Agenda for Change Handbook 2026: What Changed and What Didn’t

Last updated: 28 September 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

2026 changes at a glance

The Agenda for Change handbook is two things at once: the pay circular (the numbers — pay points, allowances) and the terms and conditions (the rules — leave, sick pay, unsocial hours, and dozens of other sections). In 2026, the first changed everywhere; the second barely changed at all. That distinction matters, because most of what staff experience as “the handbook changing” is actually just the annual pay update.

If you only remember one line: your pay went up 3.3% and your terms and conditions are essentially what they were — with reform talks, not agreed reforms, as the thing to watch.

New pay values: 2025/26 vs 2026/27

The 3.3% consolidated uplift applied to every pay point in England from 1 April 2026. “Consolidated” means the increase is baked into basic pay — it counts for pensions, overtime calculations and next year’s starting point — unlike the one-off lump sums used in some previous settlements.

Source: NHS Employers — 2026/27 pay award announcement; rates also published by Health Careers NHS.

At Band 5 entry the uplift added £1,024 a year (£31,049 to £32,073); at the top of Band 5 it added £1,247. Because the award was announced in February 2026 and paid from 1 April, there were no arrears — the first on-time implementation in recent years. For how the award was decided, see how the NHS pay award is decided.

HCAS and allowance changes

High Cost Area Supplement figures were refreshed for 2026/27. The percentages are unchanged — 20% inner London, 15% outer London, 5% fringe — but the cash minima and maxima moved with the pay round:

In practice this means a Band 5 at entry in inner London gets £6,415 (20% of £32,073 — inside the range), while a Band 9 at the top is capped at £8,746. Full worked examples: NHS London weighting (HCAS) 2026/27.

Section-by-section: what actually changed

This is where honesty matters more than comprehensiveness. We looked for a published, section-by-section set of 2026 amendments to the England AfC handbook — the kind of “Section X now reads…” change log — and did not find one. What the NHS Staff Council and NHS Employers published for 2026 centres on the pay circular: new pay values and refreshed allowances. That is itself informative: 2026 was a pay-values year, not a contractual-rewrite year.

Two genuine exceptions:

• Scotland. The Scottish handbook was amended for the move to a 36-hour full-time week from 1 April 2026, affecting references in Sections 2 (maintaining round-the-clock services), 3 (overtime) and 10 (contractual continuity) among others. If you work in Scotland, your full-time hours, overtime thresholds and hourly-rate calculations now run off 36 hours, not 37.5 — see NHS Scotland pay.
• Structural reform discussions. These are talks, not amendments — covered in the next section. Do not mistake proposals reported in the press for agreed handbook changes.

The lesson for staff: when someone tells you “the handbook changed”, always ask which handbook (England’s and Scotland’s now differ on hours), which section, and whether it is agreed or proposed. Pay circular changes affect your money immediately; contractual wording changes affect your rights — and only once agreed by the Staff Council.

Sources: Health Careers NHS — Agenda for Change pay rates; NHS Scotland AfC circular PCS(AFC)2026/02 (PDF).

Structural reform: the talks to watch

The most consequential handbook story of 2026 is something that has not happened yet. On 5 March 2026 the NHS Staff Council received a funded mandate for structural reform of Agenda for Change — in plain terms, permission and money to negotiate changes to the pay structure itself, potentially including banding, pay steps and career progression. Talks are ongoing.

Source: Parliamentary written question 114427 — AfC reform mandate.

Why this matters: the current structure dates to the 2018 framework agreement, and known pressure points include the relatively flat early-career progression in Bands 5–6 and long-standing arguments about whether some nursing roles are banded correctly. Reform could eventually change pay steps, the number of spine points per band, or how progression works — but none of this is agreed. Until the Staff Council publishes agreed amendments, treat everything you read about reform as negotiation, not news. We will update this guide when — and only when — changes are actually agreed.

What didn’t change

For all the discussion, the core of most staff’s daily experience is untouched:

• Unsocial-hours percentages: Bands 4–9 still get +30% for Saturdays and weekday nights and +60% for Sundays and public holidays under Section 2 — the structure is unchanged; only the cash values rose with basic pay.
• Annual leave, sick pay and maternity: no verified 2026 amendments to the headline entitlements — see annual leave, sick pay and maternity pay.
• Overtime rules: time-and-a-half above 37.5 hours (36 in Scotland) for Bands 1–7 stands.
• Pension: contribution tiers and the 23.7% employer contribution are set through separate processes — see NHS pension contributions.

This stability is a feature, not an oversight: the handbook is a negotiated national contract, and changing it requires Staff Council agreement. Annual change is the exception — pay values aside — not the rule.

How to check which version your trust uses

Because England’s and Scotland’s handbooks now differ on working hours — and because trusts occasionally lag in updating intranet copies — verify what applies to you:

• Your trust intranet or HR team holds the version your employer recognises. This is the authoritative source for your contract.
• NHS Employers’ handbook pages carry the current national text and amendment history for England.
• Your ESR record and payslip reflect the pay values actually applied to you — if the 3.3% uplift is missing, raise it with payroll before assuming anything about the handbook.
• Your union rep can confirm whether a reported “change” is agreed, proposed, or misunderstood.

A useful habit: when relying on any AfC clause — for an overtime dispute, a progression query, a flexible-working request — cite the section number and the version date. It ends arguments faster than quoting summaries.

Previous years’ change log

For reference, the recent annual changes:

Older change logs live with NHS Employers’ handbook amendment records. For the system behind the annual numbers, see how the NHS pay award is decided — and if the award ever lands badly, pay disputes explained covers what happens next.

Frequently asked questions

What is the Agenda for Change handbook?

The national handbook setting terms and conditions — pay, annual leave, sick pay, unsocial hours, maternity and more — for NHS staff on Agenda for Change contracts across the UK. It is agreed by the NHS Staff Council.

Where can I read the AfC handbook?

Through NHS Employers’ website and your trust’s intranet or HR team. Always check you are reading the current version, because England’s and Scotland’s texts now differ on working hours.

Has the AfC handbook changed in 2026?

Pay values rose 3.3% and HCAS figures were refreshed, but we found no broad published set of contractual amendments for England in 2026 — it was a pay-values year, not a rewrite year. Scotland’s handbook did change for the 36-hour week.

What is the 36-hour week in Scotland?

From 1 April 2026, full-time Agenda for Change staff in Scotland work 36 hours a week instead of 37.5, with the Scottish handbook updated accordingly — affecting overtime thresholds and hourly-rate calculations.

Are AfC pay bands being restructured?

Not yet. A funded mandate for structural reform talks was issued on 5 March 2026 and negotiations are ongoing, but nothing has been agreed — treat reported proposals as proposals, not changes.

Does the handbook differ between the four nations?

The core handbook is UK-wide, but each nation implements pay separately and Scotland now differs on full-time hours. Always check the version your own trust recognises.

How do I know which handbook version applies to me?

Your trust’s intranet or HR team holds the authoritative version, and your ESR record and payslip show the pay values actually applied to you. Your union rep can confirm whether a reported change is agreed or merely proposed.

Sources and independence

Source: NHS Employers — 2026/27 pay award announcement.

Source: Health Careers NHS — Agenda for Change pay rates.

Source: NHS Scotland — AfC circular PCS(AFC)2026/02 (PDF).

Source: Parliamentary written question 114427 — AfC reform mandate.

Source: NHS Pay Review Body remit letter 2027/28 — GOV.UK.

NHS Bands Pay is an independent guide and is not affiliated with the NHS. Figures were verified against official sources on 28 September 2026 and can change — always confirm with the relevant official body before making financial decisions.