NHS Hourly Rates 2026/27: Every Band, Every Region, Every Enhancement

NHS hourly rates under Agenda for Change range from £12.92 per hour at Band 2 to £66.37 per hour at the top of Band 9 in England (2026/27, effective 1 April 2026). Rates in Scotland are higher per hour due to a shorter working week (36 hours from April 2026 vs 37.5 in England). Unsocial hours enhancements add 30% for nights and Saturdays, 60% for Sundays and bank holidays.

What Is My Exact NHS Hourly Rate for My Band and Pay Step?

The NHS hourly rate for your band and pay step is determined by the Agenda for Change (AfC) pay system, which sets standardised pay for all NHS staff except doctors, dentists, and very senior managers. The rates below are effective from 1 April 2026 for England.

Role-To-Band Mapping

Many NHS staff know their job title but not their band. The table below maps common NHS roles to their AfC band so you can find your hourly rate quickly.

Complete NHS Hourly Rates 2026/27 — England

The following table shows every AfC band, every pay step, the annual salary, and the hourly rate. It also includes overtime and double-time rates (which apply to Bands 1–7 only in England, Wales, and Northern Ireland — Bands 8–9 are not eligible for overtime in these nations). Band 1 closed to new entrants from 1 December 2018; remaining Band 1 staff are paid at Band 2 rates: £12.92 per hour (https://www.nhsemployers.org/articles/pay-scales-202627).

Bands 2–4 have two pay steps (entry and top). Bands 5–9 have three pay steps (entry, intermediate, and top). Pay progression between steps takes 2–3 years depending on the band, based on satisfactory performance and Knowledge and Skills Framework (KSF) competency demonstration (https://www.nhsemployers.org/articles/pay-scales-202627).

* Band 1 closed to new entrants from 1 December 2018 (https://www.healthcareers.nhs.uk/working-health/working-nhs/nhs-pay-and-benefits/agenda-change-pay-rates).

Overtime rates of ×1.5 and double-time rates of ×2.0 apply to Bands 1–7 in England, Wales, and Northern Ireland. Bands 8–9 in these nations are not eligible for overtime payments. In Scotland, all bands including 8–9 are eligible for overtime (https://www.rcn.org.uk/employment-and-pay/NHS-Employment/NHS-conditions-of-employment).

How Is the NHS Hourly Rate Calculated from the Annual Salary?

The NHS hourly rate is calculated by dividing the annual salary by the number of weeks in a year, then by the standard weekly hours for your nation.

1. Take your annual salary (for example, £32,073 for Band 5 entry).
2. Divide by 52 weeks (= £616.79).
3. Divide by your weekly hours: 37.5 for England, Wales, and Northern Ireland (= £16.45 per hour), or 36 for Scotland from April 2026 (= £17.64 per hour).

The official hourly rates published by NHS Employers may differ by a few pence from this calculation because the exact method uses the precise number of annual hours (1,955.36 for England, based on 365 ÷ 7 × 37.5) rather than the simplified ÷ 52 ÷ 37.5 formula (https://www.nhsemployers.org/articles/pay-scales-202627).

England Worked Example

Band 5 entry: £32,073 ÷ 52 ÷ 37.5 = £16.45 per hour (approximate). The official published rate is £16.40 per hour.

Scotland Worked Example

Band 5 entry Scotland 2026/27: £34,544 ÷ 52 ÷ 36 = £18.46 per hour (approximate). Scotland’s shorter working week of 36 hours (reduced from 37 in April 2026) means the same annual salary produces a higher hourly rate than in England. Staff see no loss of overall earnings from the hours reduction (https://mynhstakehomecalculator.co.uk/nhs-hourly-rate/).

Part-time staff in Scotland have their hours recalculated using the formula: (current part-time hours ÷ 37) × 36 = new part-time hours. Earnings remain the same; the hourly rate increases because the same salary covers fewer hours.

What Do I Earn per Hour on Nights, Weekends, and Bank Holidays?

NHS staff on Agenda for Change contracts receive unsocial hours enhancements on top of their basic hourly rate. Since the 2018 AfC framework agreement, all bands (2–9) receive the same enhancement percentages: +30% for weekday nights (8pm–6am) and Saturdays, and +60% for Sundays and bank holidays (https://mynhstakehomecalculator.co.uk/nhs-hourly-rate/).

