Band 5 Nurse Review: What It Means for Your Pay

Last updated: 7 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Band 5 is the largest single band in the NHS, and it is also the band with the longest-running complaint: nurses doing Band 6 work on Band 5 pay. For years the answer was that an individual nurse could ask for their post to be evaluated, and most never did, because the process was slow, local and easy to put off. The February 2026 announcement changed the direction of travel. Instead of waiting for individual requests, the government told every NHS trust in England to review every Band 5 nursing role it employs, and set a deadline of October 2028 to finish. This page explains what was actually announced, who is in scope, how the review works, what regrading would be worth in cash, and what has not been decided yet, including the back-pay question, where the honest answer is that no official date has been published.

What was announced

On 11 February 2026, the Secretary of State for Health and Social Care announced a package of four commitments to NHS nursing staff in England, set out in a written statement to Parliament. The package was presented as a fairer deal for nursing, and its headline promise was that nurses would be paid correctly for the work they are asked to do. The four commitments were: increasing graduate pay, reviewing the work and grade of every nurse currently working at Band 5, evaluating the outcomes of the reviews to understand whether any further action is required, and establishing a single national nursing preceptorship.

The announcement came the day before the 2026/27 pay award was confirmed. On 12 February 2026 the government accepted the Pay Review Body's recommendation in full, a 3.3% uplift effective 1 April 2026, paid on time in April salaries. The two announcements are separate, and the separation matters: the 3.3% went to every Agenda for Change nurse, while the Band 5 review is about whether individual posts are in the right band at all. A nurse whose post is regraded to Band 6 gets the 3.3% rise and then the regrading on top of it. The government also confirmed it would provide employers with additional funding to support the review process and any resulting salary uplifts, so the cost of regrading does not come out of the same pot as the annual award.

NHS England followed up with formal instructions on 2 June 2026, in a letter published as PRN02508 and signed by the Chief Nursing Officer for England, Duncan Burton. The letter told every organisation that it would be required to submit a nursing Band 5 job evaluation delivery plan to its region by 31 July 2026, and that the plans should be realistic and deliverable, setting out how all Agenda for Change Band 5 nursing roles would be reviewed by October 2028. The letter described reviewing the roles of a large proportion of the nursing workforce as a significant undertaking, requiring coordinated board-level leadership across chief nursing officers, chief people officers and chief finance officers. The Royal College of Nursing, which had pressed for structural reform for months before the announcement, published an explainer on 20 February 2026 and updated it in October 2026 with the latest information.

Who is included, and who is not

The review covers all Band 5 nursing roles employed directly by NHS trusts in England. Three conditions decide whether a post is in scope, and all three have to hold: the post is a nursing role, it sits at Band 5, and the employer is an NHS trust in England. That covers staff nurses, community staff nurses, practice development nurses and the rest of the Band 5 nursing family, wherever they work in a trust, from acute wards to community teams.

The boundary that catches people out is the employer test. Nurses employed by GP practices are largely excluded, because they are not employed directly by an NHS trust and most are outside Agenda for Change altogether. The same applies to nurses employed by private providers, charities and hospices, even when they work alongside NHS services. Bank and agency nurses are not covered as post holders either, because the review evaluates substantive trust posts, not individual workers. If you are unsure who employs you, your contract and your payslip will say: if your employer is an NHS trust and your contract is Agenda for Change, you are in scope.

The review is also specific to nursing. It does not cover Band 5 midwives, allied health professionals, scientists or support workers, even though many of them have the same complaint about doing higher-banded work. The second strand of the February package, raising graduate starting pay, does reach across all Agenda for Change professions, but the role review itself is nursing only. That distinction is worth keeping straight, because the two strands are often reported as one story.

