Annex 21 Trainee Pay: What NHS Trainees Earn in 2026/27

Last updated: 6 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

What Annex 21 is

Annex 21 is a short annex to the Agenda for Change Terms and Conditions, titled Arrangements for pay and banding of trainees. It answers a single question: what do you pay someone who is training for a qualified NHS role while employed by the NHS? The answer is not a separate trainee pay scale. It is a percentage of the band maximum for the band the trainee will qualify into, and the percentage rises as completion gets closer. That is the whole mechanism, and once you know the band and the length of the training, you can work out the pay in pounds from the table on this page.

The scope matters as much as the percentages. Annex 21 covers trainees who do all their training as NHS employees. It is not the Scientist Training Programme, whose trainees are salaried at Band 6, and it is not an apprenticeship levy route, which has its own pay arrangements. If a vacancy says Annex 21 applies, the percentages on this page are your pay. If it says apprenticeship, the apprenticeship arrangements apply instead, and the figures are on the relevant route page. The distinction is worth checking before you apply, because the same training can be advertised under different arrangements by different trusts, and the pay is not the same.

Trainees usually meet Annex 21 in a job advert that quotes a percentage rather than a salary, which is why the rule causes so much confusion. An advert for a trainee post might say 70% of Band 5, and a reader who has never seen the annex has no way of knowing whether that means £27,000 or £24,000, or whether the figure is the entry point or the top of the band. This page exists to close that gap: every percentage turned into pounds, for every band, for 2026/27. The band itself is decided by job evaluation, which scores the qualified post against 16 factors, and our guide to how NHS jobs are banded explains that process. Annex 21 then decides what a trainee in that band is paid while they train. The two rules work together: evaluation fixes the band, Annex 21 fixes the trainee pay inside it.

One warning belongs at the start. Never take a single flat trainee salary per band from any source without checking which percentage and which year it refers to, because a Band 5 trainee earns four different salaries depending on the programme length, and a figure quoted without its percentage is meaningless. The table below gives all four percentages for every band, so you can match the figure to your own programme rather than trusting a single number from a forum or a job board.

The percentage schedule

The schedule has four steps, and the step is decided by the time remaining before completion, not by the year of the programme. That distinction matters for programmes that do not run in whole years, because a trainee who is 14 months from completion sits at 70%, while a trainee who is 11 months from completion sits at 75%.

Read as a programme, the schedule gives a clear progression. A two-year trainee runs at 70% in the first year and 75% in the second. A three-year trainee runs at 65%, then 70%, then 75%. A four-year trainee runs at 60%, 65%, 70% and 75%. Each year the pay rises as completion approaches, and the final year is always 75% of the band maximum, whatever the total length of the programme. The percentage is applied to the band maximum, which is the top pay point of the band, and that is the detail most people get wrong.

The common mistake is to apply the percentage to the entry point of the band instead of the top. For a Band 5 trainee in the final year, 75% of the top point, £39,043, is £29,282. But 75% of the entry point, £32,073, is £24,055, which is £5,227 less. A trainee who works from the entry point will understate their pay by more than £400 a month, and an advert that quotes a percentage without saying which point it applies to is inviting exactly that error. The annex is explicit: the percentage is of the band maximum. Every figure in the table below is worked from the top point, and the worked examples repeat the point so it cannot be missed.

Part-time trainees are paid pro rata. A trainee on a 0.6 whole-time-equivalent contract receives 60% of the full-time figure for their percentage step, and the same pro rata rule applies to annual leave and to the pension contribution, which is worked from the part-time salary. The part-time pay guide sets out the pro rata maths in full, and the part-time pay calculator will work out the exact figure for any whole-time-equivalent fraction.

Trainee pay by band, 2026/27

The table below gives the annual trainee salary for every band in England in 2026/27, full-time on a 37.5-hour week, at each of the four percentages. Find the band you will qualify into, then read across to the column that matches your time to completion. Band 1 has no row, because the band is closed to new entrants and the verified data file holds no Band 1 salary for 2026/27, so no trainee figure can be stated without guessing.

