Community Paramedic Pay 2026/27: NHS Salary Guide

Last updated: 5 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Community paramedic pay 2026/27: the Band 6 to Band 7 ladder

England awarded Agenda for Change staff 3.3% from 1 April 2026, and that award is already in these figures. A community paramedic in England in 2026/27 earns £39,959 at Band 6 entry, £42,170 at the intermediate step and £48,117 at the top of Band 6. At Band 7 the figures are £49,387 at entry, £51,932 at the intermediate step and £56,515 at the top. Both bands have three pay points, entry, intermediate and top. The range inside Band 6 is £8,158, the range inside Band 7 is £7,128, and the full range on this page, from Band 6 entry to the top of Band 7, is £16,556. The step from the top of Band 6 to the entry of Band 7 is £1,270, and the step from the top of Band 5, where newly qualified paramedics start, to Band 6 entry is £916. Those two small steps are worth noting for anyone weighing a move: the first year in the higher band pays little more than the last year in the lower band, and the real gain comes from reaching the top of the new band and from the extra responsibility that comes with it.

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 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.

Progression within each band follows the usual Agenda for Change pattern: satisfactory appraisal and completion of required training move a paramedic from entry toward the top step, but the timing follows the employer incremental progression policy and is not a promise written into the pay scale. The move from one band to the next is different in kind. It needs a post that carries the extra responsibility, and the post has to be vacant and applied for. That distinction explains why two paramedics with similar experience can sit on different bands: one covers home visits and urgent appointments to a set protocol, the other leads a community service, supervises other paramedics, holds the most complex frailty cases and carries responsibility for a whole locality, and Agenda for Change pays the post, not the person. For the wider band ladder, the Band 6 pay guide and the Band 7 pay guide set out what each band means across the NHS, and the community posts on this page follow that same ladder. The ambulance service side of the profession is covered in the paramedic salary guide, and the hourly view of that role is in the paramedic hourly pay guide.

What a community paramedic actually does, day by day

Community paramedic work starts with a visit list, not a siren. The day might open with a home visit to an older patient who has become unwell overnight, move to a care home where several residents need review, and finish with urgent same-day appointments at a GP practice for patients who need seeing today but do not need an ambulance or a hospital bed. Between visits comes the part of the job that takes as much skill as the clinical assessment: phoning the GP with a clear summary, arranging a prescription or a referral, booking a follow-up visit, and writing notes that the next clinician can act on without having to start again. A community paramedic assesses, treats where the presentation allows it, refers on where it does not, and keeps the patient at home where home is the safe place to be. That last judgement, safe at home or needs hospital, is the one the whole role turns on, and it is why these posts sit at Band 6 and Band 7 rather than at the entry band.

The caseload is different from ambulance work in ways that matter for pay and for stamina. Ambulance shifts are measured in calls, with the next call always waiting. Community work is measured in visits, with travel between them, and the gaps between visits are working time too: notes, referrals, phone calls to practices and pharmacies, and the planning that stops the next visit going wrong. Frailty dominates the list. Many patients are older, live with several long-term conditions, take a long list of medicines, and have carers or family whose view of the situation matters as much as any single observation. A community paramedic who rushes a frailty visit will miss the fall risk, the medicine problem or the carer strain that brought the referral in the first place. The job rewards unhurried assessment, plain speaking with patients and families, and the judgement to escalate fast when a visit turns out to be more urgent than the referral suggested. Advanced community roles add prescribing and clinical leadership to that picture, and those roles are the ones graded at Band 7.

Two boundaries matter, and both protect patients and paramedics. First, community paramedics work within their scope of practice and local protocols: they assess and treat what their competence covers, and they refer or escalate what it does not, rather than holding a problem that belongs with a GP, a specialist or a hospital team. Second, community paramedics are not a substitute for a GP or for district nursing: the GP holds overall clinical responsibility for the practice population, and district nurses hold the ongoing caseload for housebound patients, while the community paramedic covers the urgent and unscheduled end of that population. Where those boundaries blur, the patient gets a worse service and the paramedic carries risk that belongs elsewhere. A good community service keeps the boundaries clear in its referral criteria, and a good community paramedic checks them at the start of every visit. The neighbouring primary care role is the practice nurse, whose clinic-based chronic disease and treatment room work is covered in the practice nurse salary guide, while the community paramedic works on the visiting and urgent end of the same population.

