NHS Careers — Pay & Benefits

NHS Band 5 Salary 2025/26: Complete UK Wide Pay Guide for Nurses, AHPs & Paramedics

Pay and conditions Agenda for Change NHS Pay Bands

Last updated: November 2025 | Pay scales effective from: April 2025 (England)

Every year, thousands of newly qualified healthcare professionals join the NHS at band 5, the standard entry point for registered nurses, paramedics, allied health professionals (AHPs), ODPs (Operating Department Practitioner), radiographers and several other clinical roles. But Band 5 pay is not identical across the UK and it varies depending on pay steps, location and working patterns.

We will explain everything to you need to know about Band 5 pay in England, Scotland, Wales and Northern Ireland, including NHS take home pay, London weighting, enhancements, progression, real-world finance examples and career development.

Quick answer: What does a Band 5 professional earn in 2025/26?

England: £31,049 → £37,796. 3 pay steps: Entry (0–2 years), Mid (2–4 years), Top (4+ years)
Scotland: ~£33,200 → ~£41,400 (higher overall)
Wales: ~£31,500 → ~£38,000 (Broadly aligned with England)
Northern Ireland: ~£30,000 → ~£36,500

Most newly qualified staff start at entry level, progress to mid after 2 years, and reach top after 4 years with a satisfactory PDR.

With enhancements, overtime and London weighting, total Band 5 earnings can reach £40,000–£50,000+ depending on shift pattern and location.

What is NHS Band 5?

Band 5 is the standard starting pay band for registered healthcare professionals who have completed degree-level education and hold professional registration, for example with the Nursing and Midwifery Council (NMC) or Health and Care Professions Council (HCPC).

Band 5 Roles and Typically Responsibilities Include:

Direct patient assessment, treatment and care
Administering and managing medications
Clinical decision-making and risk management
Working within multidisciplinary teams
Teaching and mentoring students and junior staff
Applying evidence based practice and clinical guidelines

Roles at Band 5 Usually Require:

Degree-level qualification
Professional registration (NMC, HCPC, GPhC, GDC etc.)
DBS clearance where applicable
Commitment to continuing professional development (CPD)

Band 5 is covered by Agenda for Change, which determines pay structures for most NHS staff.

Current Band 5 Salary Scales 2025/26

Below is a clear breakdown of Band 5 pay across the UK. England has the most detailed published structure; devolved nations release circulars separately.

England (🇬🇧) – Band 5 salary 2025/26 (official)

Step	Years in band	Annual salary	Approx. monthly	Approx. hourly*
Entry	0–2 years	£31,049	~ £2,587	~ £15.88
Mid	2–4 years	£33,487	~ £2,791	~ £17.13
Top	4+ years	£37,796	~ £3,150	~ £19.33

*Hourly rate assumes 37.5 hours per week, 52 weeks per year.

Key Points

Standard AfC pay scale
Most staff start at the entry step
Step progression is time-based + appraisal-based
HCAS applies only in England

Scotland – Band 5 salary 2025/26 (approximate)

Step	Annual salary (approx.)
Entry	~ £33,200
Mid	~ £35,100
Top	~ £41,400

No HCAS scheme
Top step is noticeably higher than England
Earlier pay settlements often increase rates slightly more

Wales – Band 5 salary 2025/26 (approximate)

Wales usually mirrors England with small variations.

Step	Annual salary (approx.)
Entry	~ £31,500
Mid	~ £33,900
Top	~ £38,000

Enhancements similar to AfC
Often aligns with England’s pay structure

Northern Ireland (🇳🇮) – Band 5 salary 2025/26 (approximate)

Step	Annual salary (approx.)
Entry	~ £30,000
Mid	~ £32,200
Top	~ £36,500

Same step structure
No HCAS equivalent
Implementation dates may vary

UK-wide Band 5 Comparison Table (2025/26)

Nation	Entry step	Top step	Notes
England	£31,049	£37,796	Standard AfC pay scale
Scotland	~ £33,200	~ £41,400	Typically higher base pay
Wales	~ £31,500	~ £38,000	Follows England closely
Northern Ireland	~ £30,000	~ £36,500	Can lag due to settlement timing

Band 5 Step Progression Explained

Before the 2018 NHS pay deal, Band 5 previously used spine points (10–16) but now uses three steps:

Entry: 0–2 years
Mid: 2–4 years
Top: 4+ years

How Progression Works

Progression is based on:

Time in band (normally two years per step)
A satisfactory appraisal (PDR)
Meeting mandatory training requirements
No active performance or disciplinary barriers

At the Top Step

Once you reach the top step:

You continue to receive national pay awards
Enhancements and HCAS still apply
There are no further steps — you stay on this rate until promotion to Band 6+

Who Works at Band 5?

