NHS pay rises since 2010 have ranged from a two-year freeze and seven years of 1% caps to the largest recent award of 5.5% in 2024/25. Agenda for Change staff received 3.6% for 2025/26 and 3.3% for 2026/27, paid in April 2026 — yet by 2021 most staff still earned less in real terms than in 2010.
This page records every annual settlement for Agenda for Change (AfC) staff, explains what those percentages were worth after inflation, and shows how awards differ by staff group and UK nation. It is reviewed after each pay announcement and was last updated on 17 July 2026. Unless a section says otherwise, figures describe England.
What Was the NHS Pay Rise Each Year from 2010 to 2026?
Agenda for Change staff in England have received 16 annual pay settlements from 2011/12 — the first year under the austerity-era pay freeze — through to 2026/27, ranging from 0% in the two freeze years to 5.5% in 2024/25. The freeze policy itself was announced in 2010 (Institute for Government); the table below covers every pay year from the freeze onwards.
The figures are the consolidated change to nationally agreed AfC pay points as published by NHS Employers. Announcement and payment months appear where the cited source states them.
| Pay year | Headline award | Type/structure | Announced | Paid from | Source |
| 2011/12 | 0% | Pay freeze, year 1; staff earning £21,000 or less received at least £250 | — | — | Commons Library |
| 2012/13 | 0% | Pay freeze, year 2; same £250 floor for lower-paid staff | — | — | Commons Library |
| 2013/14 | 1% | First capped award under the 1%-a-year policy | — | — | NHS Employers; Commons Library |
| 2014/15 | 0% | No consolidated change to pay points | — | — | NHS Employers |
| 2015/16 | 1% | Cap extended for four years to 2019/20 by the 2015 Summer Budget | — | — | NHS Employers; Commons Library |
| 2016/17 | 1% | 1% cap | — | — | NHS Employers |
| 2017/18 | 1% | 1% cap; the Pay Review Body recommended 1% within a Treasury remit | — | — | NHS Employers; Commons Library |
| 2018/19 | 3% | Year 1 of the three-year deal worth at least 6.5% overall | — | — | NHS Employers; The Guardian |
| 2019/20 | 1.7% | Year 2 of the three-year deal | — | — | NHS Employers |
| 2020/21 | 1.57% | Year 3 of the three-year deal | — | — | NHS Employers |
| 2021/22 | 3% | Single-year award after the deal; backdated to April 2021 | July 2021 | 2021, backdated to April | BBC; NHS Employers |
| 2022/23 | 4.75% | Largest single-year award in the published series at that point | July 2022, backdated to April 2022 | — | NHS Employers; Nurses.co.uk |
| 2023/24 | 5% | — | Agreed May 2023 | — | NHS Employers; Nurses.co.uk |
| 2024/25 | 5.5% | Largest single consolidated award since 2010 | July 2024 | Around October 2024 — two months later than the 2025 award, per DHSC | Nurses.co.uk; DHSC |
| 2025/26 | 3.6% | Backdated to 1 April 2025 | 22 May 2025 | August 2025 | Commons Library; DHSC |
| 2026/27 | 3.3% | In line with the Pay Review Body recommendation | — | April 2026 | UNISON |
Across the last ten pay years (2017/18 to 2026/27), the awards read: 1%, 3%, 1.7%, 1.57%, 3%, 4.75%, 5%, 5.5%, 3.6% and 3.3%. Across the last five full years (2021/22 to 2025/26), they read: 3%, 4.75%, 5%, 5.5% and 3.6%.
When an award lands late, the missing months arrive as one lump sum in a single payslip — in 2025, the whole April-to-July arrears went through the August payroll, and staff on parental leave or who had left the trust needed separate steps to collect them (NHS SBS factsheet).
How Did Band Starting Salaries Move Between 2013 and 2023?
Every band minimum rose faster than the annual awards alone would suggest, because the 2018 deal restructured the pay spine as well as raising percentages. NHS Employers’ decade comparison shows the minimum point of each band climbing by between 28% and 57% (NHS Employers):
| Band | 2013 minimum | 2023 minimum | Change |
| Band 2 | £14,294 | £22,383 | +56.6% |
| Band 5 | £21,388 | £28,407 | +32.8% |
| Band 7 | £30,764 | £43,742 | +42.2% |
| Band 9 | £77,850 | £99,891 | +28.3% |
The bottom of the scale remains the pressure point: in community discussions, Band 2 staff have reported sitting £0.01 above the new minimum wage after some uplifts — one reason the lowest bands draw particular attention each round (r/nhs discussion). That figure is community-reported rather than official, but it matches the pattern of Band 2’s minimum rising faster than any other’s in the table above.