Rotational and primary care posts: who the employer is

Community paramedic employment is more mixed than ambulance employment, and that single fact explains most of the pay confusion around the role. Some community paramedics are employed directly by an ambulance trust, on a rotational post that splits the week between road shifts and primary care sessions. Some are employed by a primary care network or a GP federation, often through the Additional Roles Reimbursement Scheme, which funds extra roles in primary care networks. Some are employed by a GP practice directly. The employer name on the advert tells you which pattern applies, and it matters for terms: a trust or primary care network post on Agenda for Change terms pays the Band 6 and Band 7 rates on this page, with the pension, leave and enhancements that go with them, while a practice-employed post on its own terms may pay a locally set salary instead, so the advert figure governs that post. Either way, the work is the same: a visit list, a clinic list, and a record of assessments and referrals that the practice and the commissioner will want to see.

The rotational model deserves a plain explanation, because it is the route many paramedics take into community work. A rotational paramedic might spend part of the week on an ambulance, keeping emergency skills current, and part of the week in primary care, building assessment and visiting skills. The attraction is obvious: two kinds of work, two teams, and a broader skill set than either half alone provides. The pay point to check is that the band follows the post in both halves of the week, and that enhancements follow the hours actually worked, so a Saturday road shift in the ambulance half of the week attracts the same Section 2 enhancement as it would for a full-time road paramedic, while a daytime home visit in the primary care half attracts plain time. A paramedic considering a rotational post should ask how the rota is split, how unsocial hours are counted across the two halves, and how mileage is claimed for the primary care half, because those three answers decide what the post actually pays. The full monthly picture for the ambulance side, including unsocial hours, is in the paramedic take-home pay guide.

One more distinction helps applicants read adverts correctly. Some adverts describe a community paramedic post as part of a wider urgent care or frailty team, and some describe an advanced paramedic practitioner post at Band 7. The advanced post is not simply a community paramedic with more experience: it usually carries clinical leadership, supervision of other paramedics, responsibility for the most complex cases, and prescribing or advanced assessment within its scope. An applicant who wants the Band 7 route should look for that leadership and complexity in the person specification, not just for a higher salary figure. And an applicant who prefers direct visiting work should not treat Band 6 as a lesser job: for many paramedics, the home visit and the urgent appointment are the work they value most, and Band 6 is where that work sits. Registration is the same at both bands: paramedics must be registered with the Health and Care Professions Council to practise, and the band follows the post evaluation, not previous earnings.

Working pattern: daytime visits, with weekend cover

Community paramedic work follows the practice and visiting calendar rather than a 24-hour rota. Most contact happens in daytime hours, when practices are open, care homes can receive visitors and patients are awake and able to talk through their symptoms. The exceptions are weekend cover, extended-hours clinics and urgent visiting rotas, where a community paramedic presence stops a patient who needs seeing today from calling an ambulance or attending an emergency department instead. Those sessions are the hours that can attract unsocial-hours enhancements, and they are also the hours that test whether a service is genuinely accessible: a visiting service that only runs on weekday mornings excludes everyone whose crisis happens on a Saturday. A service that runs weekend visiting is usually doing so deliberately, to keep people at home, and paramedics who cover those sessions should check that the enhancement rules in the next section apply to their post.

Worked example: a Band 6 paramedic at the top step who covers an eight-hour Sunday visiting session earns eight hours at £39.33, which is £314.64, against £196.64 for eight plain hours, a difference of £118.00 for that session. A Band 7 paramedic at entry who covers an eight-hour Saturday session earns eight hours at £32.80, which is £262.40, against £201.84 for eight plain hours, a difference of £60.56. Those examples show the rates clearly, and they also show why they matter less in practice for community paramedics than for road staff: a handful of such days a month, not a rota, is the realistic pattern. The full unsocial-hours rules are explained in the unsocial hours and overtime guide, and a quick check with the hourly rate calculator will turn any of these annual figures into an hourly rate for a different contracted-hours pattern.

