NHS Pay

SSP Changes April 2026: What They Mean for NHS Staff

FP FrontlinePay Editorial

Updated October 2026

Independent guidance — not affiliated with NHS England or DHSC

Short answer

From 6 April 2026, Statutory Sick Pay is paid from the first day of sickness (the three waiting days are gone) and the lower earnings limit has been removed, so there is no minimum earnings test. SSP is the lower of £123.25 a week or 80% of your average weekly earnings, for up to 28 weeks (GOV.UK, ACAS). For most Agenda for Change staff the practical change is small, because NHS occupational sick pay under Section 14 of the Handbook is more generous, scales with service, and is meant to supplement SSP, with the two together capped at full pay. The change matters most for lower-hours staff and others who rely on SSP alone.

The Employment Rights Act 2025 reforms to SSP came into effect in April 2026 and were widely reported as a major change. This guide explains what changed, in terms you can check against GOV.UK and ACAS, and then shows how it fits with NHS occupational sick pay. For the full occupational entitlement table and the rolling-12-month rule, read NHS sick pay explained; this page does not repeat it.

What changed on 6 April 2026

Feature	Before 6 April 2026	From 6 April 2026
Waiting days	Three days unpaid before SSP started	SSP paid from the first day of sickness absence
Minimum earnings	You had to earn at least the lower earnings limit of £125 a week	Lower earnings limit removed; no minimum earnings threshold
Length of illness to qualify	Four or more days in a row	At least one full working day
Rate	A flat weekly rate	£123.25 a week or 80% of normal weekly earnings, whichever is lower
Maximum period	28 weeks	28 weeks

Sources: ACAS, statutory sick pay and GOV.UK, Statutory Sick Pay. We have not set out the previous flat weekly rate here because the sources we cite for this page describe the 2026/27 position; the current figure is £123.25.

How the new rate works

SSP, 2026/27

£123.25 a week

Or 80% of your average weekly earnings, whichever is lower. Up to 28 weeks. Tax and National Insurance are deducted.

GOV.UK says your employer uses your average weekly earnings over an 8-week period to work out what you get, you are paid for the full days you are off sick that you would normally have worked, and if you have more than one job you may get SSP from each employer. The 80% rule is new in effect for people whose earnings are low:

Average weekly earnings	80% of earnings	SSP per week
£100.00	£80.00	£80.00
£154.06	£123.25	£123.25
£200.00	£160.00	£123.25
£615.10 (full-time Band 5, entry)	£492.08	£123.25

Below £154.06 a week, 80% is the lower figure; above it, the flat £123.25 applies. These are our calculations from the two GOV.UK figures.

How it sits alongside NHS sick pay

Section 14 of the NHS Terms and Conditions of Service Handbook (England) says its arrangements are intended to supplement statutory sick pay. Three paragraphs matter for the interaction:

14.2: the scale: one month's full pay and two months' half pay in the first year of service, two and two in the second, four and four in the third, five and five in the fourth and fifth, and six and six after five years.
14.6: full pay needs to be inclusive of any statutory benefits so that sick pay is not greater than normal working pay, and the combined addition of SSP to half pay must not exceed full pay.
14.8: sick pay under the scheme, added to any statutory sickness benefits, must not exceed full pay.

In plain terms, SSP is counted towards your occupational pay, not paid on top of it. During the full pay period you receive full pay in which any SSP is included. During the half pay period, half pay and SSP can be paid together as long as the total does not exceed full pay. How your trust's payroll shows this on a payslip, and how it treats SSP weeks against the 28-week limit once your occupational entitlement ends, is for your payroll team to explain, so ask them for the calculation if the lines are unclear. Our guide to what happens when NHS sick pay runs out covers the end of occupational pay, half pay with SSP, and ESA.

ℹWhich nation?

This page quotes the England version of Section 14. Wales, Scotland and Northern Ireland have their own versions of the section, and the figures above are from the England text read in the April 2026 Handbook.

Who actually notices the change

Most substantive Agenda for Change staff have never relied on SSP as their main sick pay, because Section 14 pays full and half pay from the start of absence. The reform matters more in specific cases:

• Low-hours or bank workers who are employees and previously earned below the £125 a week threshold or lost three waiting days
• Staff whose occupational sick pay has run out and who have SSP weeks left, subject to how SSP has already been counted
• People with more than one job, who may get SSP from each employer
• New starters with a short service, whose occupational entitlement is smaller, since the scale starts at one month's full pay

Worked examples

Illustrations using 2026/27 England pay and the rules above. They are not a calculation of your own pay.

Situation	What the rules say	Illustrative result
Full-time Band 5 nurse (£32,073), three years' service, off for two weeks	Third year: four months' full pay. Full pay includes any SSP	Normal pay, about £615.10 a week before deductions. The SSP reform makes no difference
Same nurse, in a half pay period, with SSP payable alongside	Half pay plus SSP must not exceed full pay	Half pay about £307.55 plus SSP £123.25 gives £430.80, below the cap, so both can be paid in full if your trust applies it this way
Bank worker employee averaging £100 a week, off sick	No lower earnings limit; paid from day one at 80% of earnings	SSP £80 a week. Previously, earning below £125 a week meant no SSP at all
Employee averaging £200 a week, off for 3 days they would have worked	No waiting days; flat rate applies	SSP is paid for those days at a daily share of £123.25; before the change the first three days were unpaid

What has not changed

The NHS occupational scale: the same Section 14.2 table in the April 2026 Handbook.
The 12-month look-back: your remaining entitlement is your entitlement on the first day of sickness less paid sickness in the previous 12 months (paragraph 14.7).
Unsocial hours during sickness: not payable for staff who started under the Handbook on or after 1 July 2018 or whose basic pay is above £18,160 (paragraph 2.13), so a rota with lots of nights can still mean a lower payslip when off sick.
SSP limit: still up to 28 weeks.
What counts as full pay: for staff with basic pay above £18,160 and for new starters, full pay is the pay for your pay point plus high cost area supplement and any locally agreed pay protection (paragraph 14.5), so extras such as overtime and unsocial hours are not part of it.

