who stay on Annexes 5 and 6, and for staff absent because of an injury, disease or condition sustained in the discharge of their duties and not receiving injury allowance. Paragraphs 14.4 and 14.5 say the first group gets sick pay based on what they would have received at work, including regularly paid supplements and high cost area supplements. Staff above the salary threshold and new starters get full pay at their pay point plus high cost area supplements and locally agreed pay protection.

Our NHS sick pay guide covers the allowance scale itself.

Wales, Scotland and Northern Ireland

Pay during annual leave is cross-referred to paragraph 13.9 in every nation’s text (paragraph 2.16 in England, 2.15 in Northern Ireland, 2.13 in Scotland and 2.17 in Wales). Unsocial hours and sick pay differ more. In Scotland and Northern Ireland the handbook says unsocial hours payments are pensionable and count for occupational sick pay in line with paragraph 14.4 and contractual maternity pay. In Wales, for staff on pay spine points 1 to 8, unsocial hours payments are pensionable and count for sick pay. From 1 January 2015, for pay spine points 9 to 54, they are pensionable and count for contractual maternity pay only and are not payable during sickness absence. We have not read the Section 14 text for those nations, so check it locally.

What to check with your employer

Figures come from handbook version 63. Your employer or union rep confirms local arrangements.

• Which reference period does my pay use, and is it the three months or 52 weeks?
• Are my regular unsocial hours, on-call payments and high cost area supplement included?
• Do I fall into the sick-pay group that keeps unsocial hours payments?
• What does the payslip for a leave week show, and can payroll break it down?

If the pay looks wrong, contact payroll first, then a union rep. ACAS gives free advice and can help if the matter is not resolved.