Overtime: time and a half at Bands 6 and 7

At Bands 6 and 7, hours above 37.5 a week are paid at time and a half, and double time on bank holidays, for posts on Agenda for Change terms. An overtime hour at Band 6 entry is worth £30.62 and at the top of Band 6 £36.87. At Band 7 entry an overtime hour is worth £37.85, at the intermediate step £39.80 and at the top £43.31. On a bank holiday the double-time rates are £40.82 at Band 6 entry, £49.16 at the top of Band 6, £50.46 at Band 7 entry, £53.06 at the Band 7 intermediate step and £57.74 at the top of Band 7. Part-time staff are paid at plain time, plus any unsocial-hours enhancement that applies, for hours above their contracted hours up to 37.5 a week, with overtime rates only above 37.5 hours. Overtime and unsocial-hours enhancement cannot both be claimed for the same hours. Staff may elect time off in lieu instead of overtime pay.

Worked example: a Band 7 paramedic at the intermediate step who works four extra hours around a busy winter visiting week, outside any unsocial window, earns four hours at £39.80, which is £159.20 on top of the basic week. The same four hours on a bank holiday would be four hours at £53.06, which is £212.24. Those figures are gross, before tax, National Insurance and pension, and they assume the extra hours sit above 37.5 hours for the week. Extra hours below 37.5 for a part-time paramedic are paid at plain time, so the same four hours for a part-time Band 6 paramedic at entry, up to the full-time threshold, would be four hours at £20.41, which is £81.64, plus any unsocial enhancement that applies to those hours. In practice community overtime clusters around winter pressure, care home outbreaks and busy referral periods rather than around a regular rota pattern, and a service lead who plans the visiting calendar well keeps overtime low by spreading weekend cover across the team.

Mileage: the community premium

Home visiting means driving, and for community paramedics mileage is not a footnote. It is a regular, claimable part of the job, and it is the one part of community pay that ambulance road staff do not have in the same form. Under Agenda for Change Section 17, a car driver claims 59p a mile for business miles up to 4,500 miles in a year and 36p a mile above that. So 1,000 business miles in a year is worth £590.00, 4,000 business miles is worth £2,360.00, and 6,000 business miles is worth £3,195.00, because the first 4,500 miles pay £2,655.00 and the remaining 1,500 miles pay £540.00. A community paramedic covering a rural patch, where visits are miles apart, can easily run into the higher mileage bands, while a city paramedic covering a compact patch will claim less. Travel between home and the normal base is not claimable. Travel between bases, to home visits and to care homes during the working day is the claimable pattern, and the mileage rates guide covers the full Section 17 rules, including the motorcycle, cycle, passenger and reserve rates.

Mileage also affects how a community post should be compared with a road post. A Band 6 community paramedic at entry on £39,959 who claims 4,000 business miles in a year receives £2,360.00 in mileage on top of basic pay, which is real money for the cost of running a car, but it is not pensionable pay and it is not salary: it reimburses the cost of using a private car for work. A paramedic comparing a community post with a road post should therefore compare basic pay with basic pay, unsocial hours with unsocial hours, and mileage with mileage, rather than adding mileage into the salary and concluding that one post pays more than it does. One practical check at interview is worth making: ask how mileage is recorded and paid, how often it is paid, and what happens on a week when the visit list runs across a wide patch, because a service that pays mileage promptly and without argument is a service that understands community work.

London weighting: High Cost Area Supplement

Where the post is based in London on Agenda for Change terms, paramedics receive the High Cost Area Supplement, which is a percentage of basic pay subject to a minimum and a maximum for each zone. The rates are 20% of basic 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). At these bands the maximums matter at the higher steps: the percentages of these salaries run above the maximums, so the maximum applies instead of the percentage. At Band 6 entry the percentages still apply in every zone: 20% of £39,959 is £7,991.80, inside the inner minimum and maximum, so the total is £47,950.80, and 15% of £39,959 is £5,993.85, inside the outer minimum and maximum, so the total is £45,952.85. From the top of Band 6 upward, every inner, outer and fringe total in the table is a maximum case: 20% of £48,117 is £9,623.40, above the £8,746 maximum, so the total is £56,863, and the same cap logic gives £65,261 at the top of Band 7 in inner London, £62,652 in outer London and £58,785 in the fringe zone. The full London weighting rules are explained in the London weighting (HCAS) guide.

