Critical Care Outreach 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

Critical care outreach nurse pay 2026/27: the Band 6 to Band 7 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 6 salary guide and the Band 7 salary guide.

The step structure tells the story of this ladder. Inside each band, the journey is worth £8,158 at Band 6 and £7,128 at Band 7. Between bands, the step is small: £1,270 from the top of Band 6 to the entry of Band 7. A nurse who moves from Band 6 top to Band 7 entry gains just over £105 a month in basic pay, which surprises people who expect a promotion to transform their salary. The real gain at Band 7 is the higher ceiling, £56,515 against £48,117, and the different work: a service to shape as well as a caseload to run. The full journey from Band 6 entry to Band 7 top is worth £16,556 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 6 outreach nurse post and a Band 7 outreach nurse specialist post in the same team, 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 £2,211 at Band 6, from £39,959 at entry to £42,170 at the intermediate step.

What a critical care outreach nurse actually does

The outreach nurse is the bridge between the ward and the intensive care unit. When a ward patient starts to deteriorate, when breathing, heart rate, blood pressure or consciousness moves outside the expected range, the ward team calls the outreach team, and the outreach nurse comes to the bedside to assess the patient, support the ward nurses, and help decide what happens next. That decision is the heart of the job: whether the patient can be managed safely on the ward with closer observation and a changed treatment plan, whether they need a higher level of care, or whether they need to move to intensive care. The nurse does not make that call alone, and the medical team stays involved, but the outreach nurse is often the first critical care clinician at the bedside, and the quality of that first assessment shapes everything that follows.

Follow-up after intensive care is the second half of the role, and it is the part that ward-only nurses rarely see. Patients who leave intensive care for a ward are still fragile: they may need help weaning from oxygen, support with eating, drinking and moving after days in bed, and a plan for the complications that follow a critical illness, from weakness to confusion and low mood. The outreach nurse visits these patients on the ward, reviews their recovery, and watches for the early signs of a second deterioration, which is more common than most people outside critical care realise. The nurse also talks with the ward team about what to watch for, so the patient is not simply handed over and forgotten. A service that only responds to emergencies and never follows up its discharged patients is doing half the job, and a nurse applying for a post should ask how much of the week is follow-up work and how much is emergency response.

Teaching is the third strand, and it is what separates outreach from a purely reactive rapid-response role. Outreach nurses train ward nurses to spot deterioration earlier, to record observations properly, to use early warning scores as a tool rather than a tick box, and to call for help sooner rather than later. They run teaching sessions on the ward, debrief after difficult calls, and feed back patterns they see across the hospital, such as a ward where calls always come late, or a group of patients whose deterioration follows the same pattern. That teaching changes outcomes across the whole hospital, not just for one patient at a time, and it is one reason outreach posts sit at Band 6 and above: the nurse needs enough critical care experience to teach with authority, and enough confidence to challenge a plan politely when the ward team and the outreach nurse disagree about a patient.

The emotional weight of the job deserves a plain statement. Outreach nurses meet patients at their worst moments, on wards where the team is worried and the family is frightened, and sometimes the outcome is a transfer to intensive care, a difficult conversation about what treatment can and cannot do, or a death despite everyone's best efforts. They also carry the follow-up relationships with patients who survived intensive care and are rebuilding their lives, which is rewarding work that takes patience. Nurses who last in the role tend to be people who stay calm when a ward is in a hurry, who can give clear advice without taking over the ward team's patient, 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, and the clinical nurse specialist in other long-term conditions, whose caseload and teaching model is the closest parallel to outreach work.

Band 6 versus Band 7: what actually changes

At Band 6, an outreach nurse carries the referral caseload: responding to calls, assessing deteriorating patients, following up intensive care discharges, and teaching ward staff. At Band 7, the nurse carries a specialist caseload and also carries responsibility for the service itself: shaping referral criteria, setting the rota, leading audit of response times and outcomes, supervising Band 6 nurses, and representing the service in meetings with intensive care, ward matrons, medical teams and hospital management. The clinical skills overlap a great deal, which is why the pay step between the bands is only £1,270, from £48,117 at the top of Band 6 to £49,387 at the entry of Band 7. What changes is accountability: when the rota has a gap, when referrals spike, or when a new guideline needs to be turned into local practice, the Band 7 nurse is the person expected to fix it.

