NHS Pay Award 2027/28: Government Plans 2.4%

This page is for Agenda for Change staff in England, such as nurses, midwives, paramedics, AHPs, healthcare assistants and admin and support staff, who want to know when the next NHS pay rise is coming and how big it might be. The honest answer is that neither is known. What is known is how the process works, how the last two rounds ran, what the government and unions have said, and which parts are still open. FrontlinePay is independent.

Where the round has got to

The 2027/28 pay round opened on 15 July 2026 with the remit letter. On 19 October 2026 the Department of Health and Social Care and NHS England published their written evidence to the NHS Pay Review Body. The evidence says DHSC's financial and delivery plans "currently plan for a pay uplift of 2.4%", and that an award above that would have to be considered for affordability within existing DHSC budgets and would have an impact on healthcare delivery (GOV.UK). The review body has not reported, no date has been published, and the government has not announced an award. We update this page whenever a step happens, and the date at the top shows when we last checked.

What a 2.4% uplift would mean

This is arithmetic on today's England pay scale, not a forecast. The government's number is the starting point for the review body's work; it is not what the review body will recommend, and it is not what the government will decide. The table shows what 2.4% adds to the bottom and top of some bands before tax and NHS Pension.

For comparison, September 2026 CPI inflation was 3.5% (ONS, published 21 October), which is 1.1 percentage points above 2.4%. The RCN says 2.4% "is on course to be below inflation". Inflation by April 2027 could be different: the government's evidence cites a Bank of England forecast of around 2.4% CPI for 2027/28, which is the comparison the government is making. What matters for any one person is their own pay point and spending. To see where your pay stands against recent inflation, use the pay and inflation check, and to try other percentages use the NHS Pay Rise Calculator.

How the review body round works

The NHS Pay Review Body (NHSPRB) is independent. Each round has these stages, taken from the review body's own account in its 39th report (February 2026):

• • Remit letters from the governments, asking for recommendations for the next year. The England letter for 2027/28 is dated 15 July 2026.
• • A call for evidence with a deadline. For 2026/27 the review body set a deadline of 30 September 2025.
• • Written evidence from the Department of Health and Social Care, other governments, NHS Employers, unions and others.
• • Oral evidence sessions and visits to trusts, where the review body hears from staff and managers.
• • The report, sent to the governments. In 2026 this was on 5 February.
• • The government's decision, which can accept the recommendation in full, in part, or reject it. The review body's advice is not binding.
• • Implementation through payroll (ESR). This is where backdating comes from when the earlier stages run late.

Each stage has to finish early enough for staff to be paid on time in April. The review body says this in its report: it wants the process to end early enough that awards are paid without backdating, and it has asked for the 2027/28 remit letters to arrive even earlier than the 22 July 2025 letter for 2026/27 and for the parties to meet its evidence deadlines. The 2027/28 letter arrived on 15 July 2026, a week earlier than the 2026/27 letter. For how all this fits with the 2026/27 award, see NHS pay rise 2026/27 explained.

The 2027/28 timetable so far

How the last two rounds ran, and the typical window

The table uses facts from the review body's 39th report, GOV.UK and NHS Employers. The 2026/27 round is the best comparison: it started in July 2025 and ended in February 2026.

On the "typical publication window": there is no fixed date. The table below shows when each review body report was published on GOV.UK. Reports came out in mid-July for 2021, 2022 and 2023, then in November 2024, May 2025 and February 2026. The direction has been earlier, and both the review body and the government say they want it to continue. That does not tell us the 2027/28 date. Late evidence can move it: the review body noted in its February 2026 report that the Department of Health and Social Care and Northern Ireland's Department of Health both missed its written evidence deadline that year. The publication date is not always the day of the government's decision, though in 2025 and 2026 the two were the same day.

What the government has said

• The 15 July 2026 remit letter says the government is launching this round earlier than usual and wants a prompt pay announcement. It notes that the 2026/27 uplift was paid from the start of April, two months earlier than the previous year (GOV.UK).
• It said government evidence would be submitted in the autumn and would cover the funds available for 2027/28, recruitment and retention, earnings data and the 10 Year Health Plan.
• It says the NHS Staff Council has accepted a mandate on pay structure reform and negotiations have begun, and that the mandate could include headline pay uplifts for 2027/28 and 2028/29. The government will keep the review body informed, especially if a deal affects its work.
• It does not propose multi-year awards through the review body, and it does not name a size for the award.