These enhancements are separate from overtime. Overtime (×1.5 your basic rate) applies when you work beyond your contracted hours. Unsocial hours enhancements apply to shifts within your contracted hours that fall at unsocial times.

Enhanced NHS Hourly Rates 2026/27 — England (Bands 2–7)

Bands 8a–9 also receive the +30% and +60% unsocial hours enhancements for qualifying shifts, even though they are not eligible for overtime payments in England, Wales, and Northern Ireland.

Overtime is paid at time and a half (×1.5) for extra hours beyond your contracted week. Double time (×2.0) applies to work on public holidays. You can request time off in lieu (TOIL) instead of overtime pay (https://www.rcn.org.uk/employment-and-pay/NHS-Employment/NHS-conditions-of-employment).

Many NHS staff who work regular night and weekend shifts discover their holiday pay only reflects their basic rate — not their enhancement-inclusive average. Under the Flowers vs East of England Ambulance Trust ruling, if you regularly work unsocial hours, your holiday pay must include your average enhancements (https://mynhstakehomecalculator.co.uk/nhs-hourly-rate/).

Overtime pays at ×1.5, but working unsocial hours on your substantive contract pays at only ×1.30 (nights/Saturdays) or ×1.60 (Sundays). If your employer offers overtime rather than enhancements for extra shifts, the overtime rate is always higher per hour — but overtime is not guaranteed and may be refused.

How Do NHS Hourly Rates Differ Across England, Scotland, Wales, and Northern Ireland?

NHS hourly rates differ across the four UK nations because each nation sets its own pay award and, in Scotland’s case, uses a shorter working week. The AfC band structure is shared, but the annual salaries and weekly hours vary.

• England and Wales: 3.3% pay award for 2026/27, in line with Pay Review Body recommendations. Standard working week: 37.5 hours (https://www.unison.org.uk/campaigns/nhs-pay-england).
• Scotland: 3.75% pay award for 2026/27 (year 2 of a two-year deal; total increase over both years: 8.15%). Standard working week: 36 hours from April 2026. Scotland’s deal is guaranteed to be at least one percentage point above CPI inflation each year (https://www.gov.scot/publications/nhs-staff-pay/).
• Northern Ireland: The 2026/27 uplift timing is pending confirmation. Historically, Northern Ireland has the lowest NHS pay rates in the UK.

NHS Hourly Rates 2026/27 — Nation Comparison (Bands 2–7, Entry and Top)

England rates: confirmed 2026/27 (https://www.nhsemployers.org/articles/pay-scales-202627). Scotland rates: confirmed 2026/27 (https://www.gov.scot/publications/nhs-staff-pay/).

† Wales confirmed the same 3.3% pay award as England. The Wales figures above apply 3.3% to the RCN’s published 2025/26 Wales rates and are approximations pending official NHS Wales publication (https://www.rcn.org.uk/employment-and-pay/NHS-Employment/NHS-conditions-of-employment).

‡ Northern Ireland’s 2026/27 uplift is pending confirmation. The NI figures above apply 3.3% to the RCN’s published 2025/26 NI rates and are approximations.

What Is the HCAS (High Cost Area Supplement) and How Does It Change My Hourly Rate?

The High Cost Area Supplement (HCAS) adds extra pay for NHS staff working in and around London. HCAS is calculated as a percentage of basic salary, subject to minimum and maximum payments. The 2026/27 rates are:

• Inner London: 20% of basic salary, minimum payment £5,794, maximum payment £8,746 (https://www.nhsemployers.org/articles/pay-scales-202627).
• Outer London: 15% of basic salary, minimum payment £4,870, maximum payment £6,137 (https://www.nhsemployers.org/articles/pay-scales-202627).
• Fringe: 5% of basic salary, minimum payment £1,346, maximum payment £2,270 (https://www.nhsemployers.org/articles/pay-scales-202627).

The following table shows basic and HCAS-inclusive hourly rates side by side, so London-based staff can find their actual rate in a single lookup.

