Moving Between NHS Trusts: Pay and Pension Explained

If you've searched for what actually happens to your pay, service and pension when you move NHS trusts, you've probably found the same thing we did researching this page: a handful of trust HR policy PDFs that don't quite answer your specific question, and long Mumsnet and forum threads full of NHS staff comparing notes and worrying about conflicting experiences. That's not a coincidence — this is a genuinely under-documented area of NHS employment, and the honest answer to several of the questions people ask is "it depends, here's what actually determines it." This guide sets out what's established in the NHS Terms and Conditions of Service Handbook and NHS Pensions guidance, and is explicit about the parts that are administered locally rather than nationally.

Continuous NHS service: what actually carries over

The NHS Terms and Conditions of Service Handbook treats your continuous previous service with any NHS employer as reckonable for a range of entitlements — not just your time with your current trust. In practice, this means someone who has worked for three different trusts over a ten-year career, without a disqualifying gap in between, is usually treated the same as someone who has spent the whole ten years at one trust for the purposes of these entitlements. This is a genuinely valuable thing to understand, because it's widely misunderstood in the opposite direction — plenty of staff assume, wrongly, that changing trust resets the clock.

The specific entitlements this feeds into are already covered properly elsewhere on this site, so rather than re-explain each one, here's where to go for the detail:

What counts as a "break" in service — and why there's no single clean number

This is the part of continuous service that causes the most genuine anxiety, and it's worth being honest about why: there isn't one universal day-count that applies to every entitlement. The Handbook's general position is that being out of NHS employment for more than one week counts as a break at all, and a break of more than three months is generally treated as disqualifying — but individual entitlements can, and do, set their own different tolerance. Sick pay reckoning, for example, is commonly described as allowing breaks of up to twelve months without losing continuity for that specific purpose, which is a noticeably more generous threshold than the general three-month figure.

The practical takeaway is simple even where the exact rule isn't: a very short gap between finishing one NHS job and starting the next is very unlikely to cause a problem, and a long gap (several months or more) is genuinely worth checking before you assume your service will still count. If you're between two firm start and end dates and the gap is anything more than a week or two, get it confirmed rather than guessing.

Your pay point when you move trust — a genuinely confusing area

This is one of the questions we found the least consistent, honest answers to elsewhere online, so it's worth being direct about what's reasonably well established and what depends on your specific trust.

• ✓ If your new role is in the same Agenda for Change band as your old one, you should generally enter your new trust at the same pay point you'd reached, with your incremental date carrying over — not starting again from the bottom of the band
• ✓ In practice, many trusts pay new starters transferring from another NHS employer at the minimum of the band for a short initial period, while they wait for confirmation of your previous salary and service from your old employer
• ✓ That confirmation usually comes through an Inter-Authority Transfer (IAT) — see below — and once it's received, your pay point is typically corrected and backdated to your start date
• ✓ If you're moving to a different band — a promotion, effectively — that's a genuinely new post being appointed to, and you'd normally start at the entry point of the new band rather than carrying over your old point

NHS Pension continuity: the Inter-Authority Transfer (IAT) and the gap people notice

This is very likely the single biggest source of the anxiety visible in NHS staff forums about changing trust, and it's worth explaining in general terms because the underlying mechanics are genuinely reassuring even when the experience of living through them isn't.

If you move directly from one NHS employer to another, your NHS Pension Scheme membership is designed to link automatically rather than being treated as if you'd left the scheme and had to rejoin or formally transfer it in — that's a meaningfully different (and simpler) process from transferring in a pension from outside the NHS, which does involve a formal application. What actually moves between your old and new employer is largely administrative: an Inter-Authority Transfer (IAT) passes information from your previous employer's Electronic Staff Record (ESR) — including your continuous service dates, training records and leave entitlement — to your new employer's system, so you don't have to manually prove all of it yourself.