To explore your own entitlement over time, use the NHS Sick Pay Calculator and the Sick Pay Runway Calculator.

NHS Sick Pay Calculator

Full pay and half pay by length of service, the 12-month look-back, SSP and what a period off sick costs you.

Try it

What to check on your payslip

✓ Whether the OSP and SSP lines add up to the right total for your stage of sick pay
✓ That no waiting days were applied to statutory pay for absences from 6 April 2026
✓ If you are a low-hours or bank worker, that you were treated as eligible for SSP, and ask how your employment status was assessed
✓ That unsocial hours have been handled according to your contract (paragraph 2.13)
✓ That your continuous service has been counted correctly in the sick pay tier

Our payslip codes decoder explains the OSP and SSP labels, and if you are off long-term, see NHS pension and long-term sickness.

ℹSources and limits

SSP rules from GOV.UK and ACAS; occupational sick pay from the NHS Terms and Conditions of Service Handbook (England, April 2026 version), Sections 2 and 14. This is general information, not legal advice, and trust policies vary. FrontlinePay is not affiliated with the NHS or DHSC.

Related guides and tools

NHS Sick Pay Explained

The full occupational sick pay table.

NHS Sick Pay Calculator

Your full and half pay by service.

Sick Pay Runway Calculator

How long your sick pay lasts.

NHS Payslip Codes Decoder

What OSP, SSP and other labels mean.

When NHS Sick Pay Runs Out

Half pay, SSP, ESA and what comes next.

NHS Pension and Long-Term Sickness

What sickness does to your pension.

NHS Bank vs Substantive Post

Sick pay differences for bank work.

Frequently asked questions

Is Statutory Sick Pay now paid from the first day? +

Yes. ACAS says that from 6 April 2026 statutory sick pay is paid from the first day of sickness absence, whereas previously there were three waiting days. GOV.UK's eligibility page now says you must have been ill for at least one full working day, rather than four or more days in a row.

What is the lower earnings limit and has it gone? +

The lower earnings limit was the minimum average weekly earnings, £125 a week, that an employee needed to qualify for SSP. ACAS says it was removed on 6 April 2026, so workers no longer need to meet a minimum earnings threshold. GOV.UK's eligibility rules list being an employee, having done some work for your employer and being ill for at least one full working day.

What is the SSP rate from April 2026? +

GOV.UK says SSP is £123.25 a week or 80% of your normal weekly earnings, whichever is lower, for up to 28 weeks. Your employer works out your average weekly earnings over the 8 weeks before the absence. Tax and National Insurance are deducted. 80% of average weekly earnings is lower than £123.25 when your average weekly earnings are below about £154.06.

Does this change my NHS sick pay? +

Not directly. NHS occupational sick pay is set by Section 14 of the Agenda for Change Handbook and was not changed by the SSP reform in the April 2026 Handbook we read. Occupational sick pay scales with length of service from one month's full pay in your first year to six months' full pay and six months' half pay after five years. The Handbook says these arrangements are intended to supplement statutory sick pay. Check your own contract and trust policy.

Do I get SSP as well as NHS sick pay? +

The Handbook says full pay needs to be inclusive of any statutory benefits so sick pay is not greater than normal pay, and that the combined addition of SSP to half pay must not exceed full pay (paragraphs 14.6 and 14.8, England). So SSP counts towards, rather than adds to, your occupational pay, and is relevant when you are on half pay. How your trust's payroll shows SSP alongside OSP on a payslip can look different, so ask payroll to explain your own lines.

Who gains from the April 2026 changes in the NHS? +

Mostly staff for whom NHS occupational sick pay does not apply or is limited: people who are employees but not covered by an occupational scheme, and low-hours or bank workers who are classed as employees and previously fell below the lower earnings limit or lost the first three days. Most substantive Agenda for Change staff were already paid occupational sick pay without waiting days, so the day-to-day change is small.

Can NHS bank workers get SSP? +

SSP is for employees, according to GOV.UK, and employment status for bank workers depends on the individual contract, so we cannot say for everyone. If you are classed as an employee, the removal of the lower earnings limit and waiting days helps lower-paid workers. Check your bank terms and ask the bank office or payroll whether you are treated as an employee for SSP.

What is 80% of my earnings in practice? +

If your average weekly earnings over the 8 weeks before the absence were £100, 80% is £80, which is lower than £123.25, so SSP would be £80 a week. If they were £200, 80% is £160, which is higher than £123.25, so SSP would be £123.25. The crossover is average weekly earnings of £154.06.

Is there a waiting period under NHS sick pay? +

The Section 14 scale in the Handbook text we read does not describe waiting days: entitlement runs on the scale based on your reckonable service, less paid sickness in the previous 12 months. Check your trust's sickness policy for how the first days are recorded. Wales, Scotland and Northern Ireland have their own versions of Section 14.

Where can I check my sick pay entitlement? +

Use our NHS Sick Pay Calculator for the full pay and half pay on your service and the 12-month look-back, and read the sick pay explainer for the table. Your trust's sickness absence policy and payroll team can confirm how it applies to you.

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