Cardiac Nurse Salary 2026/27

Last updated: 31 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Cardiac nurse pay 2026/27: the Band 5 to Band 6 scales

England awarded Agenda for Change staff 3.3% from 1 April 2026, and the award was paid on time in April salaries. The scales below are the 2026/27 England scales for a full-time 37.5-hour week. Hourly rates are annual pay divided by 52.2 weeks and then by 37.5 hours, rounded to the nearest penny, and enhancement and overtime rates on this page are calculated from that rounded hourly rate. Monthly pay is annual pay divided by 12. Weekly pay is annual pay divided by 52.2. For the wider picture at each band, including the roles that share these scales, see the Band 5 salary guide and the Band 6 salary guide.

The step structure tells the story of this ladder. Inside each band, the journey is worth £6,970 at Band 5 and £8,158 at Band 6. Between bands, the step is small: £916 from the top of Band 5 to the entry of Band 6. A nurse who moves from Band 5 top to Band 6 entry gains just over £76 a month in basic pay, which surprises people who expect a promotion to transform their salary. The real gain at Band 6 is the higher ceiling, £48,117 against £39,043, and the different work: charge duties, the sickest patients and a hand in running the ward. The full journey from Band 5 entry to Band 6 top is worth £16,044 a year in basic pay.

One point that trips up newcomers: the band follows the post, not the person and not the job title. A trust can advertise a Band 5 staff nurse post and a Band 6 senior nurse post on the same cardiology ward, with overlapping clinical duties, and pay them from different scales. The job evaluation behind each post decides the band, based on the knowledge, responsibility and effort the post demands. That is why this page quotes bands and steps rather than a single salary figure. Anyone comparing offers should ask for the band and the step, not just the headline annual figure, because the step alone can be worth £2,519 at Band 5, from £32,073 at entry to £34,592 at the intermediate step.

What a cardiac nurse actually does

The cardiac nurse looks after people whose hearts are unwell, and the work changes with the ward. On a general cardiology ward, the nurse cares for patients admitted with chest pain, heart failure flare-ups, rhythm problems and infections of the heart, giving medicines, watching monitors, and spotting the early signs that a patient is getting worse. On a coronary care unit, the nurse cares for patients in the first hours and days after a heart attack, when monitoring is constant and treatment changes fast. In a catheter laboratory, the nurse assists during angiograms, stent procedures and device implants, preparing the patient, handing equipment to the operator, watching the monitors through the case, and recovering the patient afterwards. The same nurse may rotate through all three areas in one trust, or may stay in one area and build deep skill there.

Monitoring is the thread that runs through every setting. Cardiac nurses read heart rhythms on screen, and they learn to tell a harmless rhythm change from one that needs urgent treatment. They give medicines that change heart rate, blood pressure and fluid balance, and they watch for the effects, good and bad, in the hours after each dose. They talk with patients who are frightened, often after the worst scare of their lives, and with families who want to know what happened and what comes next. They also work closely with doctors, cardiac physiologists and pharmacists, and the best cardiac wards feel like a team sport: the nurse notices a rhythm change, the physiologist confirms the trace, the doctor changes the plan, and the pharmacist checks the new prescription, all within minutes.

Rehabilitation and follow-up are the quieter half of the job, and they matter as much as the emergency work. After a heart attack or a cardiac procedure, patients need help rebuilding confidence: walking further each day, understanding their medicines, giving up smoking, and learning what symptoms should bring them back to hospital. Cardiac rehabilitation nurses run exercise and education sessions, check progress over weeks, and catch problems before they become readmissions. Community cardiac nurses visit patients at home, especially people with heart failure whose condition needs regular review and careful adjustment of medicines. A nurse applying for a cardiac post should ask how the week splits between ward, coronary care, cath lab and rehabilitation work, because two posts with the same band and the same title can feel like different jobs.

The emotional weight of the job deserves a plain statement. Cardiac nurses meet people on the worst day of their lives, and sometimes the outcome is a death despite fast treatment and skilled care. They also meet people who walk out of hospital after a successful stent procedure and go on to live full lives, and the rehabilitation work lets them see that recovery unfold over weeks. Nurses who last in the role tend to be people who stay calm when a monitor alarms, who can explain a frightening diagnosis in plain words, and who can write a note that the next clinician can act on at 3am. The closest neighbouring roles are the intensive care nurse, who cares for critically ill patients on a unit, the heart failure nurse, who specialises in one cardiac condition, and the cardiac physiologist, who is a scientist rather than a nurse, and whose pay ladder is covered separately.

