Why comparing day rates alone misleads

Bank and agency day rates usually look high next to a salary, and that is partly the point: they pay only for days worked. A permanent post pays you for the 7.4 weeks of leave and bank holidays that a Band 5 nurse with five years' service gets, covers you through sickness and builds a pension. A worker on day-rate terms who takes the same time off earns nothing for it unless the contract says otherwise. On a salary-equivalent basis your permanent post pays about £132.68 a day gross for every day you are contracted to work, whether or not you are in that week, so a day rate that looks well above that may be only a little ahead once you allow for the time off, the pension and the risk of unfilled shifts.

Worked example: Band 5, point 2, five years' service

Full time on the real 2026/27 England scale (£34,592 a year), in the NHS Pension Scheme, no student loan, compared with bank or agency work five days a week with the same 7.4 weeks of leave and bank holidays unpaid. That is 223.7 paid days a year against 223.72 days actually worked on the permanent post. The other work is assumed not to be pensionable.

The break-even day rates for these inputs are about £140 on take-home alone and about £220 once the permanent post's pension is counted. Take-home alone favours the other work at a lower rate than you might expect because there is no 8.3% NHS pension contribution coming out of it, which is also why pension has to be looked at separately. Tick the pension box on the bank side and the other work builds some pension too: at the £180 rate that moves its total from £32,511 to £44,268, with the extra pension contribution reducing take-home slightly.

What a permanent post protects that day-rate work generally does not

Paid annual leave that grows with service

Under Section 13 of the NHS Terms and Conditions Handbook a full-time Agenda for Change employee gets 27 days' leave, rising to 29 days after five years and 33 days after ten, plus bank holidays. You are paid your normal rate for it. We show the leave in weeks and the pay it represents, but do not add it to the total: it is already in your salary and take-home, and the comparison reflects it by giving the other work the same weeks off unpaid.

Contractual sick pay under Section 14

Section 14 scales sick pay with service: one month's full pay and two months' half pay in the first year, up to six months' full pay and six months' half pay after five years. Day-rate work has no equivalent scale; you are generally relying on Statutory Sick Pay, currently £123 a week or 80% of normal weekly earnings if lower, for up to 28 weeks and only if you qualify. We show a sickness scenario of your chosen length rather than valuing the whole entitlement, because almost nobody uses all of it. For the four-week example above the permanent post pays about £2,654 before tax, against about £493 of Statutory Sick Pay.

Pension continuity

The 2015 CARE section of the NHS Pension Scheme banks 1/54th of pensionable pay each scheme year you are an active member. The risk with bank and agency work is less that pension is unavailable (some bank shifts are pensionable) and more that it is intermittent, and most umbrella arrangements do not give NHS Pension Scheme membership at all. Our guides on NHS pension for locum and bank staff and the NHS Pension Calculator show what a continuous career builds.

Redundancy and employment protections

A permanent contract carries Section 16 contractual redundancy pay after two years' qualifying service (see the Redundancy Pay Calculator), notice rights and the protections of continuous employment. Bank and agency work is more flexible for both sides precisely because it carries less commitment.

How this calculator avoids double counting

An earlier version of this page added the value of paid leave and of the whole sick pay entitlement on top of the permanent take-home figure. We changed it because that counted leave twice: your salary already pays you for the weeks you are away. The current method is simpler and fairer. Both sides cover the same working days, tax and National Insurance are worked out once on each side's real annual total using the same engine as the NHS Pay Calculator, one year of pension is valued the same way on both sides, and the protections a permanent post gives are shown as separate lines you can weigh yourself.

Absence and sick pay on your NHS payslip

If you search for what an absence line on an NHS payslip means, the honest answer is that it depends on your trust's payroll set-up. What does not vary is the entitlement behind it: sickness absence is paid at full pay, then half pay, for a period set by your length of service, with Statutory Sick Pay worked in. If a line on your payslip does not match what you expect, ask your payroll team to explain how it was calculated, and compare it with the stages in our Sick Pay Calculator. For the standard lines, see how to read your NHS payslip.

Sources and how we calculate

• NHS Terms and Conditions of Service Handbook for Section 13 annual leave, Section 14 sick pay and Section 16 redundancy.
• GOV.UK: Rates and thresholds for employers 2026 to 2027 for the Statutory Sick Pay weekly rate.
• Income tax, National Insurance, NHS Pension tiers and student loan use the same 2026/27 engine as our other pay calculators; pension accrual uses the 2015 CARE scheme rate of 1/54.
• Read our editorial policy for how we source and update figures. Last updated October 2026.