Three Mistakes to Avoid When Reading These Figures
- Reading the headline percentage as your payslip change. Position on the pay spine matters. The 2025/26 resident doctor award was publicised as an average 5.4%, yet the stated range ran from 5.1% to 6% (DHSC).
- Comparing Scotland and England on headline percentage alone. Scotland’s 2025–27 package is a two-year negotiated deal with an inflation guarantee, so a single-year comparison misleads (gov.scot).
- Treating every payment as permanent. Some elements never touch pay points. Official sources themselves describe the 2025 £750 resident-doctor payment differently — the House of Commons Library calls it a one-off payment, while the DHSC blog calls it consolidated. The amount and the 5.4% average are consistent across both.
Has NHS Pay Kept Up with Inflation Since 2010?
No — for most of the 2010s NHS pay fell in real terms, and full-time nurses’ basic pay was still lower in real terms in June 2025 than in June 2015. The House of Commons Library puts average basic pay for full-time-equivalent nurses at £41,431 in June 2025 against £42,368 (in real terms) a decade earlier — a 2.2% fall. Over the same ten years, full-time-equivalent doctors’ pay rose 4.6% in real terms to £87,701.
The erosion built up during the freeze and cap years. The Health Foundation’s analysis found that by 2021 the 1.2 million staff in hospital and community services were on average £462 a year worse off than in 2011; nurses and midwives had gained £4,044 in cash but lost £1,583 after inflation (The Guardian). The Nuffield Trust found doctors down 7% and consultants down 11% in real terms between 2010 and 2020, while support workers and newly qualified nurses sat 2% below their 2010 position.
The near-decade gap between award and inflation is visible directly in the years after the pandemic:
| Pay year | AfC award | CPI (calendar-year average) | Gap |
| 2021/22 | 3% | 2.6% (2021) | +0.4 pts |
| 2022/23 | 4.75% | 9.1% (2022) | −4.4 pts |
| 2023/24 | 5% | 7.3% (2023) | −2.3 pts |
| 2024/25 | 5.5% | 2.5% (2024) | +3.0 pts |
| 2025/26 | 3.6% | 3.4% (2025) | +0.2 pts |
| 2026/27 | 3.3% | 2.8% running rate (12 months to May 2026)* | +0.5 pts* |
Awards per the table above; CPI annual averages from the ONS series as compiled by UK Calculator (the Scottish Government independently cites the same 3.4% average for 2025). CPI peaked at 11.1% in October 2022 — the same month staff were receiving the 4.75% award. *2026 is a part-year reading. Comparing calendar-year inflation with April-start pay years is approximate; it is the cleanest like-for-like the published data allows.
The pattern since 2024 is therefore three consecutive above-inflation awards. That has closed part of the gap, not all of it: the Nuffield Trust’s 2025 analysis, quoted in the Commons Library briefing, estimates doctors’ real-terms earnings for 2025/26 still trail 2010/11 levels by between 4% and 10%.
What Are the Key Eras in Recent NHS Pay History?
Five phases explain the figures above: the freeze-and-cap austerity years, the 2018 three-year deal, the COVID-era awards, the 2022–23 strike-era settlements and the post-2024 catch-up.
Why Was NHS Pay Capped at 1% for Most of the 2010s?
Austerity spending policy fixed it. After the freeze, the government funded average public sector awards of 1% from 2013, and the 2015 Summer Budget extended the 1% policy for a further four years to 2019/20 (Commons Library). Nursing pay rose by a cumulative 2.2% across 2010 to 2015 — below inflation over the period (Nurses.co.uk).
Awards and earnings are not the same thing in this era, and that confusion still persists. Government data shows total AfC earnings grew 1.7–2.9% a year between 2010 and 2015, because roughly half of staff also moved up pay steps worth about 3% a year on average (Commons Library). The award froze; progression did not. The Royal College of Nursing responded with its “Scrap the Cap” campaign (Commons Library).
