NHS Pay Rise 2026/27 Explained

Very senior managers (VSMs) are on a separate award: 3.0% from 1 April 2026, which NHS England has advised committees to hold while eligibility criteria are finalised. See why the VSM pay uplift is delayed.

For the background, see what Agenda for Change is and how bands and pay points set your salary.

This page tracks the state of NHS pay for 2026/27 across every major staff group, and we'll keep it updated as each track moves. If you only remember one thing: "the NHS pay rise" isn't one single announcement — it's at least three separate processes running on different timelines, for different staff groups, and conflating them is the single biggest source of confusion (and misinformation) this time of year.

State of play: three tracks, three different stages

1. Agenda for Change staff — settled

Status: confirmed. Nurses, midwives, paramedics, physiotherapists, radiographers, healthcare assistants, admin and clerical staff, and every other role on the Agenda for Change contract received a 3.3% consolidated uplift on every 2025/26 pay point, effective 1 April 2026. This follows the standard NHS Pay Review Body (NHS PRB) recommendation process, and it's a consolidated rise — meaning it's baked permanently into your basic pay, not a one-off bonus. See the full Agenda for Change pay scales for 2026/27 for the exact rate at your band and point.

2. Consultants, SAS doctors & dentists (DDRB) — settled

Status: confirmed. Consultants and SAS (Specialty and Associate Specialist) doctors, along with salaried dentists, are covered by the separate DDRB (Review Body on Doctors' and Dentists' Remuneration) process rather than the NHS PRB. For 2026/27, the DDRB recommendation translated into a 3.5% headline uplift for consultants and SAS doctors, with a slightly higher 3.75% uplift for salaried dentists working in the Community Dental Service (CDS), reflecting a distinct recruitment and retention pressure in that part of the dental workforce. This settlement does not cover resident doctors.

3. Resident doctors (FY1–ST6+) — resolved June 2026, separately negotiated

Status: settled. Resident doctors (the grade previously known as "junior doctors," spanning Foundation Year 1 through to ST6 and above) have not gone through the standard DDRB process since 2023. Following sustained industrial action between 2023 and 2026 — 15 rounds in total, including a February 2026 ballot that extended the strike mandate (93% in favour on a 53% turnout) and a six-day strike from 7 to 13 April 2026 — resident doctor pay was instead the subject of direct, multi-year negotiation between the BMA and government. That negotiation concluded when the BMA UK Resident Doctors Committee and government agreed a pay-and-jobs offer on 18 June 2026, which BMA members accepted by referendum (53% in favour on a 57% turnout, voting closing 26 June 2026). The deal is backdated to 1 April 2026 and was implemented in most trusts' payslips from September 2026, alongside a restructuring of the nodal point pay system from five points to ten (one point per individual training year rather than grouped ranges), phased in with a further phase from April 2027. For the confirmed resident doctor nodal point figures, see our doctors' pay guide.

Timeline: how the 2026/27 award actually happened

Rather than just stating the headline figure, here's the dated sequence of how this year's award came together — and where the next pay round already stands. We'll keep adding to this list as the 2027/28 process moves, rather than starting a new page from scratch each year.

Resident doctor pay ran on its own separate track rather than through the standard NHS PRB process above. In brief: a February 2026 ballot extended the BMA's strike mandate (93% in favour on a 53% turnout), resident doctors then took a six-day strike from 7 to 13 April 2026, and the dispute was finally resolved when the BMA and government agreed a pay-and-jobs offer on 18 June 2026 — accepted by BMA referendum shortly after, backdated to 1 April 2026 and implemented in payslips from September 2026. See our doctors' pay guide for the confirmed figures and what the deal's nodal point restructure means for each grade.

What this means for your payslip

In most years, there's a real gap between a pay award being confirmed and it actually showing up in your bank account — the uplift is effective from 1 April, but the announcement itself typically comes after that date, leaving NHS trusts needing to reprogram pay rates across the Electronic Staff Record (ESR) system before anyone sees the new rate. 2026/27 is genuinely different on this point: NHS Employers confirmed that ESR colleagues had the detail of the award in time to pay the 3.3% Agenda for Change uplift in April 2026 salaries themselves, in line with normal ESR lead times — no lag and no backdated lump sum needed for most AfC staff, a genuine change from the more typical pattern in recent years.