HCAS-inclusive hourly rates sourced from NHS Employers 2026/27 pay scales (https://www.nhsemployers.org/articles/pay-scales-202627).

Why Is the NHS Hourly Rate Higher in Scotland than England?

Scotland’s NHS hourly rate is higher than England’s for the same band because Scotland divides the annual salary by fewer weekly hours (36 from April 2026, compared to 37.5 in England). The annual salary itself may also differ slightly due to Scotland’s separate pay negotiations.

For example, a Band 5 entry nurse in England earns £32,073 per year. Divided by 37.5 hours over 52 weeks, the hourly rate is approximately £16.40. In Scotland, a Band 5 entry nurse earns £34,544 per year (a different salary due to Scotland’s separate deal). Divided by 36 hours over 52 weeks, the hourly rate is approximately £18.40 — £2.00 more per hour.

Scotland’s two-year pay deal (4.4% in 2025/26, 3.75% in 2026/27) was negotiated separately from England’s and includes a guarantee that the award will be at least one percentage point above CPI inflation each year (https://www.gov.scot/publications/nhs-staff-pay/).

The hours reduction from 37 to 36 per week from April 2026 gives Scottish staff an additional effective hourly rate increase of approximately 2.8% on top of the 3.75% salary increase (https://mynhstakehomecalculator.co.uk/nhs-hourly-rate/). Part-time staff have their hours reduced pro rata, with no loss of earnings.

How Much Will My Hourly Rate Increase with the 2026/27 Pay Rise?

NHS Agenda for Change staff in England received a 3.3% pay award from 1 April 2026, in line with Pay Review Body recommendations (https://www.unison.org.uk/campaigns/nhs-pay-england). Scotland received 3.75%. Wales accepted the same 3.3% as England. Northern Ireland’s uplift timing is pending.

The table below shows the hourly rate change for every band and pay step in England.

NHS Hourly Rate Increase 2025/26 → 2026/27 — England

2025/26 rates sourced from NHS Employers (https://www.nhsemployers.org/articles/pay-scales-202526). 2026/27 rates sourced from NHS Employers (https://www.nhsemployers.org/articles/pay-scales-202627).

Band 2 staff in England now earn £12.92 per hour — just 21p above the National Minimum Wage of £12.71 for workers aged 21 and over. A single out-of-cycle National Minimum Wage increase could push Band 2 below the legal minimum, as happened in 2025 when Band 2 fell behind before the annual uplift was applied.

What Are the NHS Bank, Overtime, and Agency Hourly Rates?

NHS staff who want to earn more have three main options: bank shifts, overtime on their substantive contract, or agency shifts. Each pays a different rate and has different implications for your pension and service.

Bank vs Overtime vs Agency at Band 5 (England, 2026/27)

NHS Professionals — the NHS’s internal staff bank — pays at your substantive band rate plus the applicable enhancement for the shift type. A Band 5 nurse on NHS Professionals working a Sunday bank shift receives ×1.60 of their basic rate, the same as if they were on their substantive rota. The advantage over agency work is pensionability and service accumulation; the disadvantage is that the rate is lower than agency.

Agency shifts pay the highest hourly rate (typically £25–£45 per hour at Band 5) but are usually not pensionable — a significant long-term cost. Bank shifts are lower per hour but pensionable and count towards NHS service for annual leave and pay progression. Overtime at ×1.5 is the best rate for substantive staff, but it is only available to full-time employees who have already worked their contracted hours.

The RCN has warned that some employers are reducing their bank rates of pay and advises staff to check that they are being paid the correct rate (https://www.rcn.org.uk/employment-and-pay/NHS-Employment/NHS-conditions-of-employment).

If you are employed on an Agenda for Change contract and work additional hours, you should be paid your substantive rate if you are part-time (up to 37.5 hours per week), and overtime rate if you are full-time (https://www.rcn.org.uk/employment-and-pay/NHS-Employment/NHS-conditions-of-employment).

Am I Being Paid Correctly — Is My NHS Hourly Rate Above Minimum Wage, and Does My Holiday Pay Include Enhancements?