That difference matters for anyone planning a move. A Band 6 nurse who loves bedside work and dislikes committee work may be happier staying at the top of Band 6, where the pay is £48,117 and the week is mostly clinical. A nurse who wants to change how the service works, to lead a team, and to carry the argument for more outreach hours or wider ward coverage, needs the Band 7 post, even though the first year of it pays only £1,270 more than the top of Band 6. The payoff comes later in the band: Band 7 tops out at £56,515, which is £8,398 above the top of Band 6, and the Band 7 nurse builds pension on that higher figure. For the full scales at each band, see the Band 6 salary guide and the Band 7 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 ward or a high dependency unit into a first outreach post usually starts at Band 6 entry, £39,959, and moves through the steps as experience grows. A nurse with several years of intensive care experience, a critical care course, or a prescribing qualification may be appointed higher in the band or straight into a Band 7 post. Prescribing is worth asking about in any job description: an outreach nurse who can prescribe can adjust medicines at the bedside without waiting for a doctor's signature, which makes the response faster and makes the nurse more valuable to the service. It does not automatically change the band, since the band follows the evaluated post, but it strengthens a Band 7 application and it changes the daily work for the better.

Unsocial hours: the 24/7 rota is where the money is

Outreach is a round-the-clock service in most trusts, and the rota is the single biggest influence on take-home pay after the band itself. A team that covers nights and weekends earns unsocial-hours enhancements on a large share of its hours, while a team that only covers daytime weekdays 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 7 outreach nurse specialist at entry works a Sunday shift of 7.5 hours. Plain time for the shift would be £189.23 (7.5 hours at £25.23). At time plus 60%, the same shift pays £302.78 (7.5 hours at £40.37). The enhancement alone is worth £113.55 for that one shift. A nurse on a full 24/7 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 an outreach nurse, overtime usually means staying past the end of a shift because a deteriorating patient cannot be handed over mid-crisis, covering a colleague's sickness absence, or working an extra shift when referrals spike. The hourly overtime rates below are calculated from the rounded plain-time rates.

Worked example: a Band 6 outreach nurse at the intermediate step works 5 extra hours in a week at time and a half. That is 5 hours at £32.31, or £161.55, against £107.70 at plain time, an extra £53.85 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.

On-call: the figure this page does not quote

On-call is the one part of outreach nurse pay that cannot be quoted nationally, and this page does not pretend otherwise. Some services pay an on-call availability payment for being contactable out of hours, plus a payment for each call or visit. Others fold on-call into a rota allowance, and smaller services may run outreach only in daytime hours, with out-of-hours deterioration handled by the intensive care team or the hospital-at-night team instead. The frequency matters as much as the rate: a service that calls its nurse out several times a weekend pays very differently from a service 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-out visits is treated.

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 across 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 a Band 7 specialist at entry in inner London also receives £8,746, for a total of £58,133. 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 6 nurse at entry in outer London receives £5,993.85, which is 15% of the basic, above the £4,870 minimum, for a total of £45,952.85. The same nurse in the fringe zone receives £1,997.95, which is 5% of the basic, above the £1,346 minimum, for a total of £41,956.95. At the top of the ladder the fringe cap binds: a Band 7 specialist at the top receives £2,270 in the fringe zone, not 5% of £56,515, for a total of £58,785. 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 outreach nurses, and they are also the most valuable part of the package. Under the provisional 2026/27 England and Wales tiers, 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. Band 7 specialists pay 9.8% at entry and the intermediate step, £403.33 and £424.11 a month, and 10.7% at the top, £503.93 a month. The employer contributes 23.7% on top of pensionable pay, which is £9,470.28 a year at Band 6 entry and £13,394.06 a year at the top of Band 7. 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 outreach nurses that means basic pay alone, since unsocial-hours enhancements and overtime are not pensionable. That distinction matters when comparing an outreach 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 7 retires on a pension built from those years at their full value, which is one reason the Band 7 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 6 outreach nurse at entry on a 0.8 whole-time equivalent contract earns £31,967.20 a year, and a Band 7 specialist at the top on a 0.6 contract earns £33,909 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. Outreach services often offer part-time posts, because follow-up clinics and teaching sessions can be split, but the on-call commitment of a part-time post should be checked, since some services expect part-time nurses to take a full share of on-call.

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. For the full leave rules, see the annual leave guide on this site.

Mileage is occasional money for outreach nurses who travel between hospital sites, and regular money for any outreach nurse whose patch covers more than one site. 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.

Outreach versus bedside intensive care: two versions of critical care nursing

The same band and step can mean two quite different weeks, depending on whether the post is outreach or bedside intensive care. The bedside intensive care nurse cares for one or two critically ill patients on a unit, with monitors, ventilators and infusions close at hand, and a team on the same unit all shift. The outreach nurse covers the whole hospital, moves between wards, and works mostly alone or in a pair, making judgements with less equipment and less backup in the room. The day is structured by referrals, not by a bed list, and the nurse needs confidence in lone working and in deciding when a ward patient must become an intensive care patient.