Note two further cases in the table above. Band 6 intermediate in outer London is a maximum case: 15% of £42,170 is £6,325.50, above the £6,137 maximum, so the maximum applies and the total is £48,307. Band 6 intermediate in the fringe zone is still a percentage case: 5% of £42,170 is £2,108.50, inside the fringe minimum and maximum, so the percentage applies and the total is £44,278.50. From the top of Band 6 upward, the fringe maximum also binds, because 5% of £48,117 is £2,405.85, above the £2,270 maximum. The supplement follows the base of the post, not the visit address on a given day, so a paramedic who visits patients across a zone boundary does not pick up that visit supplement for the day. London community services are among the largest employers of community paramedics, because one service can cover several practices, but the supplement itself follows the same national table as every other Agenda for Change post.

Pension, part-time pay and the smaller extras

On the provisional 2026/27 England and Wales pension tiers, every Band 6 step and the Band 7 entry and intermediate steps sit in the 9.8% tier, and the top of Band 7 sits in the 10.7% tier. That is £326.33 a month on £39,959, £344.39 a month on £42,170, £392.96 a month on £48,117, £403.33 a month on £49,387, £424.11 a month on £51,932, £503.93 a month on £56,515. The employer contributes 23.7% on top, which is £9,470.28 a year at Band 6 entry and £13,394.06 a year at the top of Band 7. The 2026/27 tiers are provisional, calculated from the published 2025/26 tiers, not yet published as final. The tier is set by whole-time-equivalent salary, so a part-time paramedic is tiered on the full-time rate for the post, not on part-time earnings. The contribution tiers in full are set out in the pension contributions guide.

Part-time pay is pro rata on the full-time figure, and the part-time pay guide explains the mechanics. At 0.8 whole-time equivalent, Band 6 entry pays £31,967.20 a year. At 0.6 whole-time equivalent, the top of Band 7 pays £33,909.00 a year. Unsocial-hours enhancements and overtime are calculated on the same hourly rates as full-time staff, so a part-time paramedic covering a Sunday visiting session earns the same enhanced hourly rate as a full-time colleague on the same band and step. Annual leave follows the England tiers of 27 days plus 8 bank holidays up to 4 years of service, 29 plus 8 from 5 years, and 33 plus 8 from 10 years, pro rata for part-time staff. The mileage rates guide covers the full Section 17 rules for travel between visits. On uniforms, the uniform tax rebate guide lists ambulance staff on active service in the £185 flat-rate group, with relief of £37 at the basic rate and £74 at the higher rate, but whether a given primary care post falls in that group depends on the employer and the uniform worn, so check the group that fits the post rather than assuming the ambulance figure applies to every community role.

Two national notes complete the picture. In Wales, the award is also 3.3%, and the Real Living Wage floor of £13.45 an hour applies at the bottom of the scale. This page does not quote Wales Band 6 to Band 7 step sets, because those steps are not in the verified data file, and this page states its figures as England figures throughout. The same caution applies to Scotland: Scotland awarded 3.75% from 1 April 2026 under a two-year deal and moved to a 36-hour week from April 2026, which changes the hourly maths for Scottish posts, and the verified data file holds a Scotland Band 5 range of £34,494 to £42,977 but no Scotland Band 6 to Band 7 step set, so no Scotland community step is quoted here. In Northern Ireland, the 3.3% award is recommended but not yet implemented, so staff there should not budget on the England figures until the award is confirmed.

Qualifications: what they open, and what they do not change

Agenda for Change pays the post, not the person, so a Band 7 advanced post pays the Band 7 rate whatever qualifications the holder brings. What adverts commonly ask for is registration with the Health and Care Professions Council as a paramedic, experience in urgent or emergency care, and the judgement to assess patients alone in their homes and decide safely between treating, referring and escalating. Experience of autonomous assessment transfers well, and many community paramedics arrive from ambulance service roles, urgent care centres and emergency departments. Postgraduate study in advanced practice and prescribing helps an application for Band 7 roles, and some services support paramedics through that study in post, but no single certificate is a national pay condition, and no figure on this page depends on one. The honest route in is a track record of sound assessment and safe decision making, not a single certificate.