Three patterns in the table are worth noticing. The first is the size of the step between percentages: at Band 5 the four figures run £23,426, £25,378, £27,330 and £29,282, so each year of a programme is worth roughly £1,950 a year. The second is the overlap between bands: a trainee in the final year of a Band 6 programme, on £36,088, earns more than a trainee in the first year of a Band 7 programme, on £33,909, because the band matters as much as the percentage. The third is the range within a single band: a Band 9 trainee earns between £77,870 and £97,337 depending on the year, a spread of nearly £20,000, which is why a flat figure for a band is never enough. The Agenda for Change guide sets out the full qualified scales behind these maxima, and the band pages, starting with Band 5 pay and Band 6 pay, explain what the qualified roles at each band involve.

Worked examples: four trainees

The examples below use 2026/27 England rates, full-time, and each one shows the annual salary and the monthly pay, because monthly pay is the figure a trainee actually budgets from. Monthly pay is the annual figure divided by 12.

Example 1: Band 5 trainee nurse, two-year programme. The Band 5 maximum is £39,043. In the first year, with more than one year to completion, the trainee is paid 70%, which is £27,330 a year, or £2,277.50 a month. In the second year, the final year, the trainee is paid 75%, which is £29,282 a year, or £2,440.17 a month. The rise between the two years is £1,952 a year, or £162.67 a month. On qualifying, the trainee moves to the Band 5 entry point of £32,073, as the next section explains.

Example 2: Band 6 trainee, three-year programme. The Band 6 maximum is £48,117. In the first year the trainee is paid 65%, which is £31,276 a year, or £2,606.33 a month. In the second year the trainee is paid 70%, which is £33,682 a year, or £2,806.83 a month. In the third and final year the trainee is paid 75%, which is £36,088 a year, or £3,007.33 a month. The rise from the first year to the final year is £4,812 a year, and the monthly pay crosses £3,000 only in that final year, which is worth knowing if you are budgeting for the whole programme rather than the first year.

Example 3: Band 4 trainee, one-year programme. The Band 4 maximum is £31,157. A one-year programme sits entirely within 12 months of completion, so the trainee is paid 75% for the whole year, which is £23,368 a year, or £1,947.33 a month. There is no step up during a one-year programme, because the trainee is in the final year from the start. Short programmes like this are the simplest case under Annex 21, and they are also the case where the entry-point mistake costs the most in proportion: 75% of the Band 4 entry point, £28,392, would be £21,294, which is £2,074 less than the correct figure.

Example 4: Band 2 trainee, four-year programme. The Band 2 maximum is a single spot rate of £25,272. In the first year the trainee is paid 60%, which is £15,163 a year, or £1,263.58 a month. In the second year the trainee is paid 65%, which is £16,427 a year, or £1,368.92 a month. In the third year the trainee is paid 70%, which is £17,690 a year, or £1,474.17 a month. In the fourth and final year the trainee is paid 75%, which is £18,954 a year, or £1,579.50 a month. The rise across the whole programme is £3,791 a year, and the first year is the case where the minimum-wage floor is most likely to apply, as the final section explains.

None of these examples includes unsocial-hours or overtime payments, because those depend on the rota, but the principle is the same for trainees as for qualified staff, and the rates are worked through in the nights and weekends section below. London weighting is also separate from these figures, and a trainee in London adds High Cost Area Supplement on top of the basic pay shown here.

What happens when you qualify

On completion the trainee enters either the first pay point of the band or the next point above their training salary. In practice the first point sits above the final training salary at every band, because 75% of the top point is always below the entry point, so qualifying always means a pay rise, and the size of that rise is worth knowing before you sign up.

A Band 5 trainee finishing on £29,282 moves to the Band 5 entry point of £32,073, a rise of £2,791 a year, or £232.58 a month. A Band 6 trainee finishing on £36,088 moves to the Band 6 entry point of £39,959, a rise of £3,871 a year, or £322.58 a month. A Band 2 trainee finishing on £18,954 moves to the Band 2 spot rate of £25,272, a rise of £6,318 a year, or £526.50 a month, which is the largest proportional rise in this set, because the Band 2 spot rate is a long way above 75% of itself. The rise on qualifying is not a bonus or a discretionary award. It is the move from the trainee percentage to the qualified scale, and it happens on the date of completion, not at the next annual pay round.