The timeline

There are no nationally agreed progress milestones, which is one of the frustrations the RCN has flagged, but the fixed dates are clear enough to follow:

The 31 July 2026 deadline has passed, so every trust should now have a delivery plan in place, and trusts were told to begin reviewing roles in partnership with the staff affected and their union representatives, and to communicate the process and timescale to nurses in Band 5 roles. If you have heard nothing from your employer, that is itself worth following up, because the plan for your trust exists and should be available to staff. The reviews themselves will take time: this is the largest job evaluation exercise the NHS has attempted, and it runs alongside the ordinary work of the service.

How the review works

The review is employer-led, which means your trust does the evaluating, not a national body. Each Band 5 nursing post is checked against the NHS Job Evaluation Scheme, the same scheme that placed it in Band 5 in the first place. The scheme scores the post, not the person, against 16 national factors covering knowledge, responsibility, effort and working conditions, and the total points decide the band. Band 5 covers 326 to 395 points; Band 6 covers 396 to 465 points. A post crosses into Band 6 when its duties add up to at least 396 points, which is a small margin: a post scoring 390 points is Band 5, and a handful of extra responsibilities can tip it over the line.

The trigger for the whole programme was the updated national nursing and midwifery job profiles published by the NHS Staff Council in June 2025. National profiles are benchmark descriptions of common NHS jobs that have already been evaluated to a band, and local posts are matched against them using the job description, the person specification and information from the manager and the post holder. If a local post matches a profile closely enough, it takes that profile's band. The June 2025 profiles are the yardstick the review measures against, and they are the reason the government expects a meaningful number of posts to move: the profiles were updated to reflect what Band 5 nurses actually do now, and in many trusts the local job descriptions had not kept up.

The review is supposed to be done in partnership. The RCN's explainer says the review should be done by the employer in partnership with relevant trade unions, and should involve staff as part of the process, and NHS England's letter requires delivery plans to be realistic and deliverable, with key milestones. The legal anchor is Annex 31 of the Agenda for Change Terms and Conditions of Service Handbook, agreed as part of the non-pay deal, which recognises that staff have a contractual right to have their role evaluated, based on an accurate job description and consistent application of the agreed national job evaluation framework. The review is, in effect, the employer carrying out at national scale the evaluation that Annex 31 already entitles staff to ask for one post at a time. For the full mechanics of the scheme, see how NHS jobs are banded.

What regrading to Band 6 would be worth

The cash value of regrading depends on where you sit in Band 5, because the two bands overlap. Band 5 pays £32,073 to £39,043 a year full-time in England in 2026/27, and Band 6 pays £39,959 to £48,117. The overlap is real: the top of Band 5 at £39,043 is only £916 below the bottom of Band 6 at £39,959. A nurse at the top of Band 5 who is regraded to the bottom of Band 6 gains less than a thousand pounds a year. A nurse at the entry point of Band 5, on the other hand, gains £7,886 a year, because the whole of Band 5 sits below the Band 6 entry point.

The gross figures are only half the story, because a regrading also changes the pension tier. In 2026/27 the official pension contribution tiers run from 5.2% to 12.5%, and the employer adds 23.7%. A nurse at the entry point of Band 5 pays 8.3% of pensionable pay, £221.84 a month, while a nurse at the bottom of Band 6 pays 9.8%, £326.33 a month. The pension contribution rises by £104.49 a month on that move, which is money going into the pension, not money lost, but it does reduce the take-home gain. A nurse at the top of Band 5 already pays 9.8%, £318.85 a month, so moving to the bottom of Band 6 costs only £7.48 a month more in pension.

Worked through at the basic rate of income tax, 20%, and National Insurance at 8% above the £12,570 threshold, the take-home picture is as follows. A nurse at the top of Band 5 on £39,043 takes home about £2,380.80 a month after pension, tax and National Insurance; at the bottom of Band 6 on £39,959 that becomes about £2,429.77 a month, a gain of £48.97 a month, or £587.64 a year. A nurse at the entry point of Band 5 on £32,073 takes home about £2,040.21 a month; at the bottom of Band 6 that becomes about £2,429.77 a month, a gain of £389.56 a month, or £4,674.72 a year. These are illustrative figures for a full-time nurse with no student loan and no unsocial-hours pay, and the exact numbers depend on the individual payslip. The full band-by-band net figures are in the nurse take-home pay guide and the take-home pay by band tables.

