Agenda for Change: the Complete 2026/27 Guide
Last updated: 26 September 2026 · Figures verified against the NHS Employers 2026/27 pay circular.
What is Agenda for Change?
Agenda for Change (AfC) is the harmonised pay and conditions system covering the vast majority of NHS staff — nurses, midwives, paramedics, allied health professionals, healthcare assistants, administrative and estates staff. Doctors, dentists and very senior managers are on separate pay arrangements.
Its core idea is simple: equal pay for work of equal value. Every AfC job is evaluated against the same national criteria and placed in one of nine bands, so a Band 5 nurse in Newcastle and a Band 5 physiotherapist in Plymouth start on the same basic salary — the standard Band 5 salary of £32,073 in 2026/27.
The system is overseen by the NHS Staff Council (employers and unions together), and annual uplifts are recommended by the independent NHS Pay Review Body, which advises the government — see our guide to the NHS pay rise 2026/27.
History: from Whitley to Agenda for Change
- Before 2004: NHS staff were paid under the Whitley Council system, with separate pay scales for each staff group and long-standing equal-pay problems.
- 1 October 2004: Agenda for Change launched in England, harmonising pay across staff groups through a single job evaluation scheme.
- 2018 pay framework deal: England replaced annual spine-point increments with a smaller number of pay steps (entry, intermediate and top for most bands), linked explicitly to appraisals and statutory/mandatory training. Pay progression is no longer automatic.
- 2026 and beyond: the NHS Staff Council is in talks on structural reform of Agenda for Change, including a review of Band 5 nursing roles (target 2028) and a possible multi-year pay deal covering 2027/28–2028/29.
The nine pay bands at a glance (2026/27, England)
The table below shows the full picture, from a Band 2 salary of £25,272 to a Band 8d salary of up to £108,814. Director-level posts sit above that — see Band 9 salary.
| Band | 2026/27 pay range (FTE) | Typical roles |
|---|---|---|
| Band 2 | £25,272 | Healthcare assistant, support worker |
| Band 3 | £25,760–£27,476 | Senior healthcare assistant, emergency care assistant |
| Band 4 | £28,392–£31,157 | Nursing associate, assistant practitioner |
| Band 5 | £32,073–£39,043 | Newly qualified nurse, midwife, paramedic |
| Band 6 | £39,959–£48,117 | Experienced nurse, specialist practitioner |
| Band 7 | £49,387–£56,515 | Ward manager, advanced practitioner |
| Band 8a–8d | £57,528–£108,814 | Consultant nurse, service/deputy director |
| Band 9 | £112,782–£129,783 | Director-level roles |
Band 1 is closed to new entrants — read why Band 1 closed to new entrants. Full tables with hourly rates are on our NHS pay bands 2026/27 hub, and you can estimate your monthly take-home with the NHS pay calculator.
How jobs are banded: job evaluation
Bandings are not set by managers on a whim. Each post is scored against the national NHS Job Evaluation Scheme, which assesses factors including knowledge, skills, responsibility, effort and working conditions. The total score determines the band.
This matters for staff: if your duties have grown substantially, you can ask for your post to be re-evaluated. Unions such as the RCN, UNISON and the CSP publish guidance on requesting a re-banding.
Pay progression: how you move up
Since the 2018 framework, each band has two or three pay steps rather than yearly increments:
- Bands 2–4: entry step, then top of band after 2–3 years.
- Bands 5–7: entry, intermediate after 2 years, and top of band after around 5 years — for example, a nurse starting on NHS Band 5 pay reaches the intermediate step after two years.
- Bands 8–9: more granular steps reflecting senior experience.
Progression is subject to a satisfactory appraisal and completion of statutory and mandatory training. Moving between bands (for example, Band 5 to Band 6) requires appointment to a higher-banded post — it is not automatic with service. See how NHS pay progression works on the 2026/27 band hub. Remember that extras like NHS unsocial hours pay boost your total earnings but do not move you up the pay steps.