From there, normal step progression applies. A qualified member of staff moves to the next pay step after 12 months in post, subject to the usual appraisal and performance arrangements, and the pay step increments guide explains how those steps work and what can delay them. The training years themselves do not count as time on the qualified scale, so a trainee who qualifies into Band 5 starts at the entry point even after a four-year programme. What the training years do count towards is continuous service, which protects the leave tier, the sick pay entitlement and the redundancy reckoning, so the years are not lost, even though the pay steps start again.

What the monthly pay means after deductions

Trainees pay pension, tax and National Insurance like any other employee, and the monthly gross figures in the examples above are before those deductions. The pension contribution comes off first under the net pay arrangement, which reduces the pay that tax is charged on, and National Insurance is charged on gross pay. The contribution tiers for 2026/27 run from 5.2% on pay up to £13,259, through 6.5% on pay from £13,260 to £28,854, 8.3% on pay from £28,855 to £35,155, 9.8% on pay from £35,156 to £52,778, and 10.7% on pay from £52,779 to £67,668, to 12.5% above that, with the employer paying 23.7% on top. The personal allowance for 2026/27 is £12,570 a year, income tax is 20% on income above the allowance up to £50,270, and employee National Insurance is 8% on earnings above £12,570 up to £50,270 and 2% above that.

Take the Band 5 trainee in the second year, on £29,282 a year. Gross monthly pay is £2,440.17. The pension contribution is 8.3%, because £29,282 falls in the £28,855 to £35,155 tier, which is £202.53 a month. Tax at 20% on the remaining pay above the personal allowance is £238.03, and National Insurance at 8% is £111.41, leaving £1,888.20 a month. The employer pays a further £578.32 a month in pension contributions on top of that, which the trainee never sees on the payslip but which is part of the value of the job. A Plan 2 student loan takes nothing from this trainee, because £29,282 is below the Plan 2 threshold of £29,385, by £103. A trainee earning above the threshold pays 9% of the amount above it, so a small rise that crosses the threshold does not take 9% of the whole salary, only of the part above £29,385.

Take the Band 2 trainee in the first year, on £15,163 a year. Gross monthly pay is £1,263.58. The pension contribution is 6.5%, because £15,163 falls in the £13,260 to £28,854 tier, which is £82.13 a month. Tax at 20% on the remaining pay above the personal allowance is £26.79, and National Insurance at 8% is £17.29, leaving £1,137.37 a month. The tax figure is small because most of the monthly pay sits inside the personal allowance, and that is normal at the lower bands. The pension contributions guide sets out the tiers in full, and the payslip guide explains how to read each line once the first payslip arrives. The hourly rate calculator will convert any annual salary into an hourly rate.

Nights, weekends, overtime and London weighting

Annex 21 sets basic pay only. Everything else is paid under the normal Agenda for Change terms, at the rate for the band, and trainees are not excluded from any of it. Unsocial-hours enhancements are paid on the hours actually worked. A Band 5 trainee in the second year, on £29,282, has an hourly rate of £14.96, worked as the annual salary divided by 52.2 and then by 37.5. A Saturday hour pays time plus 41%, which is £21.09, and a Sunday hour pays time plus 83%, which is £27.37. A 7.5-hour Saturday shift is worth £158.19 against £112.19 at plain time, and a 7.5-hour Sunday shift is worth £205.31. Night hours, from 8pm to 6am on weekdays, are paid at the Saturday rate for the band, so a Band 5 trainee night hour is also £21.09. The full rates, including the Band 2 and Band 3 percentages, are in our unsocial hours and overtime guide, and the night shift pay guide works through the 6am split that decides how a night shift is paid.