Band 5 versus Band 6: what actually changes

At Band 5, a cardiac nurse carries a bay or a set of patients: observations, medicines, monitoring, documentation and escalation when a patient deteriorates. At Band 6, the nurse carries senior duties on top of the clinical caseload: coordinating the ward on a shift, taking charge when the ward manager is away, teaching Band 5 nurses and students, and looking after the sickest patients, including those fresh from the cath lab or coronary care. The clinical skills overlap a great deal, which is why the pay step between the bands is only £916, from £39,043 at the top of Band 5 to £39,959 at the entry of Band 6. What changes is accountability: when the ward is short-staffed, when a patient deteriorates on two bays at once, or when a junior nurse needs backing for a difficult escalation, the Band 6 nurse is the person expected to hold it together.

That difference matters for anyone planning a move. A Band 5 nurse who loves bedside work and dislikes coordinating a ward may be happier staying at the top of Band 5, where the pay is £39,043 and the week is mostly clinical. A nurse who wants to run a shift, to teach, and to carry the argument for better staffing or safer monitoring on the ward, needs the Band 6 post, even though the first year of it pays only £916 more than the top of Band 5. The payoff comes later in the band: Band 6 tops out at £48,117, which is £9,074 above the top of Band 5, and the Band 6 nurse builds pension on that higher figure. For the full scales at each band, see the Band 5 salary guide and the Band 6 salary guide, and for the wider specialist ladder, the clinical nurse specialist salary guide.

Experience also shapes where a nurse lands within a band. A nurse moving from a general medical ward into a first cardiac post usually starts at Band 5 entry, £32,073, and moves through the steps as experience grows. A nurse with coronary care experience, a cardiac course, or advanced life support training may be appointed higher in the band or straight into a Band 6 post. Cath-lab competence is worth asking about in any job description: a nurse who can scrub for angiography and stent cases, or who can run the monitors through a device implant, is more valuable to the service and more likely to land a Band 6 post. It does not automatically change the band, since the band follows the evaluated post, but it strengthens a Band 6 application and it changes the daily work for the better.

Unsocial hours: the seven-day rota is where the money is

Cardiology wards and coronary care units run seven days a week, and the rota is the single biggest influence on take-home pay after the band itself. A nurse on a rota with regular weekends and nights earns unsocial-hours enhancements on a large share of hours, while a nurse in a daytime-only rehabilitation clinic earns almost none. Agenda for Change Section 2 pays Bands 4 to 9 time plus 30% for Saturday and weekday night hours (8pm to 6am) and time plus 60% for Sunday and public-holiday hours. The table below applies those percentages to the rounded hourly rates from the scales above. For the full unsocial-hours rules, including overtime and time off in lieu, see the unsocial hours and overtime guide.

Worked example: a Band 5 cardiac nurse at entry works a Saturday shift of 7.5 hours. Plain time for the shift would be £122.85 (7.5 hours at £16.38). At time plus 30%, the same shift pays £159.68 (7.5 hours at £21.29). The enhancement alone is worth £36.83 for that one shift. A nurse on a full seven-day rota will see a payslip well above the basic monthly figure, and a nurse whose post is mainly weekday daytime work will see a payslip close to it. That is why two nurses on the same band and step can take home different amounts, and why asking about the rota matters as much as asking about the band.

Overtime: time and a half, double on bank holidays

Overtime in Agenda for Change is paid at time and a half for hours above the standard week, and at double time for hours worked on a public holiday, subject to the usual conditions on the service. For a cardiac nurse, overtime usually means staying past the end of a shift because a patient has deteriorated, covering a colleague's sickness absence, or working an extra shift when the ward is full. The hourly overtime rates below are calculated from the rounded plain-time rates.

Worked example: a Band 6 cardiac nurse at the top works 4 extra hours in a week at time and a half. That is 4 hours at £36.87, or £147.48, against £98.32 at plain time, an extra £49.16 for the week. Overtime is not a reliable part of the salary, and services vary in how much they offer. A nurse budgeting on overtime every week is budgeting on something the service may withdraw, so the figures above are best read as the value of an occasional extra shift, not as a second salary.

Cath-lab on-call: the figure this page does not quote

On-call is the one part of cardiac nurse pay that cannot be quoted nationally, and this page does not pretend otherwise. Centres that run primary PCI, the emergency stent treatment for heart attacks, need a cath-lab team available around the clock, and their nurses take turns being on call overnight and at weekends. Some trusts pay an on-call availability payment for being contactable out of hours, plus a payment for each call-out. Others fold on-call into a rota allowance, and smaller centres may run a daytime-only list, with out-of-hours heart attacks transferred to a regional centre instead. The frequency matters as much as the rate: a centre that calls its team out several times a weekend pays very differently from a centre that calls once a month, even on the same availability payment. The only figure that counts for a specific post is the one in that trust's local terms. Ask for it in writing before accepting a post, along with the rota pattern, the expected call-out frequency, and how travel time for call-outs is treated. The theatre nurse salary guide covers the closest parallel role, where on-call for emergency lists works in a similar way.