What Was the 2018 Agenda for Change Pay Deal?
A negotiated three-year settlement covering 2018/19 to 2020/21, worth at least 6.5% cumulatively, which ended the cap (The Guardian). Annual consolidated changes ran at 3%, then 1.7%, then 1.57% (NHS Employers).
The deal restructured the pay spine as well as raising it. Band 1 closed to new entrants from 1 December 2018 (NHS Health Careers), and entry points rose faster than the annual percentages, as the band table above shows.
How Did Covid-19 Change NHS Pay Awards?
The pandemic broke the planned sequence: the government’s initial 1% submission became a 3% award, backdated to April 2021. The government first submitted 1% to the Pay Review Body while the rest of the public sector sat under a pay freeze (Institute for Government); the Royal College of Nursing sought 12.5% and Unison a minimum of £2,000 (Institute for Government).
The final 3% award covered most NHS staff, including nurses, paramedics, consultants, dentists and salaried GPs, worth about £1,000 extra a year for the average nurse (BBC News).
Why Did NHS Staff Strike During the 2022–23 Pay Round?
Because the era’s two largest awards still landed below the steepest inflation in four decades. The 4.75% award for 2022/23 was confirmed in July 2022 and backdated to April 2022 (NHS Employers; Nurses.co.uk) — just as CPI reached 11.1% that October (UK Calculator / ONS series). A 5% award followed in May 2023 (Nurses.co.uk).
By the end of that parliament, multiple strikes were running across the service, involving nurses, resident doctors and consultants (The Lowdown); the BMA’s stated case rested on resident doctors’ real-terms erosion since 2008/09 (Commons Library, citing the BMA).
What Changed After the 2024 General Election?
The incoming government settled three consecutive above-inflation awards and moved payment earlier. The 5.5% award for 2024/25 was announced in July 2024 (Nurses.co.uk). The 3.6% award for 2025/26 was confirmed on 22 May 2025 and reached pay packets in August — two months earlier than the year before — and ministers committed to remitting the review bodies in July so future awards could land faster (DHSC).
The 3.3% award for 2026/27 was then paid in April 2026, in the pay month to which it applied (UNISON).
Who Decides How Big NHS Pay Rises Are?
Independent Pay Review Bodies recommend each settlement from evidence, and the government of the day decides whether to accept, stage or refuse it. Final decisions on implementation rest with the Prime Minister and relevant health ministers (Commons Library).
What Do the NHS Pay Review Bodies Actually Do?
They are independent of government. Each body reviews written and oral evidence from government, employers and unions, then publishes a recommendation for the coming year (Commons Library). Eight such bodies cover the public sector; they work inside remits set by the Treasury and report annually to the relevant Secretary of State (Commons Library).
Agenda for Change (AfC) is the NHS’s single pay and grading system for all staff except doctors, dentists and very senior managers. Introduced in October 2004, it covers nine pay bands, each split into step points. (NHS Employers; NHS Health Careers)
The NHS Pay Review Body (NHSPRB) recommends awards for more than one million AfC staff (Institute for Government).
Why Do Doctors and Dentists Have a Separate Review Body?
Their disputes created the system. Repeated conflict over medical pay in the NHS’s early decades produced a doctors’ review body, which first reported in 1963; a nurses’ review body followed in the 1980s, and Agenda for Change later widened that body into today’s NHSPRB (Institute for Government). The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) remains the oldest of the bodies.
The split has direct consequences. In 2025/26 the NHSPRB recommended 3.6% while the DDRB recommended 4% plus a £750 payment for resident doctors — different bodies weighing different evidence for different workforces (Commons Library).
Can the Government Reject a Pay Review Body Recommendation?
Yes. The recommendations are advisory, and governments have modified, staged and occasionally refused them (Institute for Government). The sharpest rupture came in 1970, when the doctors’ review body resigned en masse after the government slashed its recommended award (Institute for Government); blanket caps and freezes are the softer form of the same power.
The current government has broadly accepted recommendations: it took both DDRB headline figures for 2026/27 while asking for more time on two non-pay recommendations (NHS Employers), and it paid the 2026/27 AfC award “in line with Pay Review Body recommendations” (UNISON). Acceptance is a choice made each year, not a rule.
Do NHS Pay Rises Differ by Staff Group?