Overtime is paid under Section 3 at the rate for the band: time and a half for Bands 1 to 7, double time on bank holidays, and time off in lieu only for Bands 8 and 9. Overtime and unsocial-hours enhancement cannot both be claimed for the same hours, so a trainee who works overtime on a Sunday is paid the overtime rate, not the overtime rate plus the Sunday enhancement. Part-time trainees are paid plain time for hours above their contracted hours up to 37.5, and overtime rates only above 37.5, exactly as for qualified part-time staff.

London weighting is paid on top of basic pay for the hours worked, and it is calculated as a percentage of the trainee basic pay, subject to the same minimum and maximum as for qualified staff. Inner London pays 20% of basic, with a minimum of £5,794 and a maximum of £8,746. Outer London pays 15%, with a minimum of £4,870 and a maximum of £6,137. The fringe pays 5%, with a minimum of £1,346 and a maximum of £2,270. A Band 5 trainee in the second year, on £29,282, receives 20% in inner London, which is £5,856.40 a year, or £488.03 a month, because that figure sits between the minimum and the maximum. A Band 2 trainee in the first year, on £15,163, receives 20% in inner London, which is £3,032.60, below the £5,794 minimum, so the minimum pays instead, and the total inner London pay for that trainee is £20,957 a year, or £1,746.42 a month. The minimum is what makes London weighting worth real money at the lower bands, and it is the part trainees most often miss. The London weighting (HCAS) guide sets out the rates in full, and the HCAS calculator will work out the supplement for any salary and zone.

Scotland and Wales

The percentages are the same in Scotland and Wales, 75, 70, 65 and 60% by time to completion, but the band maxima are different, so the pounds are different, and you must not apply the England figures to a devolved-nation post. The schedule is the same, the scales are not.

In Scotland, a Band 5 trainee is paid against the Scottish Band 5 top of £42,977. In the final year that is 75%, which is £32,233 a year, or £2,686.08 a month. Scotland moved to a 36-hour week from April 2026, which changes the hourly maths, because the same annual salary is divided by fewer hours, and the hourly rate for that trainee is £17.15, worked as the annual salary divided by 52.2 and then by 36. Scotland awarded 3.75% from 1 April 2026 under a two-year deal, and the verified data file holds the Band 5 range only, so no other Scotland trainee figures are quoted here. The NHS Scotland pay guide sets out the award and the working week in full.

In Wales, a Band 5 trainee is paid against the Welsh Band 5 top of £39,631. In the final year that is 75%, which is £29,723 a year, or £2,476.92 a month. Wales awarded 3.3%, implemented on 1 April 2026, with a Real Living Wage floor of £13.45 an hour applied to the Band 1, 2 and 3 minimum, and the full Welsh scale differs slightly from England. The NHS Wales pay guide sets out the award in full. In Northern Ireland the 3.3% award for 2026/27 is recommended but not yet implemented, so staff there should not budget on the England figures until the award is confirmed, and no Northern Ireland trainee figures are quoted here. The four-nation pay comparison sets out the awards side by side.

Annex 21 compared with apprenticeships and the STP

Three routes into qualified NHS roles look similar from the outside and pay differently, and the advert wording is the clue to which one applies. Annex 21 trainees are NHS employees for the whole of their training, and they are paid a percentage of the band maximum. Apprentices are on levy-funded programmes, and their pay is set under the apprenticeship arrangements, not under Annex 21. Scientist Training Programme trainees are salaried at Band 6 for the three years of the programme. If you are comparing offers, the first question is not how much each route pays in year one, but which arrangement the post is advertised under, because the arrangement decides the rules for the whole programme.

The nursing degree apprenticeship is the route most often confused with Annex 21, because it is also an earn-while-you-learn path into registered nursing, over four years, with employment and university study combined. Its pay is set under the apprenticeship arrangements, and our guide to nursing degree apprenticeship pay sets out the figures. The trainee nursing associate route is a two-year foundation degree apprenticeship into a registered support role at Band 4, and our guide to trainee nursing associate pay sets out that route, including where it lands on qualifying. The Scientist Training Programme is a three-year route into clinical science, salaried at Band 6, and our guide to clinical scientist salary covers the qualified roles it leads to. None of these three routes uses the Annex 21 percentages, and none of them should be costed from the table on this page.