London weighting: what HCAS adds

High Cost Area Supplement is paid on top of basic pay for staff working in London and the fringe zone. In 2026/27, inner London pays 20% of basic pay (minimum £5,794, maximum £8,746), outer London pays 15% (minimum £4,870, maximum £6,137) and the fringe zone pays 5% (minimum £1,346, maximum £2,270). The cap binds at the top of this ladder: a Band 6 nurse at the top in inner London receives the £8,746 maximum, not 20% of £48,117, for a total of £56,863, and the same nurse in outer London receives the £6,137 maximum, for a total of £54,254. For the full HCAS rules, see the London weighting guide.

The outer London minimum rarely binds at these bands, and the caps do the work instead. A Band 5 nurse at entry in outer London receives £4,870, which is the minimum, not 15% of the basic, for a total of £36,943. The same nurse in the fringe zone receives £1,603.65, which is 5% of the basic, above the £1,346 minimum, for a total of £33,676.65. At the top of the ladder the fringe cap binds: a Band 6 nurse at the top receives £2,270 in the fringe zone, not 5% of £48,117, for a total of £50,387. These small rules are the ones that catch people out when they estimate London pay from a percentage alone, so the table above gives totals, not just percentages.

Pension: what comes off the payslip

NHS pension contributions are the largest regular deduction after tax for most cardiac nurses, and they are also the most valuable part of the package. Under the provisional 2026/27 England and Wales tiers, Band 5 nurses pay 8.3% at entry and the intermediate step, £221.84 and £239.26 a month, and 9.8% at the top, £318.85 a month. Band 6 nurses pay 9.8% at every step, from £326.33 a month at entry to £392.96 a month at the top, with £344.39 a month at the intermediate step. The employer contributes 23.7% on top of pensionable pay, which is £11,403.73 a year at the top of Band 6. The tiers are provisional, calculated from the published 2025/26 tiers, and have not yet been formally published, so a nurse should check the final tiers when they are confirmed. For the full tier table, see the pension contributions guide.

Pensionable pay is basic pay plus any pensionable allowances, and for most cardiac nurses that means basic pay alone, since unsocial-hours enhancements and overtime are not pensionable. That distinction matters when comparing a cardiac payslip with a ward payslip: a nurse who earns a lot of unsocial-hours money takes home more in the month, but builds pension on the basic only. The pension itself is a career average scheme, so each year's pensionable pay adds a slice to the retirement pension, and the slices from higher-band years are worth more than the slices from lower-band years. A nurse who spends the last years of a career at Band 6 retires on a pension built from those years at their full value, which is one reason the Band 6 ceiling matters beyond the monthly pay.

Part-time work, annual leave, mileage and uniform relief

Part-time pay in Agenda for Change is pro rata to the whole-time equivalent fraction. A Band 5 cardiac nurse at entry on a 0.8 whole-time equivalent contract earns £25,658.40 a year, and a Band 6 cardiac nurse at the top on a 0.6 contract earns £28,870.20 a year. Unsocial-hours percentages and HCAS apply to the pro rata basic in the same way as to a full-time basic, and pension contributions are calculated on the actual pensionable pay, not the whole-time equivalent figure. Cardiac services often offer part-time posts, because rehabilitation clinics and follow-up sessions can be split, but the on-call commitment of a part-time cath-lab post should be checked, since some services expect part-time nurses to take a full share of the rota.

Annual leave follows the Agenda for Change tiers: 27 days on joining, 29 days after five years of service and 33 days after ten years, plus eight bank holidays, with part-time leave calculated pro rata in hours. A nurse who works weekends will take some of those bank holidays as working days and receive the unsocial-hours enhancement instead, which is the standard trade in seven-day services.

Mileage is occasional money for ward-based cardiac nurses who travel between hospital sites, and regular money for community cardiac nurses whose patch covers clinics and home visits. Under Agenda for Change Section 17, a car user is paid 59p a mile for the first 4,500 miles in a year and 36p a mile after that. A nurse driving 5,000 miles in a year receives £2,835, and a nurse driving 4,000 miles receives £2,360. Mileage is an expense reimbursement, not pay, and it is kept separate from salary in every example on this page. For the full rates and more worked examples, see the mileage rates guide. Nurses who wear a uniform can also claim flat-rate tax relief for laundry: £125 a year for nurses, worth £25 a year at the 20% tax rate and £50 a year at the 40% rate. It is a small sum, but it is claimed through the tax code and costs nothing to ask for.