The practical friction people run into is that this administrative confirmation doesn't always land on your actual start date. It's entirely possible — and apparently a common experience, based on the volume of staff comparing notes about it — to be paid correctly and be genuinely enrolled in the scheme from day one, while your new employer's system is still waiting on the full service and pension record confirmation from your old employer to come through. That gap between "being paid and enrolled correctly" and "your full record catching up" is where a lot of the visible worry comes from, and it's a real, known practical issue rather than something you're imagining.

Moving to a lower band — pay protection, in general terms

Sometimes a move between trusts is also a move to a lower-banded role — often for personal or family reasons, such as relocating to an area with fewer higher-banded vacancies in your specialty, rather than anything to do with your performance. Agenda for Change does provide for pay protection in principle for staff affected by this kind of change, but this is genuinely one of the most locally-determined parts of the whole system: union advice on this is explicit that the specific pay protection arrangements are agreed locally by each employer, rather than set as a single fixed national figure.

That means the honest answer to "how much protection will I get, and for how long?" is that it depends entirely on your specific trust's own pay protection policy, which can vary in duration, taper and eligibility conditions. If a lower-band move is on the table for you, ask HR for your employer's specific pay protection policy document before agreeing to anything — general guidance like this page (or anything else you read online) genuinely can't tell you your own number.

What to actually do before you move trust

Given how much of this depends on administrative processes catching up rather than anything being fundamentally at risk, the most useful thing you can do is be proactive rather than assume it's automatically handled.

• ✓ Give your new trust's HR/payroll team your continuous NHS service history proactively, rather than waiting for the Inter-Authority Transfer to surface it on its own
• ✓ Ask for your agreed pay point and incremental date in writing before your start date, so you have something to check your first payslip against
• ✓ If you have any gap between jobs, however short, ask your new employer how it will be treated for each entitlement that matters to you, rather than assuming a single rule covers all of them
• ✓ If you're moving to a lower-banded role, request your specific trust's pay protection policy document before you accept, not after
• ✓ If anything looks wrong on an early payslip or your pension record, raise it with HR/payroll promptly and keep a written record of what you were told and when
• ✓ If you're a union member, loop in your rep early if anything about the move isn't resolving — this is a common enough scenario that they'll likely have handled it before

Why you can rely on this page

• ✓ Every general claim on this page is sourced from the NHS Terms and Conditions of Service Handbook, NHS Employers, NHSBSA guidance on Inter-Authority Transfers, or union (RCN) advice — not guessed or inferred from forum discussion
• ✓ Where sources genuinely don't converge on a single national rule — the exact break-in-service threshold, and pay protection terms — we say so explicitly rather than asserting a clean answer that doesn't exist
• ✓ We point you to your new trust's HR/payroll team and NHS Pensions directly wherever the accurate answer for your situation depends on local policy or your specific records, rather than asking you to rely on this page alone
• ✓ This page is dated and reviewed as part of our ongoing NHS careers coverage

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We'll email you if the NHS Terms and Conditions Handbook, Inter-Authority Transfer process, or pension continuity rules are updated.

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This guide is provided for general information only, is not affiliated with the NHS or the Department of Health and Social Care, and is not a substitute for your own trust's HR/payroll confirmation or advice from NHS Pensions or your union — for a decision that affects your own pay or pension, verify your specific position before you rely on it.

Frequently asked questions

Does my continuous NHS service really carry over when I move to a new trust? +

Generally, yes. The NHS Terms and Conditions of Service Handbook treats continuous previous service with any NHS employer as reckonable service for things like annual leave, sick pay and maternity pay qualifying periods — it isn't reset just because you've changed trust. The genuinely important detail is what counts as a disqualifying break in service between your old job ending and your new one starting (see below), so the safest approach is always to confirm your continuous service history in writing with your new trust's HR team rather than assume it's carried over automatically.