That leaves the question of which route pays more, and the honest answer is that it depends on the band, the programme length and the year, and a single comparison figure would mislead. A four-year Annex 21 trainee into Band 5 earns £23,426 in the first year, while a Band 6 salaried STP trainee earns the Band 6 entry point from the start, but the two routes lead to different qualified roles at different bands, so the comparison is not like for like. Compare the qualified role each route leads to, the band it sits at, and the pay on qualifying, and treat the training years as the price of the route, not as the whole story. The student nurse finance guide sets out the university funding picture for the full-time degree route, which is the third way into registered nursing and the one with no salary at all during training.

Annual leave, pension and the minimum-wage floor

Trainees accrue annual leave like any other member of staff. Agenda for Change gives 27 days of annual leave plus 8 bank holidays at up to 4 years of service, 29 days plus 8 at 5 years, and 33 days plus 8 at 10 years, a total of 35, 37 and 41 days, and a standard NHS day is 7.5 hours. A trainee who starts with no reckonable service is on the 27-day tier, and part-time trainees have their entitlement pro rated by whole-time equivalent. The annual leave guide sets out the tiers in full, and the annual leave calculator will work out the exact entitlement for any start date.

Trainees join the NHS Pension Scheme on the same contribution tiers as qualified staff, and the tiers are set out in the take-home section above. The employer pays 23.7% on top of the trainee salary, which is part of the value of the post even though it never appears on the payslip. The pension is one of the strongest reasons to take an NHS-employed training route over a university-only route, because the years in training build pensionable service from the start, and the scheme is the same one qualified staff build their retirement in. The pension contributions guide sets out the tiers and the employer rate in full.

The minimum-wage floor is the last protection in the annex, and it matters most at the bottom of the table. A trainee must receive at least the National Minimum Wage or the National Living Wage, whichever applies to their age, and payroll adds a supplement where the Annex 21 percentage would fall below that floor. The lowest combination in the table is a Band 2 trainee in the first year of a four-year programme, on £15,163, which is £7.75 an hour on a 37.5-hour week, so the supplement is likely to apply there. The statutory rates are set by the government each April and are not quoted on this page, because they change every year and this page only carries figures verified in the NHS pay data file. If your payslip shows a supplement line, that is the floor top-up, and it counts as pay, not as a separate allowance, so it is pensionable and taxable in the normal way.

One last check before you accept a trainee post. Ask the trust to confirm, in writing, the band you will qualify into, the percentage that applies in each year of the programme, and the annual salary for the first year. Those three facts are enough to check the offer against the table on this page, and a trust that cannot give them is a trust whose advert you should read twice. Keep the offer letter, because it is the record of what was agreed, and check the first payslip against it, line by line, with the payslip guide beside you.

Frequently asked questions

What is Annex 21 NHS pay?

Annex 21 is the part of the Agenda for Change Terms and Conditions that sets pay for trainees. A trainee is paid a percentage of the maximum of the band they will qualify into: 75% when up to 12 months remain before completion, 70% when more than one but less than two years remain, 65% when more than two but less than three years remain, and 60% when more than three years remain. The percentage applies to the top point of the band, not the entry point. A Band 5 trainee nurse on a two-year programme earns £27,330 in the first year and £29,282 in the second year in England in 2026/27, then moves to the Band 5 entry point of £32,073 on qualifying.

How much does an Annex 21 trainee earn?

It depends on the band you will qualify into and how long your training lasts, because both fix the percentage. The full table is on this page, but three examples cover most readers. A Band 5 trainee on a two-year programme earns £27,330 in year one and £29,282 in year two. A Band 6 trainee on a three-year programme earns £31,276, then £33,682, then £36,088. A Band 4 trainee on a one-year programme earns £23,368. All figures are full-time, England, 2026/27, and part-time trainees are paid pro rata. If your advert quotes a percentage rather than a salary, find your band in the table and read across to your year.

Do trainees get paid less than qualified staff?