Band 5 includes a wide range of registered clinical roles.

Nursing & Midwifery

Adult, Children’s, Mental Health, LD (Learning Disability) Nurses
ED (Emergency Department) Nurse
Theatre/Recovery Nurse
Community / District Nurse (entry level)
Newly qualified Midwife
Rotational Midwife (pre-Band 6)
School Nurse (training period)
Health Visitor (during training / pre-Band 6 consolidation)

Allied Health Professions (AHPs)

Therapies (HCPC registered):

Physiotherapist
Occupational Therapist
Dietitian
Speech & Language Therapist
Podiatrist
Prosthetist/Orthotist
Art/Music/Drama Therapist

Diagnostic & Therapeutic

Diagnostic Radiographer
Therapeutic Radiographer
Operating Department Practitioner (ODP)

Healthcare Science

Biomedical Scientist
Cardiac/Respiratory Physiologist
Neurophysiologist
Clinical Technologist

Ambulance & Urgent Care

Paramedic (Band 5 in many services)

Most NHS ambulance services appoint newly registered paramedics at Band 5 while they complete their Consolidation of Learning or preceptorship period.

Common Band 5 job titles include:

Newly Qualified Paramedic (NQP)
Paramedic – Preceptorship
Paramedic (Newly Registered)
Trainee Paramedic (Final Stage)
Ambulance Paramedic – Band 5
Paramedic (Band 5 – Consolidation Period)

Band 5 paramedics:

Are fully registered with the HCPC
Can practise autonomously but still receive structured support
Usually progress to Band 6 Paramedic after 12–24 months once competencies are signed off

After consolidation, many progress to:

Senior / Team Leader (Band 6)
Advanced Paramedic Practice roles (Band 7+)

Pharmacy, Dental, Public Health

Newly Qualified Pharmacist (GPhC registered)
Pharmacy roles in rotational early career posts
Dental Hygienist / Dental Therapist (GDC registered)
Public Health Practitioner / Health Improvement Practitioner

Band 5 vs other Bands (England 2025/26)

Band	Typical roles	Salary range (England 2025/26)	Typical requirements
Band 4	Nursing Associate, Senior HCA, Assistant Practitioner	~ £27,500 – £30,100	Foundation degree / NVQ Level 3–4
Band 5	Registered Nurse, AHP, Newly Qualified Paramedic, ODP	£31,049 – £37,796	Degree + Professional registration
Band 6	Specialist Nurse, Senior AHP, Paramedic, Team Leader	~ £38,700 – £46,600	2+ years post-registration + specialist skills
Band 7	Advanced Practitioner, Ward Manager, Lead AHP	~ £47,800 – £54,700	Significant experience, often Master’s-level

Progression from Band 5 → 6 → 7 typically takes 5 to10 years depending on speciality and opportunity.

Take Home Pay Examples (2025/26)

These figures are approximations; your actual NHS take home salary will depend on pay deductions (tax code, pension tier, student loans) and enhancements.

Example 1: Newly qualified Band 5 (entry step, outside London)

Basic salary: £31,049
Gross monthly: ~£2,587
Net take-home: ~£1,900–£2,000

Example 2: Band 5 AHP (mid step)

Basic salary: £33,487
Estimated net: ~£2,050–£2,150

Example 3: Band 5 Top Step + Regular Unsocial Hours

Base: £37,796
Enhancements: + ~£6,000
Total gross: ~£43,796
Net take-home: ~£2,350–£2,500

Example 4: Inner London Band 5 (Entry) + Nights

Base: £31,049
HCAS: ~£6,200
Enhancements: ~£8,000–£10,000
Total gross: £45,000–£48,000+
Net: ~£2,500–£2,750

London Weighting (HCAS)

HCAS applies only in England.

Typical HCAS rates (2025/26):

Inner London: 20% of basic
Outer London: 15%
Fringe: 5%

With minimum and maximum caps applied.

Example

Band 5 Entry (Inner London):
£31,049 + ~£6,210 = ~£37,259 (before enhancements)

Enhancements & Additional Pay

Most Band 5 staff working shifts receive unsocial hours payments.

Typical AfC Section 2 rates:

Evenings: +30%
Nights (midnight–6am): +60%
Saturdays: +30%
Sundays & Bank Holidays: +60%
Some bank holidays: 100% extra (double time)

Example: A standard night shift as overtime/ unsocial hours can exceed £200 total pay.

Ambulance and some acute services may apply additional policies.

