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: 12 Feb 2026 | Pay scales effective from: 1 April 2026 (England)

IMPORTANT: Major reforms announced for Band 5 nurses in February 2026. Every Band 5 nurse will have their role reviewed, with potential regrading and backpay to 1 April 2026. Read the Band 5 Reform Guide

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 2026/27?

England: ~£32,073 → £39,043: 3 pay steps: Entry (0–2 years), Mid (2–4 years), Top (4+ years)
Scotland: ~£34,196 → ~£42,642 (higher overall – awaiting official confirmation)
Wales: ~£32,539 → ~£39,254 (Broadly aligned with England)
Northern Ireland: ~£30,990 → £37,705

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 £46,000–£55,000+ depending on shift pattern and location.

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 2026/27

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 2026/27(official)

Step	Years in band	Annual salary	Approx. monthly	Approx. hourly*
Entry	0-2 years	~ £32,073	~ £2,673	~ £16.45
Mid	2-4 years	~ £33,909	~ £2,825	~ £17.39
Top	4+ years	~ £39,043	~ £3,254	~ £20.02

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

Key Points

3.3% pay rise confirmed 12 February 2026
Standard AfC pay scale
Most staff start at the entry step
Step progression is time-based + appraisal-based
HCAS applies only in England
First on-time payment in 6 years (paid end of April 2026)

Scotland – Band 5 salary 2026/27 (approximate)

Step	Annual salary (approx.)
Entry	~ £34,196
Mid	~ £36,153
Top	~ £42,642

No HCAS scheme
Top step is noticeably higher than England
Awaiting official confirmation for 2026/27

Wales – Band 5 salary 2026/27 (approximate)

Wales usually mirrors England with small variations.

Step	Annual salary (approx.)
Entry	~ £32,539
Mid	~ £35,019
Top	~ £39,254

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

Northern Ireland (🇳🇮) – Band 5 salary 2026/27 (approximate)

Step	Annual salary (approx.)
Entry	~ £30,990
Mid	~ £33,263
Top	~ £37,705

Same step structure
No HCAS equivalent
Implementation dates may vary

UK-wide Band 5 Comparison Table (2026/27)

Nation	Entry step	Top step	Notes
England	~ £32,073	~ £39,042	Official 3.3% increase from 2025/26
Scotland	~ £34,196	~ £42,642	Typically higher base pay (estimated 3%)
Wales	~ £32,539	~ £39,254	Follows England closely
Northern Ireland	~ £30,990	~ £37,705	Can lag due to settlement timing

England Band 5 – 2025/26 vs 2026/27: Yearly Comparison

Step	2025/26	2026/27	£ Increase	Monthly Increase	% Rise
Entry	£31,048	£32,073	+£1,025	+£85/month	+3.3%
Mid	£32,820	£33,903	+£1,083	+£90/month	+3.3%
Top	£37,796	£39,043	+£1,247	+£104/month	+3.3%

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 (e.g., the 3.3% increase in 2026/27)
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)	Salary range (England 2025/26)	Typical requirements
Band 4	Nursing Associate, Senior HCA, Assistant Practitioner	~ £27,500 – £30,100	~ £28,216 – £31,196	Foundation degree / NVQ Level 3–4
Band 5	Registered Nurse, AHP, Newly Qualified Paramedic, ODP	£31,049 – £37,796	~ £32,073 – £39,043	Degree + Professional registration
Band 6	Specialist Nurse, Senior AHP, Paramedic, Team Leader	~ £38,700 – £46,600	~ £39,959 – £48,118	2+ years post-registration + specialist skills
Band 7	Advanced Practitioner, Ward Manager, Lead AHP	~ £47,800 – £54,700	~ £49,248 – £55,657	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: ~ £32,073
Gross monthly: ~ £2,673
Income Tax: £325/month
National Insurance: £142/month
Pension (7.2%): £192/month
Net take-home: ~£2,025/month (estimated)

Example 2: Band 5 AHP (mid step)

Basic salary: ~ £33,903
Gross monthly: £2,825
Income Tax: £356/month
National Insurance: £142/month
Pension (9.3%): £263/month
Net take-home: ~£2,065/month (estimated)

Note: Mid step crosses into the 9.3% pension tier, which is why take-home is only slightly more than entry despite a £1,830 salary increase.

Example 3: Band 5 Top Step + Regular Unsocial Hours

Base salary: £39,043
Enhancements: ~£12,500–£17,500 (2.5–3.5 nights/week)
Total gross: ~£51,537–£56,534
Net take-home: ~£2,838–£3,028/month

Note: At £51k–£56k total gross, pension tier may rise again (depending on 2026 thresholds). That could slightly reduce net.