Yes. Each pay spine has its own review body and award, so medical staff, AfC staff and senior managers can end the same year with very different outcomes:
| Staff group | 2025/26 | 2026/27 | Sources |
| Agenda for Change (England and Wales) | 3.6% | 3.3% | DHSC; UNISON |
| Resident doctors | 4% plus a separate £750 payment — an average 5.4%, ranging 5.1–6% | 3.5% | Commons Library; NHS Employers |
| Consultants, specialty/specialist/SAS doctors, salaried GPs | 4% | 3.5% | Commons Library; NHS Employers |
| Very Senior Managers | 3.25% | — | DHSC |
Salaried dentists in community dental services receive 3.75% in 2026/27 (NHS Employers).
What Did Each Staff Group Receive in the Latest Awards?
The medical groups took the higher recent settlements, building on negotiations after the 2022–23 disputes. Resident doctors have seen an average increase of 28.9% over three years, taking expected average full-time basic pay to about £54,300 in 2025/26 (DHSC). Nurses’ average starting salary has moved from around £27,050 in 2023 to about £31,050 in 2025/26 (DHSC).
The longer view cuts the other way. Full-time nurses’ basic pay fell 2.2% in real terms between June 2015 and June 2025, while full-time doctors rose 4.6% over the same decade (Commons Library); consultants were 11% down in real terms across 2010–2020 (Nuffield Trust).
Are Resident Doctors the Same as Junior Doctors?
Yes. Junior doctors were renamed resident doctors; current official documents use the new name while the people, grades and pay spine are unchanged. The House of Commons Library expresses the alias directly — “resident doctors (formally known as junior doctors)”. Records before 2024 say “junior doctors”; the rows above and the older reports they cite mean the same group.
Do Bank Staff and GP-Practice Staff Get the Same Rise?
Not automatically. The award changes national Agenda for Change terms, and it reaches you only if your own contract derives from them. Agenda for Change is the pay system for staff employed in the NHS other than doctors, dentists and senior managers (NHS Health Careers glossary); staff of GP practices, agencies and private contractors hold separate contracts and fall outside the automatic settlement. Bank workers employed by a trust see rates move through their employer rather than through the circular directly. For these edge cases, UNISON maintains guidance on its NHS pay campaign page, where its FAQ list covers bank staff and GP or contractor employees specifically.
Do NHS Pay Rises Differ Across the Four UK Nations?
Yes. Health is devolved, so each nation sets its own award — the review bodies recommend to the devolved administrations as well as to Westminster (Commons Library). The 2025/26 outcomes ran from 3.6% in England, Wales and Northern Ireland to 4.4% in Scotland:
| Nation | 2025/26 | 2026/27 | How it is decided | Sources |
| England | 3.6% | 3.3% | UK government accepts the NHSPRB recommendation | DHSC; UNISON |
| Wales | 3.6%, aligned with England | 3.3% recommendation applies | Welsh Government, inside the NHSPRB process — its remit letter reached the review body alongside England’s and Northern Ireland’s | NHSPRB 38th Report 2025; nhsbands comparison |
| Scotland | 4.4% | 3.75% | Scottish Government, two-year negotiated deal | gov.scot |
| Northern Ireland (HSC) | 3.6% | 3.3% committed, subject to Executive budget | NI Health Minister, inside the NHSPRB process | RCN Northern Ireland; casomo HSC pay guide |
How Does Scotland’s NHS Pay Deal Differ from England’s?
Scotland negotiates directly with the health unions over multiple years instead of settling annually through the review-body sequence. Its 2025–27 deal is worth 8.15% in two stages: 4.4% from 1 April 2025 — raised from the originally offered 4.25% because the deal guarantees at least one percentage point above CPI, which averaged 3.4% — followed by 3.75% from 1 April 2026, with allowances, Recruitment and Retention Premia and the Two-Tier Agreement inside the package (gov.scot). Union members had voted 86% in favour (UNISON Scotland).
What Are the Pay Arrangements in Wales?
Wales aligned with England for 2025/26, applying the same 3.6% AfC uplift across nurses, midwives, paramedics, porters and healthcare assistants (nhsbands comparison). The NHSPRB’s 3.3% recommendation for 2026/27 formally covers Wales too (NI pay guide summarising the recommendation’s scope); the Welsh Government confirms implementation separately within that process, which is why no distinct Welsh figure appears above.