There is one more honest point about qualifications. Assessment skill alone does not make a community paramedic. The post also needs the professional habits that surround lone working in patients' homes: accurate records, clear handover, safeguarding awareness, and the judgement to call for help rather than hold a problem that belongs with a GP or a hospital team. Services often recruit advanced community paramedics from within their own visiting teams, because a lead needs to know how the referral pathways, the visiting rota and the practice relationships fit together, not just how to hold a good assessment. A paramedic arriving from road work brings strong emergency skills, but should expect a learning period on chronic disease, frailty, prescribing pathways and practice systems, and should not assume that a previous salary sets the NHS band: the band follows the post evaluation, not the previous earnings.

Progression: specialist, advanced practitioner, or service lead

The honest progression story has three directions. The first is upward inside community work: Band 6 community paramedic to Band 7 advanced practitioner or service lead, then to roles that lead an urgent care or frailty service across a primary care network or a locality. The second direction is back across to ambulance service leadership: community experience in assessment, frailty and referral is strong preparation for specialist and consultant paramedic roles, and for practice education roles that train the next generation. The third direction is into wider urgent care leadership, where running a visiting service at scale is the job, and where the Band 7 lead experience of owning a service end to end is the direct preparation.

Getting to Band 7 needs an advanced post, and that is the part that takes planning. The usual route is a track record of sound autonomous assessment across a patch, ownership of complex frailty cases, support for less experienced paramedics, and the judgement that the Band 7 evaluation looks for. Experience across more than one setting, road and primary care, matters, because a lead is judged on the whole service working well, not on one visit list. A paramedic who wants the advanced route should ask their service manager what the Band 7 posts in the service actually do, and should seek the complex cases and service development work that matches that description before the vacancy appears. For paramedics who do not want the lead route, Band 6 community posts are skilled jobs in their own right, with the same NHS pension and annual leave as every other Agenda for Change post where Agenda for Change terms apply.

Frequently asked questions

What band is a community paramedic?

In England in 2026/27, community paramedic posts sit at Band 6 and Band 7. Band 6 pays £39,959 at entry, £42,170 at the intermediate step and £48,117 at the top. Band 7 pays £49,387 at entry, £51,932 at the intermediate step and £56,515 at the top. Band 6 has three pay points and Band 7 has three pay points. Newly qualified paramedics start at Band 5, which pays £32,073 to £39,043, and community posts sit above that entry band because the work carries autonomous assessment, home visiting and primary care decision making. The band follows the post, not the person: a paramedic who works a rotational post split between an ambulance trust and a primary care network is paid on the band of that post, and a paramedic employed by a GP practice or primary care network on its own terms is paid on the terms in the advert rather than on Agenda for Change. Check the band and the employer in the advert rather than assuming either from the title alone.

How much does a community paramedic earn a month?

In England in 2026/27, a full-time community paramedic at Band 6 earns £3,329.92 a month at entry, £3,514.17 a month at the intermediate step and £4,009.75 a month at the top, before tax, National Insurance and pension deductions. At Band 7 the monthly figures are £4,115.58 at entry, £4,327.67 at the intermediate step and £4,709.58 at the top. Those are gross figures for a full-time 37.5-hour week, before any overtime, mileage or London weighting. A part-time paramedic is paid pro rata: at 0.8 whole-time equivalent, Band 6 entry pays £31,967.20 a year, and at 0.6 whole-time equivalent, the top of Band 7 pays £33,909.00 a year. These figures cover posts banded on Agenda for Change; where a practice or primary care network employs on its own terms, the advert figure governs that post.

What is the hourly rate for a community paramedic?

In England in 2026/27, the hourly rates run from £20.41 at Band 6 entry through £21.54 at the Band 6 intermediate step and £24.58 at the top of Band 6, then £25.23 at Band 7 entry, £26.53 at the Band 7 intermediate step and £28.87 at the top of Band 7. Hourly rates are annual pay divided by 52.2 weeks and then by 37.5 hours, rounded to the nearest penny, and the unsocial-hours and overtime rates on this page are calculated from that rounded hourly rate. The full annual, monthly, weekly and hourly table is at the top of this page, and the hourly rate calculator will turn any of these annual figures into an hourly rate for a different contracted-hours pattern.