Cardiac nurse versus cardiac physiologist: two different professions

The cardiac nurse and the cardiac physiologist work side by side in cardiology, and newcomers often mix them up. The nurse is a registered nurse who cares for patients: observations, medicines, monitoring, procedures support and rehabilitation. The physiologist is a healthcare scientist who runs the diagnostic and device work: ECG recording, echocardiography, exercise testing, pacemaker and defibrillator follow-up, and the technical side of cath-lab cases. Both wear scrubs in the cath lab and both read heart rhythms, but they train differently, register differently, and sit on different pay ladders. A nurse who loves the technical side, the traces and the devices, may find the physiologist route appealing, but it means retraining as a scientist, not a sideways move within nursing. The cardiac physiologist salary guide covers that ladder in full, and its Band 5 to Band 7 shape will look familiar, since both ladders use the same Agenda for Change scales.

Pay differs between the two mainly through working pattern, not through basic pay. Both earn the same basic for the same band and step, and both earn the same HCAS for the same zone. The nurse on a seven-day ward rota may earn more unsocial-hours money than a physiologist on a mainly weekday diagnostic rota, while a physiologist on a device on-call rota may earn on-call money the ward nurse never sees. A nurse choosing between staying in nursing and retraining as a physiologist should weigh the work honestly: nursing offers direct patient care and rehabilitation relationships, physiology offers diagnostic depth and device expertise. The cardiac physiologist salary guide gives the numbers for that comparison, and the heart failure nurse salary guide covers the closest nursing specialism.

Private-sector comparison, kept qualitative as it should be: private hospitals and clinics do employ nurses with cardiac skills, and their pay is set by the employer rather than by a national scale, so it varies by provider, region and role. Some private posts pay above the NHS basic for the same experience, and some pay below it once pension, leave and sick pay are counted. The NHS package at Band 5 and Band 6 includes the career average pension with a 23.7% employer contribution, Agenda for Change leave tiers, and nationally set unsocial-hours rates, which are hard to match post for post in a private contract. A nurse comparing an NHS cardiac post with a private offer should compare the whole package, including pension and leave, not just the headline annual figure.

Scotland, Wales and Northern Ireland

Scotland has a 3.75% award from 1 April 2026 and a 36-hour week, which changes the hourly maths even where the annual figure looks close to England. The shorter week is worth real money in hourly terms, and it also changes the overtime threshold, since overtime in Scotland starts above 36 hours rather than 37.5. Scotland Band 5 pays £34,494 to £42,977, which is £18.36 to £22.87 an hour on the 36-hour week. Wales has a 3.3% award implemented 1 April 2026, and Wales Band 5 pays £32,557 at entry, £35,114 at the intermediate step and £39,631 at the top, which is £16.63, £17.94 and £20.25 an hour. Northern Ireland has a 3.3% recommendation for 2026/27 that has not been implemented, so no 2026/27 Northern Ireland figure is quoted here. No Scotland or Wales Band 6 salary figures are quoted on this page, because the data file does not hold them, and this page does not fill the gap by guessing.

The honest picture: what cardiac nurse pay does and does not do

Cardiac nurse pay is solid, transparent and nationally set, which is its strength. A nurse can look up the band scale, add the unsocial-hours percentage for the rota, add HCAS for London, and know the gross figure within a few pounds. There are no hidden bonuses and no negotiation over the basic: the scale is the scale. The ceiling is the weakness. Band 5 tops out at £39,043, and a nurse who wants more must move to Band 6, which means a ward to coordinate, not simply more years in the same job. Cath-lab on-call pay, which can be a meaningful part of a cardiac income in centres that run primary PCI around the clock, is set locally and varies, so the national scales alone do not tell the whole story for this specialty. The job itself is the reason to take it: the chance to catch a rhythm change early, to help a patient through a heart attack and back to a full life, and to teach people to look after their hearts. The pay is fair for the band. The rota, the call-out frequency, and the split between ward, coronary care, cath lab and rehabilitation work are what should decide the choice between two cardiac posts at the same band.

Frequently asked questions

What band is a cardiac nurse?