What About Northern Ireland?
Northern Ireland’s Health and Social Care service reaches the same headline awards through a slower route. The Health Minister signed off the 3.6% award in May 2025, in line with the NHSPRB recommendation (RCN Northern Ireland), but Executive sign-off delayed delivery: the award was announced in November 2025 and paid in February 2026, with back pay to 1 April 2025 (casomo HSC pay guide). For 2026/27, the Minister has committed to the recommended 3.3% from 1 April 2026, but formal confirmation awaits the Executive’s budget settlement (NI pay guide). HSC staff sit on the same Agenda for Change framework, employed by the six HSC organisations rather than NHS trusts (casomo).
What Is the Most Recent NHS Pay Rise?
The most recent NHS pay rise took effect in April 2026, when Agenda for Change staff in England received a 3.3% consolidated uplift in line with Pay Review Body recommendations (UNISON). In Scotland, staff received a 3.75% uplift from 1 April 2026, the second stage of a two-year deal (gov.scot).
The three most recent full settlements for AfC staff in England are:
- 2026/27: 3.3%, paid April 2026.
- 2025/26: 3.6%, confirmed 22 May 2025, paid August 2025.
- 2024/25: 5.5%, announced July 2024.
Doctors’ and dentists’ awards run in parallel: the DDRB’s 3.5% recommendation for 2026/27 was accepted on 25 March 2026, with uplifts anticipated in June pay packets, backdated to 1 April (NHS Employers; Commons Library).
Each award is implemented through an official pay and conditions circular and advisory notices — the 2025 cycle’s notices sit alongside the NHS Employers pay scales for 2025/26. Awards take effect from 1 April and are backdated when settlement comes later (DHSC; NHS SBS). For the current band-by-band rates, see the NHS Employers pay scales or the Health Careers April 2026 rates; to estimate take-home pay under the new figures, use the Nurses.co.uk pay calculator.
Sources and How This Page Is Verified
Every figure on this page comes from a public, checkable source, stated as the published consolidated change to national pay points, with the source linked inline beside the claim. Official material: NHS Employers’ decade review, 2025/26 pay scales and 2026 doctors’ award notice; the DHSC 2025 award explainer; gov.scot pay rates; Commons Library briefings CBP-10374 and CDP-2017-0165; the NHSPRB 38th Report. Union and sector material: UNISON England, UNISON Scotland, RCN Northern Ireland, Nurses.co.uk, NHS SBS. Independent analysis: the Institute for Government, the Nuffield Trust, the Health Foundation via The Guardian, The Lowdown and BBC News. Inflation figures use the ONS annual CPI series as compiled by UK Calculator. This page is reviewed after each award announcement and updated when official circulars publish; last review: 17 July 2026.
NHS Pay Rise History FAQs
What is the biggest NHS pay rise since 2010?
The 5.5% consolidated award delivered in July 2024 for 2024/25 is the largest single Agenda for Change headline award since 2010 — above the 5% awarded in 2023/24 and far above the years of 1% caps that ran before the 2018 pay deal. (Nurses.co.uk; NHS Employers)
Why was NHS pay capped at 1% in the 2010s?
Austerity-era public spending policy. After a two-year pay freeze for most staff, governments funded average awards of 1% from 2013, and the 2015 Summer Budget extended the 1% policy for four further years, until the 2018 pay deal broke the cap. (Commons Library)
Are NHS pay rises backdated?
Yes. Awards normally take effect from 1 April, the start of the NHS pay year, and are backdated when the announcement lands later. In 2025, staff received the uplift in their August pay, with arrears covering April to July. (DHSC; NHS SBS)
What is the difference between a consolidated and a one-off payment?
A consolidated uplift permanently raises every pay point and counts towards pensionable pay; a one-off payment is a single sum that leaves pay scales unchanged. In 2025/26, resident doctors received both types — a 4% permanent uplift plus a £750 payment the Commons Library describes as one-off. (DHSC; Commons Library)
How does NHS pay in Scotland compare to England?
Scotland’s two-year deal pays 4.4% from April 2025 and 3.75% from April 2026, guaranteed to stay at least one percentage point above CPI inflation. England’s Agenda for Change staff received 3.6% for 2025/26 and 3.3% for 2026/27. (gov.scot; UNISON)