NHS Pay Calculator (Agenda for Change)

NHS pay in England is structured under the Agenda for Change (AfC) framework, which groups roles into nine pay bands. Most bands have two or three pay points (entry, intermediate and top), and staff move up a step after 2 or 3 years in the band. For 2026/27, Band 5, covering newly qualified nurses, starts at around £32,073 and rises to £39,043 at the top of the band, reached after 4 years. AfC covers nurses, allied health professionals, admin and support staff, but not doctors, and pay rises are announced annually for implementation in April.

In addition to basic pay, many NHS staff receive High Cost Area Supplements (HCAS) for working in London and surrounding areas. Inner London pays 20% of basic salary, with a minimum of £5,794 and a maximum of £8,746, Outer London 15% (£4,870 to £6,137), and the Fringe, a defined list of areas around London, 5% (£1,346 to £2,270). A Band 5 nurse on the entry point in Inner London receives £6,414.60, and anyone on basic pay above £43,730 gets the £8,746 maximum.

Take your band, pay point and location and the calculator returns total gross pay including any supplement, then works back to take-home after income tax, National Insurance and NHS Pension contributions. Pension contributions are tiered from 5.2% to 12.5% of pensionable pay, which includes HCAS, and the tier rate applies to all of it, so the deduction climbs as you move up the band and the jump between two adjacent pay points is not always the improvement it looks on paper. Pension comes off before income tax but not before National Insurance.

Basic pay understates what many NHS staff actually earn, because shift work attracts premiums. Saturdays and weekday nights between 8pm and 6am are paid at time plus 47% for Band 1, 41% for Band 2, 35% for Band 3 and 30% for Bands 4 to 9, and Sundays and public holidays at time plus 94%, 83%, 69% and 60%, so the lowest paid staff receive the largest proportional uplift. On-call availability is paid separately as a percentage of basic pay, set by how often you are on call. For anyone on a rotating rota these premiums add a large share to base pay, which is why the band on its own says little about annual earnings.

Doctors sit outside Agenda for Change on their own structure. Under the June 2026 pay deal, backdated to 1 April 2026, a foundation year 1 doctor earns £41,226 and FY2 £47,610, and core and specialty trainees start at £55,355 and reach £77,348 at the top of the scale. A consultant earns £113,565-£150,569 in base pay before clinical impact awards. Salaried GPs are paid within a range of £78,699 to £118,759, while partners take a share of practice profit, which varies widely from one practice to another.

The NHS Pension is a substantial part of the package rather than a footnote. It builds at 1/54th of pensionable pay each year on a career average basis, revalued by CPI + 1.5% each year while you are an active member, and employers pay in a further 23.7% of pensionable pay on top. The cost in the meantime is real: a Band 6 at the top of the band in Outer London on £54,254 gross contributes 10.7%, or £5,805, before income tax and National Insurance take their share, leaving take-home of about £38,177.

Progression within a band follows length of service, subject to meeting the expected standards at a pay progression review, with a step every 2 or 3 years carrying staff to the top in 2 to 5 years depending on the band. Moving to a higher band means applying for a different job rather than waiting for it, although experience carries across and can set your starting point within the new band. Nurses commonly move from Band 5 to Band 6 within 5 years where they push for it, while Band 6 to Band 7 usually calls for a masters degree and a specialist role. Turnover across NHS staff averages 12%, which is why retention remains a standing concern.