Unsocial hours are worth checking too, because the enhancement is a percentage of the hourly rate, so a higher band lifts every enhanced hour. Bands 5 and 6 both attract time plus 30% on Saturdays and weekday nights, and time plus 60% on Sundays and public holidays. A Band 5 nurse earns £16.38 to £19.95 an hour in 2026/27, so Saturday and night hours pay £21.29 to £25.94, and Sunday and bank holiday hours pay £26.21 to £31.92. A Band 6 nurse earns £20.41 to £24.58 an hour, so the same hours pay £26.53 to £31.95 on Saturdays and nights, and £32.66 to £39.33 on Sundays and bank holidays. Overtime for Bands 1 to 7 is time and a half, and double time on bank holidays, so the hourly gain compounds across a rota. The detail is in the unsocial hours and overtime guide.

For context, the 2026/27 pay award itself added £1,024 a year at the entry point of Band 5, from £31,049 to £32,073, and £1,247 a year at the top, from £37,796 to £39,043, about £104 a month gross. Regrading is worth far more than the annual award for a nurse near the bottom of Band 5, and far less for a nurse already at the top, which is why the review matters most to newer nurses and to staff whose duties have grown fastest since they were last evaluated. The full current figures are in the Band 5 pay guide and the Band 6 pay guide.

What the review is not

Four misunderstandings keep circulating, and each one is worth clearing up plainly.

• It is not an automatic uplift. The RCN is explicit on this point: this is not automatic progression, and it is not just business as usual either. It is a mandatory review of all Band 5 nursing roles in England, and the outcome for any single post depends on the evaluation. Some posts will move to Band 6, some will stay at Band 5, and a post that stays put has still been reviewed, which is the point of the exercise.
• It is not a pay rise for everyone. The 3.3% award in 2026/27 went to every Agenda for Change nurse. The review is different: it changes the band of individual posts, and only the posts that score at Band 6 move. A nurse whose post stays at Band 5 keeps the 2026/27 rate for that band, and any future award, but gains nothing from the review itself.
• It is not back pay to April 2026. Some commentary states that regraded nurses will receive back pay to 1 April 2026. No official publication has set a back-pay date for roles regraded through this review, and this page does not repeat the claim as fact. The 1 April 2026 date that does appear in official sources belongs to a different process: a Parliamentary answer of 9 October 2026 said that changes from the NHS Staff Council's pay-structure negotiations would be backdated to 1 April 2026. That is about the structure of the pay scales, not about individual regrading through the Band 5 review. If and when an official back-pay position for regraded roles is published, this page will be updated.
• It is not the individual appeal process. A nurse who disagrees with the banding of their own post has always been able to ask for it to be evaluated under Annex 31, and to appeal the outcome through the local job evaluation process. That individual route still exists, and it is separate from this national programme, which reviews every post whether or not anyone asked. The national review does not replace the individual right, and the individual right does not wait for the national review.

The other three commitments

The Band 5 review was one strand of a four-part package, and the other three strands are worth knowing about because they shape the same workforce. The first is graduate pay: the Secretary of State asked the NHS Staff Council to prioritise raising graduate starting pay across all Agenda for Change professions, nurses, midwives, allied health professionals and scientists, as part of the structural reform talks. No reformed starting points have been published yet, and the graduate pay strand is a separate negotiation from the Band 5 review.

The third strand is evaluation of the review outcomes: the government committed to review the evidence gathered from the Band 5 reviews to determine whether any further action is required, which is the mechanism that could turn a set of local regradings into a national change. The fourth is a single national nursing preceptorship standard, led by the Chief Nursing Officer for England, to improve the consistency of support for newly qualified nurses. Newly qualified nurses can find the current position in the newly qualified nurse pay guide and the preceptorship pay guide. For the wider pay round the review sits inside, see the 2026/27 pay rise in full and the 2027/28 pay outlook.

