NHS Career Break Scheme

Last updated: 23 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

The NHS career break scheme explained: 3 months to 5 years of unpaid leave, what happens to your pay and pension while you are away, the true cost of keeping pension membership going, and your right to return.

Burnout, young children, an ageing parent, a degree you never finished, a year of travel before it is too late: there are good reasons to step away from NHS work for a while without resigning. The career break scheme exists for exactly this. It is a formal Agenda for Change arrangement, not an informal favour, which means there are defined rules about length, pay, pension and return rights. This page explains the scheme as it affects your money: what you earn (nothing), what happens to your pension, what it costs to keep pension membership alive, and how the return works. Where trust policies differ, we say so and tell you what to get in writing. Our flexible working guide covers the alternatives if you need lasting change rather than time out.

What the career break scheme is

A career break is an agreed period of extended unpaid leave during which your employment continues but is effectively paused. The scheme covers breaks of 3 months to 5 years. Shorter periods of unpaid leave are a separate, locally agreed arrangement with your manager and do not use the career break framework.

The scheme is designed for substantial life events: raising children beyond maternity or parental leave, caring for relatives, full-time study, travelling, or simply an extended rest after years of shift work. The defining feature, and the reason it beats resigning, is the planned return: you leave with an agreement about coming back, rather than reapplying from scratch later. That agreement is the document that matters most in the whole process.

Career breaks sit within the Agenda for Change national terms, but trusts write their own local policies on top: application forms, notice periods, qualifying service expectations and the exact return arrangements. Always read your own trust's career break policy alongside this national overview.

Applying: eligibility and approval

There is no absolute national qualifying period written into the scheme, but in practice:

• It needs employer agreement. A career break is not a statutory right like maternity leave. Your trust can refuse on operational grounds, and in hard-to-cover specialties they sometimes do.
• Apply in writing, well in advance. Most trust policies ask for applications several months before the intended start, with a written business case covering cover arrangements for your post.
• Continuous service usually matters. Many trusts expect a period of continuous NHS service before granting a break, and some limit how soon you can take a second break after returning from the first. Check your local policy.
• A good application addresses cover. Managers approve breaks they can plan around. Proposing timing that avoids winter pressures and suggesting how your post could be covered materially improves your chances.

If your trust refuses, ask for the reasons in writing. Sometimes a shorter break, different dates or a part-time arrangement instead will be approved where a five-year absence would not.

Pay during a career break: what you earn and what pauses

A career break is unpaid. For the duration of the break you receive no basic salary, no unsocial-hours enhancements, no overtime and no High Cost Area Supplement. That is the core financial fact to plan around: a year out at Band 5 top (£39,043) means £39,043 of salary not earned, and the household budget needs to absorb it.

• Your pay point is held. You return at the salary you left on. You do not progress up the pay scale while away: a Band 6 nurse who leaves at the intermediate point (£42,170) returns at £42,170, not at the top of the band. Our pay step guide explains how progression normally works.
• Annual pay awards still move the scale. While the pay points themselves rise with national awards, your position on the scale is what is held. If the whole scale rises 3% while you are away, you return to your old point on the new scale.
• Continuous service is generally preserved. The break does not normally reset your continuous NHS service for the purposes of entitlements linked to it, but confirm this in your agreement, since some benefits treat long breaks differently.
• Other employment is usually allowed but check. Many agreements permit work elsewhere during the break; some restrict it. Read the terms before signing anything with another employer.

Pension during a career break

This is the section that costs people the most money when misunderstood. During an unpaid career break, you have two options for your NHS Pension Scheme membership:

• Let it pause. Your pensionable membership stops for the break. Everything you have built up is preserved and revalued, and you rejoin the scheme when you return. This costs nothing now but leaves a gap in your pension record. Our leaving the NHS guide explains preserved benefits.
• Keep it going by paying both contributions. You can maintain continuous pensionable membership through the break by paying the full contributions yourself: your normal employee contribution plus the employer's 23.7% that the trust would have paid. This keeps your pension record unbroken, which matters for final-salary link purposes for older benefits and for the sheer value of extra pensionable years.

The cost of keeping membership going is substantial, because you are paying both sides. Worked examples using the provisional 2026/27 contribution tiers:

• Band 5 nurse at entry (£32,073): employee 8.3% = £2,662.06 a year (£221.84 a month); employer 23.7% = £7,601.30 a year (£633.44 a month). Combined: about £855.28 a month to keep full membership.
• Band 6 nurse at the top of the band (£48,117): employee 9.8% = £4,715.47 a year (£392.96 a month); employer 23.7% = £11,403.73 a year (£950.31 a month). Combined: about £1,343.27 a month.

A year's unbroken membership at Band 5 entry therefore costs around £10,263.36 out of pocket. Whether that is worth it depends on your age, how close you are to retirement and what the gap does to your plans: this is a decision for an independent financial adviser, not a guess. Whatever you choose, arrange it before the break starts with your trust pensions officer; sorting pension contributions retrospectively is difficult. Our pension contributions guide has the full tier tables.

