NHS Pay Rise 2026/27 Explained

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+) — ongoing, separately negotiated

Status: not settled via the standard process — under direct negotiation. Resident doctors (the grade previously known as "junior doctors," spanning Foundation Year 1 through to ST6 and above) have not gone through the DDRB process since 2023. Following sustained industrial action between 2023 and 2025 over what the BMA characterised as a significant real-terms erosion of pay since 2008/09, resident doctor pay has instead been the subject of direct, multi-year negotiation between the BMA and government. That negotiation is still ongoing into 2026/27. We're covering it factually and neutrally here: this is a live, contested process rather than a finished one, and we'd rather point you to figures we can stand behind than publish a number here that goes stale in weeks. For the latest confirmed resident doctor nodal point figures, see our doctors' pay guide, which we're updating in parallel with this page as the negotiation develops.

What this means for your payslip

Even once a pay award is confirmed, there's usually a gap before it actually shows up in your bank account — and this is the single biggest source of "where's my pay rise?" queries every year. The uplift is effective from 1 April, but the announcement itself typically comes after that date, and NHS trusts then need to reprogram pay rates across the Electronic Staff Record (ESR) system used across the NHS. In practice, that means:

• Your April and possibly May payslips may still show the old 2025/26 rate.
• Once ESR is updated, your new rate applies going forward, and you should receive a backdated lump sum covering the difference for every month since 1 April 2026.
• This arrears payment often lands as a separate, larger-than-usual line on one payslip — worth checking your payslip breakdown rather than assuming it's an error.

Want to see your own new numbers rather than working it out by hand? Use the 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.

Year	Track	Shape of the award
2026/27	Agenda for Change	3.3% consolidated, applied uniformly across all bands and points
2026/27	Consultants / SAS / dentists (DDRB)	3.5% headline (3.75% for salaried CDS dentists)
2026/27	Resident doctors	Ongoing separate negotiation — not a single settled percentage
Recent prior years	Agenda for Change	Varied year to year — some years a flat percentage across the board, other years weighted with extra consolidated amounts for lower bands

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

Get notified the moment next year's pay award is announced

We track the NHS PRB and DDRB processes as they happen. We'll email you the day the 2027/28 pay rise is confirmed — no waiting for it to trickle through the news.

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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 banding supplements.
• NHS Pay Calculator — see your own exact new salary.

Frequently asked questions

Has the 2026/27 NHS pay rise been backdated? +

The 3.3% Agenda for Change uplift is effective from 1 April 2026 — it isn't a 'backdated' rise in the sense of covering a prior year, but because pay awards are typically confirmed after the financial year has already started, and payroll systems (ESR) need time to reprogram every pay point, most staff don't see the new rate in their April payslip. Employers are required to apply arrears back to 1 April 2026 once the new rates are live in payroll, so if your payslip caught up in, say, June or July, you should have received a lump sum covering the shortfall from April onwards alongside your new ongoing rate.

Why haven't doctors had their pay rise confirmed? +

Two different processes are running in parallel and it's easy to conflate them. Consultants, SAS doctors and dentists go through the independent DDRB process, and that was settled for 2026/27. Resident doctors (FY1 through ST6+) are on a separate track: since 2023, the BMA and government have negotiated resident doctors' pay directly, outside the standard review-body cycle, following the 2023-2025 industrial action over pay restoration. That negotiation is multi-year and ongoing, which is why resident doctor figures for 2026/27 should still be treated as provisional rather than final.

Will there be a 2027/28 pay rise announcement soon? +

The NHS Pay Review Body process runs annually, so the cycle for 2027/28 will begin with fresh evidence submissions from NHS Employers, trade unions and government later in the 2026/27 pay year, with a recommendation typically expected in the new year and a decision announced before or around the start of the next financial year. There's no fixed calendar date guaranteed — recent years have seen announcements land anywhere from midwinter to the following summer.

Does the 3.3% uplift apply to every Agenda for Change band? +

Yes — the 3.3% consolidated uplift applies across all Agenda for Change bands and pay points, from Band 2 through to Band 9, effective 1 April 2026. It's a percentage uplift on the existing 2025/26 pay point rather than a flat cash amount, so higher pay points see a larger cash increase for the same percentage. See our full Agenda for Change pay scales for 2026/27 for the resulting figures at every band and point.

Is the resident doctors' pay dispute still ongoing in 2026? +

The relationship between resident doctors and government has been contentious since 2023, when strike action over real-terms pay erosion became a defining story in NHS industrial relations. As of this update, resident doctor pay for 2026/27 remains subject to the separate BMA-government negotiation track rather than a single confirmed DDRB-style award, so specific nodal point figures can change as that process develops — check our doctors' pay guide for the latest confirmed numbers.

Do NHS pension contributions change when pay goes up? +

Your NHS Pension contribution tier is based on your actual pensionable pay, so a pay rise can move you into a higher contribution percentage band if it pushes your salary past one of the tier thresholds — it doesn't happen automatically just because there's been a general pay award, only if your new salary crosses a specific threshold.

Is the NHS pay rise the same thing as a cost-of-living payment? +

No, and conflating the two is a common source of confusion. The 3.3% Agenda for Change uplift is a consolidated rise — it's built permanently into your basic pay at every point on the scale, so it compounds into every future pay award. A cost-of-living payment, where one has been used in past years, is typically a one-off, non-consolidated payment that doesn't increase your ongoing basic salary or your pension calculation the way a consolidated rise does. For 2026/27, the confirmed award for Agenda for Change staff is consolidated, not a one-off payment.

How does this year's award compare with the recent pattern of NHS pay negotiations? +

Every year's award has its own shape, and it's worth resisting the urge to compare headline percentages across years as if they were identical in structure. Some past awards have applied a single flat percentage uniformly across every band and point, as 2026/27 does; others have layered in additional flat-rate, non-percentage elements weighted toward lower pay points, which changes the real cash and percentage impact depending on where you sit on the scale. See the section below on how this year's award fits the broader pattern for more detail.

Does the 2026/27 pay rise apply the same way in Scotland, Wales and Northern Ireland? +

Wales and Northern Ireland follow the same Agenda for Change pay spine as England and generally implement the same NHS Pay Review Body-derived award, so the 3.3% consolidated uplift applies there too, subject to each nation's own government formally confirming and funding it. Scotland is different: NHS Scotland negotiates its own pay deal separately and on its own timetable, so Scottish Agenda for Change staff are on a distinct settlement rather than the 3.3% figure — see our NHS Scotland pay scales guide for the confirmed Scottish rates.

What should I do if my payslip still shows the old rate months after the award was confirmed? +

First, check whether your trust has announced an implementation date for the new rates — a gap of a month or two between confirmation and the new rate appearing in ESR (the NHS payroll system) is normal, and arrears back to 1 April 2026 should follow once it's updated. If significantly more time has passed with no update and no communication from your trust about when arrears will land, that's a reasonable question to raise directly with your trust's payroll team, since implementation timelines can vary between employers even for a nationally agreed award.