Scotland, Wales and Northern Ireland

The review covers England only. Scotland negotiates Agenda for Change pay directly with the trade unions and does not use the Pay Review Body at all, and it has not announced an equivalent Band 5 review. Its two-year deal, 4.4% then 3.75%, runs to 31 March 2027, with a move to a 36-hour week from April 2026. Wales makes its own decision through the Pay Review Body route, and it matched the 3.3% award in 2026/27 with a Real Living Wage floor lifting Band 2 to £26,300, but it has announced no Band 5 review either. Northern Ireland is further behind: the 3.3% recommendation for 2026/27 had still not been implemented at the last check, and an RCN strike ballot was under way, closing on 20 November 2026. The current position in each nation is in the Scotland pay guide, the Wales pay guide, the Northern Ireland pay guide and the pay scales by country comparison. The Northern Ireland ballot is covered in the RCN Northern Ireland strike ballot 2026 page.

What to do now

Nothing needs to be applied for, and no form needs to be filled in. The review is employer-led, and your trust should be in touch with the process and timescale for your organisation. A few practical steps are worth taking while the reviews run:

• Read your job description. The evaluation turns on what the post actually involves, measured against an accurate job description. If yours is years out of date, or it leaves out responsibilities you carry every shift, raise it with your manager now, because an out-of-date description is the single most common reason a post scores lower than it should.
• Keep a record of your duties. Note the responsibilities that go beyond a standard Band 5 description: supervision of other staff, accountability for a caseload or a budget, specialist clinical decisions, out-of-hours leadership. The evaluation scores duties, not job titles, so a diary of what you actually do is more useful than a job title.
• Ask about your trust's delivery plan. Every trust had to submit one by 31 July 2026. Ask your line manager or your union representative what it says about your area, and when your post is scheduled to be reviewed. If you have heard nothing, that is a reasonable question to ask.
• Talk to your union representative. Reviews are done in partnership with the trade unions, and your representative will know how the process is running in your trust, and what to do if you disagree with an outcome. The RCN is monitoring the process at workplace, employer and national level as part of the official oversight group.
• Do not budget on a regrading. Until your post has been evaluated and the outcome is confirmed, your pay is the 2026/27 Band 5 rate. A regrading, if it comes, is worth between £916 and £7,886 a year gross depending on where you sit in the band, but it is not money in the bank until the review says so, and no back-pay date has been confirmed.
• Check your pension tier if you are regraded. Moving from the bottom of Band 5 to Band 6 moves you from the 8.3% pension tier to the 9.8% tier, which adds £104.49 a month to your pension contribution. That is pension saving, not a loss, but it changes the take-home figure, so check the payslip when the change lands. The tiers are in the NHS pension contributions guide.

Frequently asked questions

Will every Band 5 nurse be regraded to Band 6?

No. The review is mandatory for every Band 5 nursing role in England, but regrading is not automatic. Each post is evaluated against the NHS Job Evaluation Scheme, and it moves to Band 6 only if its actual duties score in the Band 6 range of 396 to 465 points, against 326 to 395 for Band 5. A post whose duties already match its Band 5 description stays at Band 5. The government has committed additional funding for any salary uplifts that do result, so a regrading is paid for, but nobody should assume their own post will change band until their employer's review says so.

When will I know if my role is being regraded?

Your employer should tell you. Every trust had to submit a delivery plan to its NHS England region by 31 July 2026, setting out how all its Band 5 nursing roles will be reviewed by October 2028. Trusts were told to begin reviewing roles in partnership with staff and union representatives, and to communicate the process and timescale to nurses in Band 5 roles. There are no nationally agreed progress milestones, so the timing depends on your own trust's plan. If you have heard nothing, ask your line manager or your union representative what your trust's delivery plan says.

Am I included if I work in a GP practice?