Yes, and that is the point of the arrangement. A trainee is paid less than the qualified rate for the same band because they are still training, and the gap closes as completion approaches: 60% at the start of a four-year programme, rising to 75% in the final year. On completion the trainee enters either the first pay point of the band or the next point above their training salary. A Band 5 trainee finishing on £29,282 moves to the Band 5 entry point of £32,073, a rise of £2,791 a year. In practice the first point sits above the final training salary at every band, so qualifying always means a pay rise, and normal step progression then applies from there.

Does Annex 21 apply to apprenticeships?

No. Annex 21 covers trainees who do all their training as NHS employees. Apprenticeship routes, including the nursing degree apprenticeship, are levy-funded programmes with their own pay arrangements, and the Scientist Training Programme pays its trainees at Band 6. If your vacancy says Annex 21 applies, the percentages on this page are your pay. If it says apprenticeship, see our guide to nursing degree apprenticeship pay for the figures that apply instead, and if you are on the two-year nursing associate route, see trainee nursing associate pay.

What is the minimum a trainee can be paid?

A trainee must receive at least the National Minimum Wage or the National Living Wage, whichever applies to their age, and payroll adds a supplement where the Annex 21 percentage would fall below that floor. The floor is most likely to bite at the lowest combinations: a Band 2 trainee in the first year of a four-year programme earns £15,163, which is £7.75 an hour on a 37.5-hour week, so the supplement matters there. The statutory rates themselves are set by the government each April and are not quoted here, because they change every year and this page only carries figures verified in the NHS pay data file. If your payslip shows a supplement line, that is the floor top-up, and it is part of your pay, not a separate allowance.

Do trainees get unsocial hours and overtime pay?

Yes. Annex 21 sets basic pay only, and the normal Agenda for Change terms apply on top of it. Unsocial-hours enhancements are paid on the hours actually worked, at the rate for the band: a Band 5 trainee in the second year of training, on £29,282, has an hourly rate of £14.96, so a Saturday hour pays £21.09 and a Sunday hour pays £27.37. Overtime above 37.5 hours in a week is paid at time and a half for Bands 1 to 7, or double time on bank holidays, and Bands 8 and 9 receive time off in lieu only. Overtime and unsocial-hours enhancement cannot both be claimed for the same hours. The full rates are in our unsocial hours and overtime guide.

Does Annex 21 apply in Scotland and Wales?

The percentages are the same in Scotland and Wales, 75, 70, 65 and 60% by time to completion, but the band maxima are different, so the pounds are different and you must not apply the England figures to a devolved-nation post. A Band 5 trainee in Scotland, where the Band 5 top is £42,977, earns £32,233 in the final year, or £2,686.08 a month, and the 36-hour Scottish week makes the hourly rate £17.15. A Band 5 trainee in Wales, where the Band 5 top is £39,631, earns £29,723 in the final year, or £2,476.92 a month. In Northern Ireland the 3.3% award for 2026/27 is recommended but not yet implemented, so no Northern Ireland trainee figures are quoted here. The nation guides are NHS Scotland pay and NHS Wales pay.

What happens to my pay when I finish training?

You move onto the qualified scale for your band. The rule is that you enter either the first pay point of the band or the next point above your training salary, and in practice the first point is above the final training salary at every band. A Band 5 trainee finishing on £29,282 moves to £32,073, a rise of £2,791 a year or £232.58 a month. A Band 6 trainee finishing on £36,088 moves to £39,959, a rise of £3,871 a year. A Band 2 trainee finishing on £18,954 moves to the Band 2 spot rate of £25,272, a rise of £6,318 a year. From there you progress through the pay steps of your band in the normal way, and the pay step increments guide explains how those steps work.

Sources and independence

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

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

Source: Agenda for Change Terms and Conditions, Annex 21, Arrangements for pay and banding of trainees, as reproduced by NHS Scotland and NHS Wales.

NHS Bands Pay is an independent guide and is not affiliated with the NHS. Figures were verified against official sources on 6 November 2026 and can change, always confirm with the relevant official body before making financial decisions.