Do community paramedics get unsocial hours pay?

Yes, for posts on Agenda for Change terms. Bands 6 and 7 sit in the Bands 4 to 9 group, so the rates are time plus 30% for Saturdays and weekday nights (8pm to 6am) and time plus 60% for Sundays and bank holidays. A Saturday hour at Band 6 entry is therefore worth £26.53 against a plain rate of £20.41, and a Sunday hour at the top of Band 7 is worth £46.19 against a plain rate of £28.87. Most community paramedic work happens in daytime hours, so unsocial-hours income is usually smaller than for ambulance road staff on a 24-hour rota, but weekend cover, extended-hours clinics and urgent home visiting can all fall in an unsocial window, and the enhancement is contractual, not discretionary, for posts on Agenda for Change terms.

Do community paramedics get overtime pay?

At Bands 6 and 7, yes: hours above 37.5 a week are paid at time and a half, and double time on bank holidays, for posts on Agenda for Change terms. An overtime hour at Band 6 entry is worth £30.62 and at the top of Band 6 £36.87. At Band 7 entry an overtime hour is worth £37.85, at the intermediate step £39.80 and at the top £43.31. On a bank holiday the double-time rates are £40.82 at Band 6 entry, £49.16 at the top of Band 6, £50.46 at Band 7 entry, £53.06 at the Band 7 intermediate step and £57.74 at the top of Band 7. Part-time staff are paid at plain time, plus any unsocial-hours enhancement that applies, for hours above their contracted hours up to 37.5 a week, with overtime rates only above 37.5 hours. Overtime and unsocial-hours enhancement cannot both be claimed for the same hours. Staff may elect time off in lieu instead of overtime pay.

How does mileage work for a community paramedic?

Community paramedics travel for the job, so Section 17 mileage is a real part of take-home income. For a car, the Agenda for Change rate is 59p a mile up to 4,500 miles in a year and 36p a mile above that. So 1,000 business miles in a year is worth £590.00, 4,000 business miles is worth £2,360.00, and 6,000 business miles is worth £3,195.00, because the first 4,500 miles pay £2,655.00 and the remaining 1,500 miles pay £540.00. Travel between home and the normal base is not claimable; travel between bases, to home visits and to care homes during the working day is the claimable pattern. The mileage rates guide covers the full Section 17 rules, including motorcycle, cycle, passenger and reserve rates.

How much do community paramedics earn in London?

Where the post is based in London on Agenda for Change terms, paramedics receive the High Cost Area Supplement: 20% of basic 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). At these bands the maximums matter, because the percentages of these salaries run above the maximums at the higher steps. Band 6 entry pays £47,950.80 in inner London, because 20% of £39,959 is £7,991.80, inside the minimum and maximum, so the percentage applies. Band 6 top pays £56,863 in inner London, because 20% of £48,117 is £9,623.40, above the £8,746 maximum, so the maximum applies. Band 7 top pays £65,261 in inner London, £62,652 in outer London and £58,785 in the fringe zone, all three being maximum cases. The supplement follows the base of the post, not the visit address on a given day.

What is the pay difference between a community paramedic and an ambulance paramedic?

There is no separate community paramedic pay scale. Both roles are paid on Agenda for Change, and the difference is the band and the working pattern, not a different set of rates. Ambulance service paramedics typically start at Band 5 and progress to Band 6, with specialist and advanced roles at Band 7, while community paramedic posts in primary care are typically graded at Band 6 and Band 7 from the start, because the post carries autonomous assessment and prescribing-level decision making in patients' homes and care homes. An ambulance paramedic on a 24-hour rota will usually earn more in unsocial-hours enhancements than a community paramedic on a daytime pattern at the same band, while a community paramedic will usually claim more mileage. A rotational post split between an ambulance trust and a primary care network keeps Agenda for Change terms when both employers use Agenda for Change, so the band and the enhancements follow the post in both halves of the week.