A higher salary also changes what you could borrow: see the effect on your own band in the NHS Mortgage Calculator.

A few things still worth checking on your own payslip:

• If your trust doesn't use standard ESR timing, or your payroll runs slightly differently, your April payslip could still land a pay period behind — check your payslip's effective date against 1 April 2026 rather than assuming.
• If you are behind and later receive a catch-up payment, it will show as a backdated lump sum covering the shortfall since 1 April 2026, usually as a separate, larger-than-usual line — worth checking your payslip breakdown rather than assuming it's an error.
• DDRB staff (consultants, SAS doctors, salaried CDS dentists) should check their own trust's implementation timing separately — the on-time April confirmation above specifically covers the Agenda for Change award processed through ESR.

Want to see your own new numbers, and exactly what any back pay would be worth after tax, NI and pension? Use the NHS Pay Rise Calculator 2026/27 — pre-filled with the confirmed award percentages — or the plain NHS Pay Calculator to plug in your band and point and see your 2026/27 salary, including London weighting where it applies.

Recent NHS pay awards in context

Pay awards vary meaningfully from year to year, both in headline size and in how they're structured — some years have applied a flat percentage uplift across every band and point, while others have layered in additional flat-rate or consolidated payments weighted towards lower-paid bands to give proportionally more help to the lowest earners. We're deliberately not putting specific percentages against past years here unless we can stand fully behind the number — where we're not certain of an exact historical figure, we'd rather describe the pattern than risk stating something wrong.

How this year's award fits the recent pattern of NHS pay negotiations

Headline percentages get most of the attention, but understanding why NHS pay negotiations look the way they do each year — and why one year's figure isn't always directly comparable to the last — is genuinely useful context, without needing to pin exact numbers on years we can't fully stand behind.

• The shape of an award matters as much as the size. A flat percentage uplift, applied uniformly across every band and point, affects staff differently from an award that layers in extra flat-rate or consolidated cash amounts weighted toward the lower pay points. Both can be described with a single "headline" percentage in the press, but the real effect on an individual payslip can differ noticeably depending on which structure was used and where you sit on the scale.
• Government isn't obliged to accept the NHS Pay Review Body's recommendation in full. As the note above explains, the NHS PRB is independent and advisory — its recommendation goes to government, which can accept it, partially accept it, or reject it. In years where the gap between the recommendation and what's ultimately implemented has been wide, that gap has itself become a significant point of contention between government, NHS Employers and trade unions, sometimes escalating into formal disputes or industrial action.
• Industrial relations have shaped how pay is negotiated, not just the outcome. The period since 2023 has seen a marked increase in formal disputes and industrial action across parts of the NHS workforce, most visibly among resident doctors (see the section above). That backdrop has changed the negotiating environment for every staff group to some degree — evidence submissions to the NHS PRB and DDRB increasingly reference recruitment and retention pressures directly linked to pay, rather than pay being treated as a purely administrative annual adjustment.
• A single year's percentage rarely tells the full story on its own. Whether a given year's award represents a real-terms increase, a real-terms cut, or something in between depends on inflation over the same period — a comparison this page deliberately doesn't attempt, since it would mean projecting or assuming inflation figures we can't verify with confidence at time of writing. If that comparison matters to you, the Office for National Statistics publishes the relevant inflation data independently.

Why you can rely on this page

• ✓ We clearly separate what's confirmed (Agenda for Change, DDRB) from what's still being negotiated (resident doctors) — never blending the two into one misleading figure
• ✓ Every percentage and date on this page reflects an officially confirmed award, not a leak, rumour or media prediction
• ✓ We deliberately avoid stating historical pay award percentages we can't fully verify, rather than risk publishing a wrong number
• ✓ This page is dated and actively maintained as each of the three pay tracks moves through its own timeline

Keep reading

• Agenda for Change pay scales 2026/27 — every band and point, in full.
• NHS doctors' pay explained — resident doctor nodal points, consultant pay and resident doctor allowances.
• NHS Pay Calculator — see your own exact new salary.