NHS Pay Bands Explained: 2025 Full Guide
Understanding how NHS Pay Bands work can help you make smart career moves and track your earnings confidently. We will help you understand how bands work, how pay rises happen and where you might go next.
What Are NHS Pay Bands?
NHS pay bands are like salary brackets. They group jobs based on things like responsibility, experience and qualifications. Most roles fall between Band 2 (entry level) and Band 9 (executive roles).
Each band has fixed pay points. Staff usually move up yearly within a band based on performance. Band 1 used to exist for the lowest-paid jobs but it was closed to new staff in 2018.
Who uses NHS Pay Bands?
The pay band system is part of Agenda for Change (AfC), which covers about 90% of NHS staff across England, Wales and Northern Ireland – including:
How NHS Pay Bands Began?
Before 2004, the NHS used a complicated grading system called the Whitley Councils. There were over 650 grading variations across Trusts , meaning the same role could be paid very differently in two places.
To simplify things, Agenda for Change was introduced in 2004. It brought:
What is Agenda for Change (AFC)?
Agenda for Change is the official NHS pay system for non-medical staff. It was designed to ensure:
It’s used in England, Wales and Northern Ireland. Scotland has its own AfC agreement but the principles are similar.
What Happened to Band 1?
Band 1 covered the most basic roles such as hospital cleaners and porters. In 2018, Band 1 was closed. Most staff were moved into Band 2, often with better job descriptions and development opportunities.
You can no longer apply for Band 1 jobs, Band 2 is now the starting point.
Who Decides NHS Pay Bands?
The NHS Pay Review Body (NHSPRB) advises the government on NHS pay. It reviews:
Each year, it recommends a pay rise — for example, 3.6% uplift for England in 2025/26, and 4.25% for Scotland.
NHS Pay Bands 2025/26: Roles, Salaries and Entry Points
Career Progression in NHS Pay Bands
Progression usually means applying for a higher banded job. Here’s how typical journeys look:
Band 2 > Band 3: Develop in current role, shadow senior HCAs
Band 3 > Band 4: NVQ Level 3 or Apprenticeship
Band 4 > Band 5: Nursing degree or other qualification
Band 5 > Band 6: CPD, years of experience, mentorship
Band 6 > Band 7+: Leadership roles or advanced clinical practice
Is Banding Fair? Can It Be Challenged?
The banding system uses a national Job Evaluation Scheme, which scores jobs based on factors like decision-making, communication, and working conditions.
If your responsibilities grow but your band doesn’t change — you can request a re-banding. Trade unions can support the process.
NHS Pensions by Pay Band
The NHS Pension Scheme is a defined benefit scheme, meaning your pension depends on your earnings and time worked, not stock market performance.
NHS Disability Support and Reasonable Adjustments
Every NHS Trust is required to offer fair support to disabled staff. This may include:
Some roles even have dedicated Disability Advocates or Workplace Adjusters to help staff thrive.
Other NHS Entitlements by Band
All NHS staff under AfC enjoy:
Entitlements don’t vary drastically by band, but higher bands often come with leadership CPD budgets or line manager responsibilities.
What’s Next in future for NHS Pay Bands?
There are ongoing calls for 2026/27 to address structural changes within the AfC pay, focusing on following:
AI tools, digital transformation, and apprenticeship expansion may reshape how progression works in the next 5 years.
