What is Agenda for Change?
Agenda for Change (AfC) is the single pay framework that covers almost all NHS staff in England, Scotland, Wales and Northern Ireland \u2013 the only large group it does not cover is doctors and dentists. It was introduced in 2004 to put all non-medical NHS roles on a consistent national pay structure rather than letting individual trusts negotiate locally.
Under AfC, every NHS job is matched to a band from Band 2 up to Band 9, based on the role's responsibility, complexity and required qualifications. Each band then has a published salary range with progression points. Where you sit inside the band depends on your years of experience.
The pay rates are reviewed annually following the NHS Pay Review Body recommendation, and updated by NHS Employers each April. The figures in this guide are the 2026/27 NHS Employers rates for England (effective from 1 April 2026). Always check the live tables on the NHS Employers website before quoting them, as they change every April.
NHS pay bands at a glance (2026/27, England)
The annual full-time band ranges below are the published NHS Employers (England) figures for 2026/27, rounded to whole thousands. Band 1 is closed to new entrants and is not shown. These are basic salary ranges only \u2013 unsocial-hours, on-call and overtime payments sit on top in most clinical roles.
- Band 2 \u2013 around \u00a325k. Healthcare assistants, domestic and porter roles, basic support staff.
- Band 3 \u2013 around \u00a326k to \u00a327k. Experienced healthcare assistants, basic clinical support workers, administrative roles.
- Band 4 \u2013 around \u00a328k to \u00a331k. Senior support workers, assistant practitioners, nursing associates.
- Band 5\u2013 around \u00a332k to \u00a339k. Newly qualified registered nurses, midwives, paramedics, physiotherapists, occupational therapists, radiographers, speech & language therapists.
- Band 6 \u2013 around \u00a340k to \u00a348k. Senior nurses, specialist practitioners, junior team leaders.
- Band 7 \u2013 around \u00a349k to \u00a357k. Advanced clinical practitioners, ward managers, advanced specialists.
- Band 8a \u2013 around \u00a358k to \u00a365k. Consultant-level practitioners, service managers, principal clinical scientists.
- Band 8b \u2013 around \u00a367k to \u00a377k. Senior service managers, lead consultants.
- Band 8c \u2013 around \u00a380k to \u00a392k. Director-level consultants, head-of-service roles.
- Band 8d \u2013 around \u00a394k to \u00a3109k. Senior director, deputy director-level roles.
- Band 9 \u2013 around \u00a3113k to \u00a3130k. Most senior leadership and the most senior consultant roles.
These ranges are 2026/27. They go up each April. For the point-by-point pay step tables (which differ across England, Scotland and Wales), use the live NHS Employers table for the country and band you need.
NHS Band 5 salary: the newly qualified nurse band
Band 5 is the headline band for most adult learners aiming at an NHS clinical career. It is the entry point for registered nurses, midwives, paramedics, physiotherapists, occupational therapists, radiographers and speech & language therapists \u2013 in other words, the registered allied-health professions you qualify into with a degree.
On 2026/27 figures (England), Band 5 ranges from around \u00a332k at entry to around \u00a339k at the top of the band, with two progression points along the way. A newly qualified nurse joins at the bottom point and moves up after two years, then again after another two.
Most nurses then either move to Band 6 (specialist or senior nurse) within a few years, or stay at Band 5 with progression through pay points. To see the full degree route into Band 5 nursing as an adult learner, see our career guide on how to become a nurse in the UK.
Bands 2 to 4: NHS support roles
Bands 2 to 4 cover the NHS support and assistant workforce. They are the routes in for people without a degree or a registered clinical qualification, and they remain a credible long-term career in their own right.
- Band 2 \u2013 healthcare assistants, domestic staff, porters. The most common entry route for school leavers and adult career-changers.
- Band 3 \u2013 experienced healthcare assistants, basic clinical support workers, ward clerks. Typically reached after a year or two at Band 2 plus a Care Certificate.
- Band 4 \u2013 senior support workers, assistant practitioners, nursing associates. A nursing associate is a regulated NMC role; assistant practitioners hold a Level 5 qualification.
For the full picture of Band 2 to 4 routes (training, NVQ / Diploma options, and how to move up), see NHS healthcare support careers.
How NHS pay progresses
Within a band, you move along progression points based on years of experience at the band, not on annual reviews. Most bands have an entry point and one or two intermediate points before the top of the band.
Between bands, you progress by moving to a higher-banded role \u2013 typically by applying for a more senior post once you have the qualifications and experience for it. The most common progression routes are:
- Band 2 \u2192 Band 3 \u2192 Band 4 \u2013 by gaining the Care Certificate, NVQ / Diploma qualifications, or moving into nursing associate or assistant practitioner roles.
- Band 4 \u2192 Band 5 \u2013 by completing a registered clinical degree, most commonly a Nursing or Midwifery degree.
- Band 5 \u2192 Band 6 \u2192 Band 7 \u2013 by gaining post-registration specialist qualifications and moving into senior, specialist or ward manager roles.
Where common NHS roles sit
A quick reference for the roles people most commonly research:
- Healthcare assistant \u2013 Band 2, progressing to Band 3 with experience.
- Domestic / porter / cleaner \u2013 Band 2.
- Nursing associate \u2013 Band 4 (NMC-registered).
- Assistant practitioner \u2013 Band 4.
- Newly qualified nurse \u2013 Band 5 (NMC-registered).
- Newly qualified midwife \u2013 Band 5 (NMC-registered).
- Newly qualified paramedic \u2013 Band 5 (HCPC-registered).
- Physiotherapist / occupational therapist / radiographer \u2013 Band 5 entry (HCPC-registered).
- Senior staff nurse / specialist nurse \u2013 Band 6.
- Ward manager / advanced practitioner \u2013 Band 7.
For the regulated clinical degree route into the Band 5 professions, the standard adult pathway is an Access to HE Diploma followed by a degree. See the dedicated routes: Access to HE Nursing and Access to HE Midwifery.
Do NHS salaries vary by region?
The headline AfC pay bands are national \u2013 a Band 5 nurse is paid the same base salary in Newcastle as in Sheffield. There are, however, two real sources of regional variation:
- High Cost Area Supplements (HCAS) \u2013 a percentage uplift on top of basic pay for staff working in and around London (Inner London \u00a320%, Outer London \u00a315%, Fringe \u00a35%), within minimum and maximum cash limits set by NHS Employers.
- Country differences\u2013 Scotland and Wales run their own AfC pay tables, which differ from England. Northern Ireland sometimes lags slightly. Always check the right country's table.
Funding support for NHS-bound students
Many of the routes into NHS Band 5 professions \u2013 nursing, midwifery, allied health \u2013 are eligible for the NHS Learning Support Fund (LSF), which sits on top of standard student finance for eligible degree students. It is non-repayable and is in addition to Student Finance.
For what the LSF currently covers (training grant, parental support, travel and dual accommodation expenses), see our briefing for nursing students: NHS Learning Support Fund: what nursing students need to know.