Annual leave and other benefits

• Annual leave: your statutory minimum leave usually continues to accrue during unpaid leave, but the contractual top-up above it (AfC gives 27 days plus 8 bank holidays at under 5 years' service, rising to 29 and then 33 days) depends on your trust's policy. Get the position in writing.
• Sick pay: occupational sick pay does not accrue or pay out during a break, since there is no salary to replace. Our sick pay guide covers the normal scheme.
• Death in service: check whether cover continues during the break. This is exactly the kind of detail that varies and should be confirmed before you go.
• Salary-sacrifice schemes: car lease, cycle schemes and similar arrangements usually pause or end, since there is no salary to sacrifice from.

Returning from a career break

The return is the point of the scheme, so plan it as carefully as the departure:

• Return rights. The intention is that you return to the same post or, if that is not possible, a similar post at the same band and pay. Get this written into the agreement, including what happens if the post has been restructured or deleted while you were away.
• Confirm in advance. Agreements usually require you to confirm your return date some months ahead. Miss the deadline and the trust may treat the post as vacant.
• Plan your re-entry. After years away, mandatory training, IT systems, clinical guidelines and even the layout of the hospital will have changed. Ask about a supported return: supernumerary shifts, refresher training and a named mentor for the first weeks. Good trusts offer this; if yours does not volunteer it, ask.
• Revalidation. NMC-registered staff must maintain revalidation through the break or plan how to restore it. Factor this into the true cost of a long absence.

Career break vs the alternatives

A break is not always the right tool. Consider:

• Flexible working: staying employed on a changed pattern (part-time, compressed hours, term-time only, nights-only) keeps pay, pension and progression ticking over. If the problem is the rota rather than the job, flexible working usually beats a break.
• Part-time hours: dropping to 0.6 or 0.8 WTE can deliver much of the breathing space of a break while keeping most of the income and full pension membership. See our part-time pay guide.
• Unpaid parental leave: for childcare specifically, 18 weeks of unpaid parental leave per child is a statutory right and may cover the need without a formal career break. See our parental leave guide.
• Secondment or a different role: sometimes the issue is the post, not work itself. A change of setting can reset burnout without any break at all.

The right choice is the smallest change that solves the problem. A career break is the biggest lever: powerful, but expensive in lost earnings and pensionable time.

Frequently asked questions

How long can an NHS career break be?

The Agenda for Change career break scheme covers breaks of 3 months to 5 years. Shorter periods of unpaid leave are a separate arrangement agreed locally with your manager. The scheme is designed for substantial breaks: extended childcare, caring responsibilities, study, travel or a trial of a different life, with a planned return to the NHS at the end.

Is an NHS career break paid?

No. A career break is unpaid leave: you receive no salary, no unsocial-hours enhancements and no overtime for the duration of the break. Your pay point is generally held as it was when you left, so you return at the same salary, but you do not progress up the pay scale while you are away.

What happens to my NHS pension on a career break?

You have a choice. You can let your pensionable membership pause, in which case your built-up benefits are preserved and you rejoin on return, or you can keep your membership going through the break by paying both the employee and the employer contributions yourself. For a Band 5 nurse at entry (£32,073), that means about £855.28 a month: £221.84 employee (8.3%) plus £633.44 employer (23.7%). Confirm the exact arrangement with your trust pensions officer before the break starts.

Do I keep accruing annual leave during a career break?

Your statutory minimum annual leave usually continues to accrue during unpaid leave, but the contractual top-up above the statutory minimum depends on your trust's career break policy. Check the policy and get the position in writing before you go: this is one of the details that varies between employers. Our annual leave guide covers the standard 27/29/33-day tiers.

Can my trust refuse a career break request?

Yes. A career break is not an automatic right: it needs your employer's agreement, and trusts can refuse on operational grounds. Applications are made in writing, usually well in advance, and many trusts expect a period of continuous NHS service first. A well-planned application that addresses cover for your post stands the best chance.

Will I get my old job back after a career break?

The scheme is built around returning: the intention is that you come back to the same post or, if that is not possible, a similar post at the same band and pay. Get the return terms written into your career break agreement, including how far in advance you must confirm your return date and what happens if the post has been restructured. Ask about refresher support, since clinical skills and mandatory training need updating after a long absence.

Can I work elsewhere during an NHS career break?

Often yes, but check your agreement first. Many trusts allow other employment during a break, while some restrict work for competing healthcare employers or require you to declare it. Conflicts of interest and working-time considerations still apply, so do not assume: read the terms you signed.

What is the difference between a career break and flexible working?

A career break is an extended period of unpaid absence, from 3 months to 5 years, with employment effectively paused. Flexible working means staying employed on a changed pattern: part-time hours, compressed hours, term-time working or adjusted shifts, with pay continuing pro rata. If you need lasting change rather than time out, flexible working or part-time hours usually serve better.