Regional Differences Summary

England

Full AfC structure
HCAS applies in London

Scotland

No HCAS
Often pays higher base rates

Wales

Very close to England
Minor differences depending on annual settlement

Northern Ireland

Sometimes behind due to pay round timing
Structure matches England (Entry → Mid → Top)

Moving Between Nations

If you move between UK nations:

Your Band usually transfers
Your time in band typically carries over for step progression
Your salary changes to the host nation’s rate
You may gain/lose HCAS depending on region

Career Progression Beyond Band 5

Band 6 Roles Usually Require:

2+ years post-registration experience
Specialist modules or training
Greater clinical or leadership responsibility

Band 7 Roles Often Require:

Advanced practice skills
Master’s level study
Service-level leadership experience

Many staff progress from Band 5 → 6 within 2 to 5 years, and Band 7 within 5 to10 years.

Real world Band 5 earning examples

Example 1: Newly Qualified Nurse (Inner London, Mixed Shifts)

Total gross: ~£47,000
Net: ~£2,500–£2,700/month

Example 2: Paramedic, mid step, rural Wales

Total gross: ~£40,000
Net: ~£2,250–£2,400/month

Example 3: Physiotherapist, Scotland, 0.6 WTE*

Gross: ~£24,000
Net: ~£1,500–£1,700/month

(Whole Time Equivalent, working 60% of a standard full-time job)

Common misconceptions about Band 5 pay

❌ Myth: “All Band 5 staff earn the same.”

Enhancements, HCAS, part-time working and on-call arrangements can create large differences.

❌ Myth: “I get an automatic raise every year.”

Steps require time in band + satisfactory PDR.

❌ Myth: “London weighting covers the cost of living.”

HCAS helps but does not fully offset London rent and transport costs.

❌ Myth: “Band 5 is low pay.”

Band 5 is entry level for registered professionals, and with enhancements many earn above the UK median wage.

Frequently asked questions

Band 5 nurses in England earn between £31,049 (entry) and £37,796 (top step) in 2025/26. Total earnings can be higher with unsocial hours enhancements and, in London, High Cost Area Supplements (HCAS). Many Band 5 nurses earn £40,000–£50,000+ when working nights and weekends.

The starting salary for Band 5 in England is £31,049 (entry step). Scotland and Wales typically pay slightly more, while Northern Ireland may be a little lower depending on the timing of pay settlements.

It usually takes around four years to reach the top step of Band 5. Staff progress from Entry (0–2 years) to Mid (2–4 years), then to Top (4+ years), based on satisfactory appraisals (PDRs) and meeting local competency and training requirements.

Yes. Band 5 staff working in eligible areas of London receive High Cost Area Supplements (HCAS). Indicative rates are around 20% of basic pay for Inner London, 15% for Outer London and 5% for fringe areas, subject to minimum and maximum amounts. HCAS is added on top of basic salary and is usually pensionable.

Band 5 staff who work shifts may receive additional payments for unsocial hours, for example:

+30% for evenings
+60% for nights and Sundays
+30% for Saturdays
Up to double time for some bank holidays

Enhancements can add £5,000–£12,000+ per year, depending on the rota pattern and number of unsocial shifts worked.

No. Pay progression between steps is linked to time in band and a satisfactory appraisal (PDR), as well as completing mandatory training and meeting role-specific competencies. National pay awards (percentage uplifts) may also be agreed, but these depend on national negotiations and are not guaranteed every year.

No. England, Scotland, Wales and Northern Ireland negotiate pay separately. Scotland often pays slightly higher Band 5 rates, Wales is usually very close to England, and Northern Ireland can lag behind due to the timing of pay deals. The overall structure is similar, but the exact figures differ by nation.

Not in the same way as in the private sector. Basic pay is set by the Agenda for Change framework. However, some employers may recognise significant previous NHS service by starting staff on a higher step within the band, and recruitment and retention premia may apply in shortage specialties or hard-to-recruit areas.

Yes. Many clinicians move from Band 5 to Band 6 after gaining 1–3 years of post-registration experience and completing relevant specialist training. Examples of Band 6 roles include Specialist Nurse, Senior Physiotherapist, Senior Radiographer, Paramedic Practitioner and various team leader posts.

Yes. Band 5 posts usually require a degree-level qualification (for example BSc Nursing, BSc Paramedic Science, BSc Physiotherapy) and professional registration with the appropriate body such as the NMC, HCPC, GPhC or GDC. Band 5 is the entry level for most registered professionals under Agenda for Change.

Key takeaways

Band 5 is the main entry band for registered clinical professionals.
England pays £31,049–£37,796 in 2025/26.
Scotland and Wales typically pay slightly more; NI may lag.
Enhancements and HCAS can push earnings above £45k–£50k.
Step progression depends on time in band + appraisal.
Clear career routes lead to Band 6 and Band 7 roles.