• 19 October 2026, joint DHSC and NHS England evidence: its financial and delivery plans currently plan for a 2.4% uplift, alongside an NHS productivity assumption of 2% a year. It says every 0.5% on pay costs about £750 million, and that anything above the plan would need difficult trade-offs. It names the 2026/27 award as 3.3%, accepted in full (GOV.UK).
• On inflation, the evidence cites the Bank of England's July 2026 forecast that CPI in 2027 to 2028 will be around 2.4%, after averaging 3.0% in 2026 to 2027, with risks skewed to higher inflation. It also says there are concerns about inflation being a primary indicator in pay setting (GOV.UK).
• Nursing Times notes that the government can choose whether to implement the review body's recommendation. The Department has said it aims to have pay rises in staff's pockets as close to 1 April 2027 as possible (Nursing Times).

Unions said in September that a change of Health Secretary after the letter slowed the pay structure talks (next section). The government's 2.4% is a funding assumption in its evidence, not an award.

What unions have said

• RCN, 19 October 2026: its General Secretary, Nicola Ranger, said a 2.4% award "is on course to be below inflation" and would be a betrayal of nursing staff, and that the RCN will not entertain the review body process. The RCN says it has withdrawn from it along with 13 of the 14 health unions and wants ministers to negotiate directly (RCN). Unison's Helga Pile called the process a "dead duck" (Nursing Times).
• RCN, 16 July 2026: called it disappointing that the remit letter came before the structural reform talks had concluded, described the review body process as outdated and flawed, and said the letter could open a route to direct multi-year talks on headline pay, but only if the government provides the funding (RCN).
• Fourteen unions, September 2026: as reported by Nursing in Practice on 11 September, they said the pay structure talks had stalled after a change of Health Secretary, and that the 2027/28 pay rise should now be considered in the same set of talks (Nursing in Practice). The Department says it has given the Staff Council a funded mandate.
• Review body evidence: the review body reported that most Agenda for Change unions did not give it evidence for 2026/27 (39th report). We have not seen which unions will submit for 2027/28.
• Scotland, 2 October 2026: The RCN and other health unions submitted a 2027/28 claim to the Scottish Government, asking for talks to start by December and finish in time for an April 2027 uplift (RCN).
• Northern Ireland, 13 October 2026: the RCN opened a strike ballot over the unpaid 2026/27 award, open until 20 November 2026 (Nursing Times).

We found no ballot or industrial action over 2027/28 pay for Agenda for Change staff in England as of 22 October 2026. For how strikes work, see NHS strikes and industrial action explained and who represents you in NHS staff representation.

The minimum wage pressure

The National Living Wage is £12.71 an hour. The bottom of Bands 1 and 2 in England is £25,272 a year, about £12.92 an hour on the 37.5-hour week (our conversion), only 21p above it. The Low Pay Commission is due to report on rates from 1 April 2027 by the end of October 2026; its April 2026 consultation letter gave an indicative range of £13.02 to £13.34 an hour. If the final rate is in that range, the lowest pay points would need to rise before or with the 2027/28 award. The review body's February 2026 report notes that interim uplifts had to be applied to Bands 1 and 2 from 1 April 2025 to stay compliant before its recommendation could be implemented. We do not know whether that will be needed again. See the Budget page, which tracks the minimum wage announcement.

What is not known

• ✕ The size of the 2027/28 award. 2.4% is the government's funding assumption in its evidence, not a decision. The review body has not reported, and we do not forecast what it will recommend.
• ✕ The date it will be announced, and the date it will reach payslips.
• ✕ Whether the award comes through the review body, through the NHS Staff Council talks on pay structure, or both.
• ✕ Whether a two-year deal covering 2027/28 and 2028/29 is agreed. The remit letter says the Staff Council mandate could include headline uplifts for both years.
• ✕ Whether the lowest Agenda for Change points will need an interim uplift to stay above the National Living Wage from 1 April 2027.
• ✕ What Scotland, Wales and Northern Ireland will do. Each government decides its own approach.

What you can do now

• ✓ Check you are on the right band and pay point with the 2026/27 pay scales, and whether an increment is due. Increments are separate from the annual award
• ✓ Use the NHS Pay Rise Calculator with 2.4% or any other percentage as a what-if, not a forecast
• ✓ See how your pay has moved against inflation with the pay and inflation check
• ✓ If you are paid late after an award, back pay is calculated from 1 April. The back pay calculator shows what it is worth
• ✓ If you are a union member, ask your branch what evidence your union is giving this year
• ✓ Subscribe below if you want the figure the day it is announced

Related guides

General information as of 22 October 2026. FrontlinePay is independent and is not affiliated with the NHS, the NHS Pay Review Body, DHSC or any trade union.