The 2026/27 pay award
The government accepted the NHS Pay Review Body's 39th Report in full on 12 February 2026: a 3.3% consolidated uplift to every Agenda for Change pay point, effective 1 April 2026. It was paid on time in April salaries — the first on-time award in six years. Details: NHS Employers pay award announcement 2026. We break down what the 2026/27 pay award means for each band and how it compares with previous years.
For comparison, the 2025/26 award was 3.6% (announced May 2025, paid August 2025 with arrears), documented on GOV.UK.
Agenda for Change terms and conditions
Pay is only part of the package. AfC standardises conditions across England, including:
- Working week: 37.5 hours full-time.
- Annual leave: 27 days plus 8 bank holidays on appointment, rising to 29 days after 5 years' service and 33 days after 10 years (part-time pro rata) — full details of NHS annual leave entitlement.
- Sick pay: occupational sick pay on a sliding scale by length of service, from 1 month full + 2 months half pay in year one up to 6 months full + 6 months half pay after 5 years.
- Maternity pay: 8 weeks full pay, 18 weeks half pay plus statutory maternity pay, 13 weeks SMP only and 13 weeks unpaid, after 12 months' NHS service.
- Unsocial hours and overtime: unsocial hours enhancements for nights, weekends and bank holidays; time-and-a-half overtime for bands 1–7.
- High Cost Area Supplement: NHS London weighting of 20%/15%/5% by zone.
- Pension: the NHS Pension Scheme, with employer contributions of 23.7% of pensionable pay — see NHS pension contribution tiers.
Who decides NHS pay?
- NHS Pay Review Body (NHSPRB): the independent body that gathers evidence from unions, employers and the Department of Health and Social Care, then recommends the annual uplift.
- The government (DHSC): accepts, rejects or modifies the recommendation and funds it.
- NHS Staff Council: the employer–union partnership that negotiates the AfC handbook itself, including structural changes.
- Unions: the RCN, UNISON, CSP, BDA and others submit evidence and ballot members on offers.
- Devolved nations: Scotland, Wales and Northern Ireland run their own processes — Scotland negotiates directly with unions rather than using the Pay Review Body. See NHS Scotland pay bands.
Frequently asked questions
What is Agenda for Change in simple terms?
It is the national NHS pay system that puts every non-medical job into one of nine pay bands based on a standard job evaluation, so staff doing work of equal value are paid equally. It has covered most NHS staff since 1 October 2004.
Who is covered by Agenda for Change?
Nurses, midwives, health visitors, paramedics, allied health professionals, healthcare assistants, admin and clerical staff, estates and support workers — over a million staff in England. Doctors, dentists and very senior managers have separate pay systems.
How do NHS pay increments work now?
England uses pay steps, not yearly increments: bands 2–4 have two steps (top reached after 2–3 years) and bands 5–7 have three steps (top after around 5 years), subject to appraisal and mandatory training.
What was the Agenda for Change pay rise for 2026/27?
3.3% on all pay points from 1 April 2026, announced 12 February 2026 and paid on time in April salaries.
Does Agenda for Change apply in Scotland?
Scotland uses the Agenda for Change framework but negotiates its own pay awards directly with unions — 3.75% for 2026/27 — and moved to a 36-hour week in April 2026.
What is the difference between Agenda for Change and Whitley?
Whitley was the pre-2004 system of separate pay scales per staff group. Agenda for Change replaced it with one harmonised nine-band structure and a single job evaluation scheme to deliver equal pay for work of equal value.
Can my banding change if my job changes?
Yes. If your duties have grown significantly, you (or your manager, or your union) can request a re-evaluation of the post under the NHS Job Evaluation Scheme, which may move it to a higher band.
This is an independent guide and is not affiliated with the NHS. Agenda for Change terms are set out in the NHS Terms and Conditions of Service Handbook; always check your trust's ESR record and your payslip for your actual pay.