Pay differs between the two versions mainly through unsocial hours and on-call, 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 outreach nurse on a 24/7 rota may earn more unsocial-hours money than a bedside nurse on a fixed unit rota, while on-call arrangements vary so much by trust that no comparison holds nationally. A nurse choosing between the two should weigh the working pattern honestly: bedside work offers a team on hand and deep knowledge of a few patients, outreach work offers variety, autonomy, and teaching across the hospital. The intensive care nurse salary guide covers the bedside role in full, and its unit-based working pattern will feel familiar to anyone who has worked a critical care rota.

Private-sector comparison, kept qualitative as it should be: private hospitals and home-care providers do employ nurses with critical care 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 6 and Band 7 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 outreach 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. Wales has a 3.3% award implemented 1 April 2026. 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 or Band 7 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 outreach nurse pay does and does not do

Outreach 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 6 tops out at £48,117, and a nurse who wants more must move to Band 7, which means a service to lead, not simply more years in the same job. On-call pay, which can be a meaningful part of an outreach income in services that run a 24/7 rota, 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 deterioration early, to keep patients out of intensive care when ward care can be made safe, and to teach ward teams to spot trouble sooner. The pay is fair for the band. The rota, the call-out frequency, and the split between emergency response and follow-up work are what should decide the choice between two outreach posts at the same band.

Frequently asked questions

What band is a critical care outreach nurse?

Most critical care outreach nurses sit at Band 6, and outreach nurse specialists and team leads sit at Band 7. In England in 2026/27, Band 6 pays £39,959 at entry, £42,170 at the intermediate step and £48,117 at the top, and Band 7 pays £49,387 at entry, £51,932 at the intermediate step and £56,515 at the top. The band follows the post, not the job title, so one trust can employ a Band 6 outreach nurse and a Band 7 outreach lead in the same team, with the lead carrying service responsibility on top of the clinical caseload.

How much does a critical care outreach nurse earn a month?

In England in 2026/27, a Band 6 critical care outreach nurse earns £3,329.92 a month at entry, £3,514.17 at the intermediate step and £4,009.75 at the top, before tax, National Insurance and pension deductions. A Band 7 outreach nurse specialist earns £4,115.58 a month 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 unsocial-hours enhancement, on-call payment or London weighting.

Do critical care outreach 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 6 outreach nurse at entry earns £26.53 an hour on a Saturday or at night and £32.66 on a Sunday or bank holiday, against £20.41 plain time. At the top of Band 7, £28.87 an hour becomes £37.53 and £46.19. Outreach teams that run a 24/7 rota earn these enhancements for a large share of their hours, which is why the rota pattern matters as much as the band.

Do critical care outreach nurses get on-call pay?

Yes, in most services, but there is no national on-call rate to quote. Some services pay an availability payment for being contactable out of hours plus a payment for each call or visit, and others fold on-call into a rota allowance. The frequency matters as much as the rate: a service that calls its nurse out several times a weekend pays very differently from a service that calls once a month, even on the same availability payment. 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-out visits is treated.

Do critical care outreach 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 6 outreach nurse at entry in inner London earns £47,950.80 in total, and a Band 7 outreach nurse specialist at entry in inner London earns £58,133, because the 20% supplement is capped at £8,746. A Band 7 specialist at the top in inner London earns £65,261 in total.

What pension contribution does a critical care outreach nurse pay?

Under the provisional 2026/27 England and Wales tiers, Band 6 outreach nurses pay 9.8% of pensionable pay at every step, from £326.33 a month at entry to £392.96 a month at the top. Band 7 outreach nurse specialists pay 9.8% at entry and the intermediate step, £403.33 and £424.11 a month, and 10.7% at the top, £503.93 a month. The employer contributes 23.7% on top, which is £13,394.06 a year at the top of Band 7. The 2026/27 member tiers are provisional, calculated from the published 2025/26 tiers, and have not yet been formally published.

Can a critical care outreach nurse work part-time?

Yes. Part-time pay in Agenda for Change is pro rata to the whole-time equivalent fraction. A Band 6 outreach nurse at entry on a 0.8 whole-time equivalent contract earns £31,967.20 a year, and a Band 7 outreach nurse specialist at the top on a 0.6 contract earns £33,909 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 post should be checked before accepting it, since some services expect part-time nurses to take a full share of on-call.

How does critical care outreach 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. Wales has a 3.3% award implemented 1 April 2026. 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 or Band 7 salary figures are quoted on this page, because the data file does not hold them, and this page does not invent the rest.