NHS maternity pay

NHS staff on Agenda for Change contracts can get occupational maternity pay that is much more generous than the statutory minimum, as long as they have enough continuous NHS service before the baby is due. The scheme, in Section 15 of the NHS Terms and Conditions of Service Handbook, pays a period at full pay, then a period at half pay plus Statutory Maternity Pay, then SMP alone. In return you agree to come back to NHS work for a minimum period afterwards.

How the occupational scheme is built

The NHS scheme sits on top of the statutory one. Everyone who qualifies for SMP gets it, and the NHS scheme tops it up in stages:

1. Eight weeks at full pay. SMP is included in this, not added on top.
2. Fourteen weeks at half pay, with SMP added, as long as the total does not go above full pay.
3. The remaining 17 weeks of the 39-week SMP period at SMP only: £194.32 a week for 2026/27, or 90 per cent of your average earnings if that is lower.
4. The final 13 weeks of the 52-week leave, unpaid.

These stages, and the service rule below, are set in Section 15 of the handbook, which NHS Employers publishes. Your trust’s maternity policy repeats them. If your employer is not on Agenda for Change, for example a GP practice, the occupational scheme does not apply automatically and your contract decides what you get.

Who qualifies

There are two separate tests.

The statutory test decides whether you get SMP. You need 26 weeks’ continuous employment with your current employer by the 15th week before the due week, and average earnings of at least £129 a week. Our maternity leave and pay guide covers SMP in full.

The NHS test decides whether you get the occupational top-up. You need 12 months’ continuous NHS service by the beginning of the 11th week before the expected week of childbirth. It looks at continuous NHS service, not just service with your current trust. So a nurse who moved trusts a few months before becoming pregnant may not have enough service with the new trust for SMP but can still qualify for NHS occupational pay because earlier NHS service counts. This makes the timing of a move worth thinking about. Our guide to moving between NHS trusts explains how continuous service is treated, and HR can confirm before you accept a new post.

Bank-only workers are not usually covered by the occupational scheme. If you have a substantive post and do bank shifts on top, the bank earnings may count towards your SMP average.

The return-to-work condition

To get the occupational part, you must say in writing that you intend to return to NHS employment for at least three months after your leave. The handbook allows you to return to a different NHS employer, and the period can be worked part-time. If you do not return, or leave before the period is up, your employer can reclaim the occupational pay you received above SMP. They cannot reclaim SMP.

If you are not sure whether you will come back, you can choose to take SMP only. That leaves nothing to repay but gives you less during the leave.

Holiday, pension and pay rises during leave

Annual leave and public holidays keep accruing during the whole maternity leave, at your Agenda for Change rate of 27, 29 or 33 days plus 8 public holidays. Many people take the accrued leave at the end, before their return date, which also pushes back the start of the return-to-work period.

You stay in the NHS Pension Scheme. Contributions are taken from the pay you actually receive during paid leave. Unpaid maternity leave has its own rules on whether pension can be bought for that period. The NHS Pension Scheme guide and NHSBSA can explain this for your situation.

If a national pay award is paid while you are on leave, it should be applied to your maternity pay. The 2026/27 award of 3.3 per cent in England was effective from 1 April 2026, so anyone on maternity leave since then should see it reflected, and possibly a recalculation of SMP if the rise fell within the earnings period.

Sharing leave and returning

You can end maternity leave early and convert the rest into shared parental leave. The NHS handbook also provides occupational pay for shared parental leave on similar conditions, though how it splits between parents depends on what each parent’s employer offers.

When you go back, you can ask for flexible working from day one of employment, including a phased return using accrued leave. Your employer has up to two months to decide, so put any request in writing well before your return date. Your union rep or HR can check your maternity pay calculation if it does not match the policy.