Most cardiac nurses on cardiology wards sit at Band 5, and senior cardiac nurses, charge nurses and cath-lab leads sit at Band 6. In England in 2026/27, Band 5 pays £32,073 at entry, £34,592 at the intermediate step and £39,043 at the top, and Band 6 pays £39,959 at entry, £42,170 at the intermediate step and £48,117 at the top. The band follows the post, not the job title, so one trust can employ a Band 5 staff nurse and a Band 6 senior nurse on the same ward, with the senior nurse carrying charge duties, teaching and the sickest patients.

How much does a cardiac nurse earn a month?

In England in 2026/27, a Band 5 cardiac nurse earns £2,672.75 a month at entry, £2,882.67 at the intermediate step and £3,253.58 at the top, before tax, National Insurance and pension deductions. A Band 6 cardiac nurse earns £3,329.92 a month at entry, £3,514.17 at the intermediate step and £4,009.75 at the top. Those are gross figures for a full-time 37.5-hour week, before any unsocial-hours enhancement, on-call payment or London weighting.

Do cardiac nurses get unsocial-hours pay?

Yes, when the hours are worked. Agenda for Change Section 2 pays Bands 4 to 9 time plus 30% for Saturday and weekday night hours (8pm to 6am) and time plus 60% for Sunday and public-holiday hours. A Band 5 cardiac nurse at entry earns £21.29 an hour on a Saturday or at night and £26.21 on a Sunday or bank holiday, against £16.38 plain time. At the top of Band 6, £24.58 an hour becomes £31.95 and £39.33. Cardiology wards and coronary care units run seven days a week, so most cardiac nurses earn these enhancements for a real share of their hours.

Do cardiac nurses get on-call pay for cath labs?

Cath-lab nurses on a primary PCI rota usually do, but there is no national on-call rate to quote. Some trusts pay an availability payment for being contactable out of hours plus a payment for each call-out, and others fold on-call into a rota allowance. The frequency matters as much as the rate: a centre that runs primary PCI around the clock calls its nurses out far more often than a centre that runs a daytime-only list with occasional cover. Ask for the local terms in writing before accepting a post, along with the rota pattern, the expected call-out frequency, and how travel time for call-outs is treated.

Do cardiac nurses get London weighting?

Yes, in London. High Cost Area Supplement in 2026/27 is 20% of basic pay in inner London (minimum £5,794, maximum £8,746), 15% in outer London (minimum £4,870, maximum £6,137) and 5% in the fringe zone (minimum £1,346, maximum £2,270). A Band 5 cardiac nurse at entry in inner London earns £38,487.60 in total, and a Band 6 cardiac nurse at the top in inner London earns £56,863, because the 20% supplement is capped at £8,746. A Band 6 nurse at the top in outer London earns £54,254 in total.

What pension contribution does a cardiac nurse pay?

Under the provisional 2026/27 England and Wales tiers, Band 5 cardiac nurses pay 8.3% of pensionable pay at entry and the intermediate step, £221.84 and £239.26 a month, and 9.8% at the top, £318.85 a month. Band 6 cardiac nurses pay 9.8% at every step, from £326.33 a month at entry to £392.96 a month at the top. The employer contributes 23.7% on top, which is £11,403.73 a year at the top of Band 6. The 2026/27 member tiers are provisional, calculated from the published 2025/26 tiers, and have not yet been formally published.

Can a cardiac nurse work part-time?

Yes. Part-time pay in Agenda for Change is pro rata to the whole-time equivalent fraction. A Band 5 cardiac nurse at entry on a 0.8 whole-time equivalent contract earns £25,658.40 a year, and a Band 6 cardiac nurse at the top on a 0.6 contract earns £28,870.20 a year. Unsocial-hours percentages and High Cost Area Supplement apply to the pro rata basic in the same way as to a full-time basic, and pension contributions are calculated on the actual pensionable pay, not the whole-time equivalent figure. The on-call share of a part-time cath-lab post should be checked before accepting it, since some services expect part-time nurses to take a full share of the rota.

How does cardiac nurse pay differ in Scotland, Wales and Northern Ireland?

Scotland has a 3.75% award from 1 April 2026 and a 36-hour week, which changes the hourly maths and the overtime threshold, since overtime in Scotland starts above 36 hours rather than 37.5. Scotland Band 5 pays £34,494 to £42,977, which is £18.36 to £22.87 an hour on the 36-hour week. Wales has a 3.3% award implemented 1 April 2026, and Wales Band 5 pays £32,557 at entry, £35,114 at the intermediate step and £39,631 at the top, which is £16.63, £17.94 and £20.25 an hour. Northern Ireland has a 3.3% recommendation for 2026/27 that has not been implemented, so no 2026/27 Northern Ireland figure is quoted here.