NHS sick pay entitlement by length of service

Paragraph 14.2 of the NHS Terms and Conditions of Service Handbook sets the scale of allowances. It is worded identically in the England, Wales and Scotland and Northern Ireland sections. The week figures are an approximate conversion; the Handbook itself counts in months.

How NHS sick pay works with Statutory Sick Pay

NHS occupational sick pay is designed to supplement SSP, not replace it (paragraph 14.1). Two rules matter. Full pay is inclusive of any statutory benefits, so SSP is not paid on top of full pay. And "the combined addition of statutory sick pay to half pay must not exceed full pay" (paragraph 14.6). In practice that means half pay plus SSP while SSP lasts, then half pay alone.

SSP is currently £123.25 a week or 80% of your normal weekly earnings, whichever is lower, for up to 28 weeks (gov.uk). From 6 April 2026 there are no waiting days and no lower earnings limit.

Worked example: 6 years' service, £31,000 salary, 30 weeks off

Someone with more than five years' service is on the top tier: about 26.1 weeks at full pay, then about 26.1 weeks at half pay. Over a 30-week absence:

That is £16,905.24 gross for the 30 weeks, against £17,835.60 at full pay throughout. Across the whole year, once tax, National Insurance and pension are taken into account, the calculator estimates the absence costs about £608 in take-home pay.

The 12-month look-back, in plain English

Paragraph 14.7 says the period and rate of sick pay for an absence is worked out "by deducting from the employee's entitlement on the first day of sickness, the aggregate periods of paid sickness absence during the 12 months immediately preceding that day". Your entitlement is a rolling balance. Each time you start a new absence, look back exactly 12 months, add up paid sickness (at full or half rate), and take it off your tier's scale. Only after 12 months with no paid sickness is the full scale back.

Worked example: 2.5 years' service, 6 weeks off in spring, a new absence in October

Someone in their third year (4 months' full pay, 4 months' half pay, about 17.4 weeks each) had paid sickness from 2 March to 12 April 2026, which is 6 weeks. If a new absence starts on 1 October 2026 that spell is still inside the 12-month window, so they have 11.4 weeks of full pay and 17.4 weeks of half pay left, not the full 17.4 and 17.4. Their full scale returns on 12 April 2027 if they have no more paid sickness before then.

What counts as pay when you are off sick

For most staff, "full pay" for sick pay is the salary at your pay point plus any high cost area supplement and locally agreed pay protection that was in payment the day before the absence began (paragraph 14.5). Enhancements for unsocial hours, such as nights and weekends, are not included, which is why take-home pay on sick leave can drop even at "full pay" if your normal pay includes a lot of enhancements. Staff in post on 30 June 2018 with basic pay of £18,160 or less, and staff absent because of an injury or disease from their NHS work, are paid what they would have received had they been at work (paragraph 14.4). Use the Unsocial Hours Calculator to see how large your own enhancements are.

What happens when NHS sick pay runs out

When your full and half pay are used up you fall back on SSP while it lasts (up to 28 weeks in total), then to no sick pay. Two protections exist. After 12 months of continuous sickness absence, half pay is reinstated if you have more than five years' service and your entitlement ran out before a final review meeting for long-term absence took place, or if you have less than five years' service and no final review took place within 12 months of the absence starting (paragraph 14.10). And NHS Pension ill-health benefits may be open to you if you cannot return to work, so read the guides on ill health retirement and your pension and long-term sickness. Sick pay stops on your last day of employment (paragraph 14.3). If a long absence is leading to a capability or dismissal process, see what happens next if you are dismissed. If you have been invited to an absence review meeting, the sickness absence tracker and meeting pack counts your absences and working days over a rolling 12 months.

Sick pay, income protection and the gap

Even at full pay, a long absence means your income drops once half pay or SSP begins. If you have a mortgage or dependants, it is worth knowing the size of that gap before you need it. The free Income Protection Gap Calculator turns your sick pay into a monthly shortfall, and our income protection guide explains what cover does. If payroll gets your pay wrong when you move from full to half pay, our overpayment guide sets out your rights.

How we calculate: method and sources

The tier table is read directly from paragraph 14.2 of the NHS Terms and Conditions of Service Handbook, and the look-back from paragraph 14.7 (14.6 in the Scotland and Northern Ireland edition). We checked Sections 14 against the current Handbook (NHS Employers, version 63 from 1 October 2026; the section is unchanged from the previous version). SSP figures are from gov.uk, checked 7 October 2026. The calculator splits your modelled absence into phases week by week (full pay, half pay plus SSP, half pay, SSP only, nothing), assumes the 28-week SSP clock starts on day one of the absence, and runs tax, National Insurance, pension and student loan once on a combined annual figure. See our editorial policy.