Largely, no. The review covers Band 5 nursing roles employed directly by NHS trusts in England, under Agenda for Change. Nurses employed by GP practices are usually outside Agenda for Change and outside this review. If you are unsure who employs you, your payslip and contract will say: if your employer is an NHS trust and you are on an Agenda for Change contract, you are in scope. Bank and agency nurses are not covered as post holders in the same way, because the review evaluates substantive trust posts.

How much more would Band 6 pay?

It depends where you sit in Band 5. A nurse at the top of Band 5 on £39,043 who moved to the bottom of Band 6 on £39,959 would gain £916 a year gross, about £76.33 a month, and about £48.97 a month after pension, tax and National Insurance. A nurse at the entry point of Band 5 on £32,073 who moved to the bottom of Band 6 would gain £7,886 a year gross, about £657.17 a month, and about £389.56 a month after deductions. A nurse at the top of Band 5 who moved to the top of Band 6 on £48,117 would gain £9,074 a year gross. Hourly, Band 5 pays £16.38 to £19.95 and Band 6 pays £20.41 to £24.58 in 2026/27.

Will I get back pay if I am regraded?

That has not been confirmed. No official publication has set a back-pay date for roles regraded through this review, so do not budget on one. Some commentary quotes back pay to 1 April 2026, but that date comes from a different process: the Parliamentary answer of 9 October 2026 said changes from the NHS Staff Council's pay-structure negotiations would be backdated to 1 April 2026, which is not the same as regrading through the Band 5 review. What is confirmed is that the government will provide additional funding for the review and for any salary increases that follow. This page will be updated the moment an official back-pay position is published.

Do I need to apply or do anything?

No application is needed. The review is employer-led: your trust evaluates your post, not you, and it should involve you and your union representatives in the process. The most useful thing you can do is keep an honest record of what your post actually involves day to day, because the evaluation turns on duties, not job titles. If your job description is out of date, or it leaves out responsibilities you carry every shift, raise that with your manager, because Annex 31 of the Agenda for Change Terms and Conditions gives you a contractual right to have your role evaluated on an accurate job description.

Does the review cover Scotland, Wales or Northern Ireland?

No. This is an England-only programme, announced by the Secretary of State for Health and Social Care for NHS trusts in England. Scotland negotiates Agenda for Change pay directly with the trade unions and does not use the Pay Review Body; Wales makes its own decision through the Pay Review Body route; Northern Ireland is still waiting for its 2026/27 award to be implemented. None of the devolved administrations has announced an equivalent Band 5 review. The four-nation comparison for current pay is in the NHS pay scales by country guide.

What is Annex 31, and why does it matter here?

Annex 31 of the NHS Terms and Conditions of Service Handbook, agreed as part of the Agenda for Change non-pay deal, recognises that staff have a contractual right to have their role evaluated, based on an accurate job description and consistent application of the agreed national job evaluation framework. It matters because the Band 5 review builds on that right: the review is the employer carrying out, at national scale, the evaluation Annex 31 already entitles staff to ask for individually. If your post is evaluated and you disagree with the outcome, the normal route is the local job evaluation appeal process, which is separate from this national review programme.

Sources and independence

Source: Department of Health and Social Care, written statement HCWS1329, 11 February 2026 (four nursing commitments, including the review of every Band 5 nursing role).

Source: NHS England, Nursing Band 5 job evaluation (PRN02508): delivery plans due 31 July 2026, all roles reviewed by October 2028.

Source: Royal College of Nursing, Band 5 NHS nursing roles review in England explained (published 20 February 2026, updated October 2026).

Source: Nursing Times, Deadlines set by NHS England for reviewing Band 5 nurse roles (3 June 2026).

Source: NHS Employers, Pay and Conditions Circular (AfC) 2026/27 (3.3% award, effective 1 April 2026; Band 5 and Band 6 scales).

NHS Bands Pay is an independent guide and is not affiliated with the NHS. Figures were verified against official sources on 7 November 2026 and can change, always confirm with the relevant official body before making financial decisions. No back-pay date for regraded roles has been published; this page will be updated when one is confirmed.