NHS sick pay in your first year

During your first year of NHS service, Section 14 of the NHS Terms and Conditions of Service Handbook gives you one month’s full pay and two months’ half pay. Statutory Sick Pay (SSP) is payable from your first day off sick as well. If you already have NHS service from a previous employer, you may not be on the first-year scale at all.

What the first-year entitlement is

Paragraph 14.2 of the England text (handbook version 63) says that “during the first year of service” you get “one month’s full pay and two months’ half pay”. The scale then climbs. In the second year it is two months’ full and two months’ half, and after five years’ completed service it is six months of each.

The England text attaches no waiting condition or minimum period of service to this. The handbook text for Scotland, Wales and Northern Ireland was not read for this guide, so check your own nation’s version if you work there. The full scale is in NHS sick pay.

Earlier NHS service counts

Paragraph 14.2 refers to Section 12 for what counts as service. Paragraph 12.1 says an employee’s continuous previous service with any NHS employer counts as reckonable service for NHS agreements on redundancy, maternity, sick pay and annual leave. So a nurse who moves from one trust to another, or a porter who changes jobs within the NHS, does not necessarily go back to the first-year scale.

Paragraph 12.5 deals with breaks. On returning to NHS employment, previous NHS service counts towards sickness absence entitlement where there has been a break or breaks in service of 12 months or less. A longer break is not covered by that paragraph, and your new employer’s HR team can tell you how they would treat it.

Service outside the NHS is a matter of discretion. Paragraph 12.2 lets employers take into account periods of employment with non-NHS employers, in the UK or abroad, where they judge it relevant to NHS employment. Nothing in the handbook makes that automatic, so ask before you rely on it. Our guide to moving between NHS trusts covers the wider picture, and a separate guide on reckonable service goes into more detail.

Recent sickness reduces what is left

You do not get a new allowance with each illness. Paragraph 14.7 says the period and rate of sick pay is worked out by taking your entitlement on the first day of sickness and deducting the paid sickness absence in the 12 months immediately before that day.

The allowance is short in your first year, so this bites early. If you have used part of the one month of full pay, the rest is all you have left for a later absence in the same 12 months. Some absences are disregarded, including unpaid sick absence and absence from an injury or disease wholly or mainly attributable to NHS employment, sustained in discharge of duties. See NHS injury allowance for that route.

The handbook text read for this guide does not say whether paid sickness at a previous NHS employer counts towards the 12-month deduction at your new one. Ask HR to confirm how they will treat it.

How full pay is worked out for new starters

Paragraph 14.5 says that for new starters, full pay is pay in line with the appropriate pay point, plus any high cost area supplements and locally agreed pay protection. It is worked out as at the day before the sickness begins. Regular supplements such as unsocial hours payments are handled differently for some longer-serving staff under paragraph 14.4, and the sources here do not say how they apply to new starters, so ask payroll about those. The pay points are in NHS Agenda for Change pay bands.

SSP on top of first-year pay

Paragraph 14.6 says full pay includes any statutory benefits, and that SSP added to half pay must not exceed full pay. So SSP does not raise your total above your normal pay. The details are in NHS sick pay and SSP.

Once your first-year entitlement is used up, SSP is what remains. It is the lower of £123.25 a week and 80% of your normal weekly earnings, and it can last up to 28 weeks. Since 6 April 2026 it starts on the first day of sickness and there is no lower earnings limit, according to Acas. gov.uk says someone who has not yet had 8 weeks’ pay because they started recently can still qualify, as long as they are an employee, have done some work and have been ill for at least one full working day. The Statutory Sick Pay guide has the full rules.

Before you start a new NHS job with a health condition

These are the questions to put to the HR team before your first day:

• Does my earlier NHS service count, and has the break between jobs been 12 months or less?
• What is my full pay for sickness purposes, and which supplements are included?
• How will paid sickness in the last 12 months be counted?
• What happens to my pay if my sickness absence continues past the first-year allowance?

Our guide to the occupational health check covers that stage of recruitment. For disputes about how your entitlement was worked out, your union rep or Acas can advise.