NHS sick pay and Statutory Sick Pay: how they fit together

The NHS sick pay scheme in Section 14 of the Terms and Conditions of Service Handbook is written to sit on top of Statutory Sick Pay, and the handbook sets one limit on the combination: you cannot end up with more than your normal pay. SSP is £123.25 a week, or 80% of your average weekly earnings if that is lower, for up to 28 weeks. Since 6 April 2026 it is paid from your first day of sickness, with no lower earnings limit to meet.

The scale of full and half pay by length of service is in NHS sick pay, and the SSP rules are in Statutory Sick Pay.

What Section 14 says about SSP

The handbook (England text, version 63) opens Section 14 by saying its arrangements “are intended to supplement statutory sick pay to provide additional payment during absence due to illness, injury or other disability.” The NHS scheme tops SSP up.

Two later paragraphs set the ceiling. Paragraph 14.6 says full pay “needs to be inclusive of any statutory benefits (so as not to make sick pay greater than normal working pay)”, and that “the combined addition of statutory sick pay to half pay must not exceed full pay.” Paragraph 14.8 applies the same limit to any statutory sickness, injuries or compensation benefits, including allowances for adult or child dependants.

In plain terms, on full pay you receive your normal pay and SSP is counted inside it. On half pay, SSP can be added to your half pay, as long as the two together stay at or below your full pay. How your payroll team shows this on your payslip is a local matter, so ask them if the lines look odd.

SSP from day one

Before 6 April 2026, SSP did not start until the fourth day of sickness, and you had to earn at least the lower earnings limit to qualify. The Employment Rights Act 2025 removed both rules. According to Acas, SSP is now payable from the first day of sickness, so part-time and lower-paid staff qualify. The rate is the lower of 80% of average weekly earnings and the weekly flat rate. Our Employment Rights Act 2025 guide covers the rest of the changes.

gov.uk lists three conditions: you must be classed as an employee, have done some work for the employer, and have been ill for at least one full working day. SSP is paid for the days you would normally have worked, and your employer works out average earnings over an 8-week period. Someone who started recently and has not yet had 8 weeks’ pay can still qualify.

A hypothetical example

The numbers below are made up to show how the limit works. They are not a pay scale.

Say your full pay would be £500 a week, so half pay is £250. The weekly SSP figure is the lower of £123.25 and 80% of your average weekly earnings. With earnings of £500, 80% is £400, so SSP is £123.25. Half pay plus SSP comes to £373.25, which is under £500, so the handbook limit is not reached.

Now say your full pay would be £150 a week. Half pay is £75. SSP is the lower of £123.25 and £120, which is £120. Added together that would be £195, more than full pay, so the paragraph 14.6 limit would apply and the total could not go above £150.

Your own figures will differ, because your band, pay point and any high cost area supplement decide what full pay is. See NHS Agenda for Change pay bands for the pay points.

When NHS pay has been used up

SSP is paid by your employer for a maximum of 28 weeks. gov.uk says you do not qualify once you have received that maximum. The sources read for this guide do not say how the 28 weeks are counted while you are on NHS full or half pay, so ask your payroll team how your weeks are being tracked.

When SSP is due to stop, your employer must give you form SSP1. gov.uk says this comes within 7 days if SSP stops unexpectedly while you are still sick, or on or before the start of the 23rd week if SSP will end before your sickness does. gov.uk says you may be able to apply for Universal Credit or Employment and Support Allowance. If your NHS sick pay runs out earlier, our guide to what happens when NHS sick pay runs out covers reinstatement and the next steps.

Tax and National Insurance

SSP is paid like normal wages, and gov.uk says tax and National Insurance will be deducted. NHS sick pay also goes through payroll, so your take-home pay on sick leave depends on your tax code and pay level. Is sick pay taxed? goes through the detail, and the take-home pay calculator shows what a given gross figure becomes.

Returning on reduced hours

Paragraph 14.14 says that during rehabilitation, employers should allow a return on reduced hours or home working without loss of pay. The same paragraph adds that any such arrangement “needs to be consistent with statutory sick pay rules”. Your employer and occupational health decide the details, and your union rep can help if the arrangement is unclear.