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

Base salary: £32,073
HCAS (Inner London): £6,415
Base + HCAS: £38,488
Enhancements: ~£12,316–£16,421 (3–4 nights/week)
Total gross: ~£50,804–£54,909
Net take-home: ~£2,810–£2,966/month

London Weighting (HCAS)

HCAS applies only in England.

Typical HCAS rates (2026/27):

Zone	Rate	Minimum	Maximum	Applied to Band 5 Entry
Inner London	20%	£5,867	£8,745	£6,415 (within range, no cap)
Outer London	15%	£4,932	£6,275	£4,932 (min cap applies*)
Fringe	5%	£1,217	£2,109	£1,604 (within range, no cap)

*Outer London: 15% of £32,073 = £4,811, which falls below the minimum cap of £4,932, so the minimum is applied.

HCAS Examples (Band 5 Entry 2026/27)

Inner London: £32,073 + £6,415 = £38,488 (before enhancements) Monthly net: ~£2,304

Outer London: £32,073 + £4,932 = £37,005 (minimum cap applied) Monthly net: ~£2,227

Fringe: £32,073 + £1,604 = £33,677 Monthly net: ~£2,053

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: Newly Qualified Nurse (Inner London, Mixed Shifts)

Base: £32,073
HCAS (Inner): £6,415
Enhancements: ~£8,000 (mixed shift pattern)
Total gross: ~£46,488
Net take-home: ~£2,722/month

Example: Paramedic, mid step, rural Wales (with shifts)

Base: ~£35,019 (Wales mid step estimated)
Enhancements: ~£8,965 (2 nights/week)
Total gross: ~£43,984
Net take-home: ~£2,591/month

Example: Physiotherapist, Scotland, 0.6 WTE*

Full-time salary: ~£34,196 (Scotland entry, estimated)
0.6 WTE gross: ~£20,518
Net take-home: ~£1,423/month

*Whole Time Equivalent — working 60% of a standard full-time contract

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.

Historical Pay Progression: Band 5 Entry Salary (England)

Year	Entry Pay	Pay Rise	vs Inflation
2022/23	£27,055	+3.0%	Below inflation — real-terms pay cut
2023/24	£28,407	+5.0%	Below inflation — real-terms pay cut
2024/25	£29,970	+5.5%	Broadly matched inflation
2025/26	£31,048	+3.6%	Above forecast inflation
2026/27	£32,073	+3.3%	Above forecast inflation (CPI 2.2%)

Total increase since 2022/23: +£5,018 (+18.5% over 4 years)

Frequently asked questions

The 3.3% pay rise takes effect from 1 April 2026 and will be paid at the end of April 2026. This is the first on-time payment in 6 years — no backdating required.

No. If you are employed on an AfC contract on 1 April 2026, the increase applies automatically to your salary.

Yes. All Band 5 nurses in England will have their role reviewed by their employer. Those working at Band 6 level will be regraded with backpay to 1 April 2026. This is funded separately from the 3.3% award. Read our full Band 5 Reform Guide for details.

2024/25: 5.5% | 2025/26: 3.6% | 2026/27: 3.3% While lower than recent years, it is above forecast inflation (2.2%) and paid on time for the first time in 6 years.

At mid step (£33,903) your pension tier rises from 7.2% to 9.3%, adding approximately £71 more in pension deductions per month. This partially offsets the salary increase. You are still building a larger pension, so the money is not lost.

Possibly. NHS pension tiers are based on pensionable pay. Entry step (£32,073) sits in the 7.2% tier. Mid step (£33,903) crosses into the 9.3% tier. Check your payslip from April 2026.

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 entry salary is £32,073 in England (2026/27), top step is £39,043
The 3.3% pay rise takes effect 1 April 2026 (first on-time payment in 6 years)
Mid step crosses into a higher pension tier (9.3%) which reduces net pay gain
London HCAS adds £4,932 (Outer) to £6,415 (Inner) for Band 5 entry
Fringe HCAS adds £1,604 for Band 5 entry
Enhancements for regular nights can add £12,000–£17,500 to annual earnings
Scotland typically pays higher base rates (estimated £34,196–£42,642)
Wales and NI broadly follow England (est. £32,539 and £30,990 entry respectively)
Progression from entry to top takes 4 years with satisfactory annual appraisals
Band 5 nurses also receive mandatory role reviews — potential regrading to Band 6
Total earnings with London weighting and night shifts can exceed £50,000–£55,000
Clear career routes lead to Band 6 and Band 7 roles.