How long a gap between NHS jobs is safe before I lose continuous service? +

This genuinely varies by which entitlement you're asking about, which is part of why it causes so much confusion. The Handbook's general definition treats more than one week out of NHS employment as a break, and more than three months as a disqualifying break for most purposes — but individual entitlements can set their own, different tolerance (sick pay reckoning, for example, is commonly described as allowing breaks of up to 12 months). Don't rely on a single number from any general guide, including this one — ask your new trust's HR team to confirm how your specific gap will be treated before you hand in notice.

Will I keep my current pay point when I move to a new trust in the same band? +

In most cases, moving to a role in the same Agenda for Change band means you keep your existing pay point and incremental date, rather than starting again at the bottom. In practice, though, many trusts pay new starters at the minimum of the band initially, while they wait for your previous employer to confirm your salary and service — usually through an Inter-Authority Transfer (IAT) — and then backdate the adjustment once it comes through. This is a real, fairly common source of a confusing first payslip, not a sign that anything has gone wrong.

What is an Inter-Authority Transfer (IAT)? +

It's the electronic process NHS employers use to pass your employment data — including your continuous service dates, statutory and mandatory training status, and annual leave entitlement — from your old organisation's Electronic Staff Record (ESR) to your new one, rather than you having to prove everything manually. It's a genuinely useful process when it works smoothly, but it depends on your old employer's records being up to date and the request being actioned promptly, which is why it doesn't always keep pace with your actual start date.

Does my NHS Pension just stop and restart when I change trust? +

No — if you move directly from one NHS employer to another, your NHS Pension Scheme membership is generally designed to link automatically rather than treating you as having left and rejoined the scheme. What can lag behind is the administrative confirmation of your service record between your old and new employer's payroll systems, which is a different thing from your pension entitlement itself being at risk. See our NHS Pension Scheme (2015) guide for how the scheme works day to day.

Why does it sometimes feel like my new trust's payroll and my pension record are out of sync? +

Because, in practice, they're handled by two related but separate administrative processes. Your new trust can generally get your salary right from day one using the pay information you and your line manager agree, while the fuller confirmation of your continuous service and pension record depends on the Inter-Authority Transfer between employers completing in the background. A short gap between 'being paid correctly' and 'your full service history being reflected in the system' is a known practical friction point, not evidence that your pension itself has been lost.

If I move to a lower-banded role, will my pay be protected? +

Possibly, but this is genuinely one of the most employer-specific areas of Agenda for Change. Pay protection for staff moving to a lower band — often for personal or family reasons rather than performance — is provided for in principle under the Handbook (Annex 15), but the RCN's own advice is explicit that the specific arrangements are 'agreed locally', meaning the amount, duration and taper of any protection depends on your individual trust's policy. Always ask HR for your employer's specific pay protection policy in writing before agreeing to move, rather than assuming a standard national figure applies.

Should I get anything in writing before I start at a new trust? +

Yes — this is the single most useful thing you can do to avoid the anxiety visible in NHS staff forums about moves going wrong. Before your start date, ask your new trust's HR or payroll team to confirm in writing your agreed pay point, your understanding of your continuous service history, and (if relevant) any pay protection arrangement. It doesn't prevent every administrative delay, but it gives you something concrete to point to if your first few payslips don't match what you expected.

Does this apply the same way to moves within the same trust, like an internal promotion? +

Not in the same way — an internal move within one employer doesn't involve continuous service or an Inter-Authority Transfer at all, since your employment with that trust never breaks. The genuinely relevant questions for an internal move are usually about pay point placement in a new, higher band rather than continuity of service — see our guide to NHS pay progression and increments for how that works.

Who should I actually ask if something looks wrong after I move trusts? +

Start with your new trust's HR or payroll team, since they're the ones who can see both your agreed offer and whatever has (or hasn't) come through via the Inter-Authority Transfer. If you're not getting a clear answer, or the issue involves your pension specifically, NHS Pensions can confirm your recorded service history directly. If you're a union member, your rep (RCN, Unison, Unite, GMB and others all handle this regularly) can also help chase up an unresolved query — this is a common enough issue that they'll usually have seen it before.