National Minimum Wage Comparison

The National Minimum Wage (NMW) for workers aged 21 and over from April 2026 is £12.71 per hour (https://www.breakroom.cc/en-gb/employers/nhs/pay). The NHS Band 2 entry rate in England is £12.92 per hour — just 21p above this legal floor. Band 3 entry at £13.17 per hour is 46p above NMW.

UNISON has warned that “the pay system remains at risk of breaching minimum wage requirements if future awards continue to lag behind NMW increases” (https://unison.org.uk/campaigns/nhs-pay-england). The National Minimum Wage rises by a larger percentage each year than the NHS pay award. In April 2026, the NMW rose by approximately 6.7%, while the NHS pay award was 3.3%. If this pattern continues, lower NHS pay bands will fall behind the legal minimum.

The Real Living Wage (a voluntary rate based on the cost of living, set by the Living Wage Foundation) is £14.80 per hour in London and £13.45 per hour in the rest of the UK (https://www.breakroom.cc/en-gb/employers/nhs/pay). A Band 2 worker earning £12.92 per hour in England earns below the Real Living Wage. A Band 3 entry worker at £13.17 per hour also earns below the Real Living Wage outside London.

Holiday Pay and the Flowers Ruling

Under the Working Time Regulations and the Flowers vs East of England Ambulance Trust ruling, if you regularly work unsocial hours (nights, weekends, or overtime), your holiday pay must reflect your average earnings — including those enhancements — not just your basic hourly rate.

Many NHS staff are underpaid on holiday pay. If your payslip shows only your basic rate for periods of annual leave, and you regularly work nights or weekends, you may be owed back pay. Raise this with your payroll department and, if necessary, your union representative (https://mynhstakehomecalculator.co.uk/nhs-hourly-rate/).

Do not assume your holiday pay is correct just because it appears on your payslip. If you regularly work unsocial hours and your holiday pay only reflects your basic hourly rate, you may be underpaid. Check whether your average hourly rate (including enhancements) is used for holiday pay calculations. If not, raise a query with payroll and, if necessary, your union representative.

Frequently Asked Questions

How Much Is NHS Pay per Hour?

NHS hourly pay under Agenda for Change in 2026/27 ranges from £12.92 per hour (Band 2 entry, England) to £66.37 per hour (Band 9 top, England). Scotland’s rates are higher per hour due to a 36-hour working week. Unsocial hours enhancements add 30% for nights and Saturdays, 60% for Sundays and bank holidays.

What Is the NHS Pay Circular for 2026?

The 2026/27 NHS pay circular confirms a 3.3% pay award for Agenda for Change staff in England and Wales, effective 1 April 2026, in line with Pay Review Body recommendations. Scotland received 3.75% as part of a two-year deal. Northern Ireland’s uplift timing is pending confirmation.

What Is the Top Band 5 Hourly Rate in the NHS?

The top Band 5 hourly rate in 2026/27 is £19.97 per hour in England (annual salary £39,043, 4+ years’ experience). In Scotland, the top Band 5 hourly rate is £22.93 per hour due to the shorter 36-hour working week. With Sunday enhancements (+60%), the top Band 5 rate in England rises to £31.95 per hour.

Is the NHS Getting a Pay Rise in 2026?

Yes. NHS Agenda for Change staff in England and Wales received a 3.3% pay rise from 1 April 2026, in line with Pay Review Body recommendations. Scotland received 3.75%. UNISON has called the England award insufficient, noting it is below the current inflation rate of 3.4%.

What Is the NHS Hourly Rate for a Healthcare Assistant?

A healthcare assistant (HCA) is typically on Band 2, earning £12.92 per hour in England (2026/27). On a Saturday or night shift, this rises to £16.80 per hour with the +30% unsocial hours enhancement. On a Sunday or bank holiday, it rises to £20.67 per hour (+60%).

Does Working in London Increase My NHS Hourly Rate?

Yes. The High Cost Area Supplement (HCAS) adds 20% for Inner London, 15% for Outer London, and 5% for the Fringe zone. A Band 5 entry nurse earning £16.40 per hour basic would receive £19.68 per hour in Inner London, £18.89 per hour in Outer London, or £17.22 per hour in the Fringe zone.