NHS District Nurse Hourly Pay 2026/27: What Band 6 and Band 7 Earn an Hour

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

By the NHS Bands Pay editorial team

District nursing is one of the few NHS jobs where the hourly rate alone tells less than half the story. The basic rate matters, but so do the miles driven between visits, the weekend rota, the on-call commitment and the London weighting. A district nurse at the top of Band 6 on a plain weekday rota and the same nurse on a weekend-heavy rota in inner London can take home very different monthly pay from the same job title. This guide puts every element in hourly terms, so the comparison is honest.

The figures below are for England in the 2026/27 pay year, after the 3.3% Agenda for Change uplift effective 1 April 2026. District nurses are Agenda for Change staff, so the band rates, unsocial hours rules and overtime rules on this page all come from the national handbook. Scotland, Wales and Northern Ireland are covered separately near the end, because their awards and working weeks differ.

District nurse hourly rates 2026/27 at a glance

District nursing sits mainly on two bands. Band 6 is the qualified district nurse who holds a caseload, visits patients at home and works largely alone in the community. Band 7 is the team lead or locality manager who carries a smaller caseload alongside supervision, allocation and service decisions. Band 5 community staff nurses support district teams but are not district nurses in the qualified sense, and they appear in the progression section rather than in this table.

The gap between the bottom and the top of the district nurse range is wide: £8.46 an hour separates a Band 6 nurse at the entry step from a Band 7 nurse at the top of the band. In annual terms that is £16,556. The smaller gaps are the ones that catch people out. Moving from the top of Band 6 to the entry step of Band 7 adds only £1,270 a year, or £0.65 an hour, because the top of one band sits close to the bottom of the next. Promotion still pays, but the first Band 7 year is not the leap the job title suggests.

How the NHS hourly rate is worked out

Take the full-time annual salary, divide it by 52.2, then divide the result by 37.5. That is the whole formula. The 52.2 is the number of weeks in the NHS year, and 37.5 is the standard full-time week in England. A Band 6 district nurse on £39,959 a year therefore earns £765.50 a week, and £765.50 divided by 37.5 gives £20.41 an hour. A Band 7 nurse at the top of the band on £56,515 a year earns £1,082.66 a week, or £28.87 an hour.

A single day shift of 7.5 hours is worth £153.08 at the Band 6 entry rate and £216.53 at the Band 7 top rate. Those day values are useful when comparing a district nurse post with agency or bank shifts quoted by the day. The hourly rate is also the base for everything else on this page: unsocial hours enhancements, overtime rates and London weighting are all calculated from it. The enhancement tables below are worked out from the rounded hourly rates shown in the table above, which keeps every figure on this page consistent with every other figure.

One caution about the formula. It assumes a 37.5 hour week. Part-time district nurses use the same hourly rate, but their annual salary is pro rata, and Scotland uses a 36 hour week from April 2026, which changes the divisor. The Scotland section below explains why a Scottish hourly rate cannot be read off the England table.

Band 6 district nurse hourly pay in detail

Band 6 is where most district nurses sit. The entry step pays £20.41 an hour, £3,329.92 a month. The intermediate step pays £21.54 an hour, £3,514.17 a month. The top of the band pays £24.58 an hour, £4,009.75 a month. The climb from entry to top is £4.17 an hour, or £8,158 a year, and it is earned through incremental progression rather than negotiation: Agenda for Change pay steps are automatic on satisfactory performance, subject to the usual appraisal process.

What Band 6 buys in practice is autonomy. A Band 6 district nurse assesses patients at home, plans care, manages complex wounds, administers intravenous antibiotics in the community, supports end-of-life care at home and decides when a patient needs hospital admission. The hourly rate has to be read alongside that responsibility, because the community setting means lone working, clinical decisions without a ward team at hand, and a car as a workplace. The mileage section below covers the driving costs that come with the job.

For a nurse moving into district nursing from a Band 5 hospital post, the entry step is the honest comparison. Band 5 pays £16.38 an hour at entry, so the move to Band 6 entry adds £4.03 an hour, or £7,886 a year. A nurse already at the top of Band 5 on £19.95 an hour gains only £0.46 an hour by moving to Band 6 entry, which is why experienced Band 5 nurses sometimes feel the promotion barely registers in the first year. The gain grows with each Band 6 increment, and the top of Band 6 is £4.63 an hour above the top of Band 5.

Band 7 district nurse hourly pay in detail

Band 7 district nursing is team leadership as much as clinical work. The entry step pays £25.23 an hour, £4,115.58 a month. The intermediate step pays £26.53 an hour, £4,327.67 a month. The top of the band pays £28.87 an hour, £4,709.58 a month. A Band 7 nurse typically leads a locality team, allocates caseloads, supervises Band 6 and Band 5 colleagues, handles complex case reviews and carries accountability for service standards across a patch.

The step from Band 6 to Band 7 deserves a straight answer. From the top of Band 6 at £24.58 an hour to the entry step of Band 7 at £25.23 an hour is £0.65 an hour, or £1,270 a year. That is a small reward for a large jump in responsibility, and it is a known feature of the Agenda for Change structure rather than a district nursing quirk. The Band 7 range then opens up: the top of Band 7 is £3.64 an hour above Band 7 entry, and £8.46 an hour above Band 6 entry. Nurses weighing a Band 7 post should judge it on the full range and the management workload, not on the first-year uplift alone.

Band 7 also changes the overtime picture. Bands 1 to 7 all qualify for contractual overtime pay, so a Band 7 district nurse still earns time and a half for hours above 37.5 a week, and double time on bank holidays. Band 8 nurses move to time off in lieu only, which is one more reason the Band 7 to Band 8a step changes the deal in ways the hourly table does not show. See our Band 7 pay guide for the wider Band 7 picture.

Unsocial hours: what each kind of hour pays

District nursing rotas include evenings, weekends and bank holidays, because patients at home need care seven days a week. Agenda for Change Section 2 pays Bands 4 to 9 an extra 30% for Saturday and weekday night hours, and an extra 60% for Sunday and bank holiday hours. Night hours are weekday hours between 8pm and 6am. The table gives every district nurse step.

Worked example: a Band 6 district nurse at the entry step works a 12 hour Saturday shift. At plain time that shift is worth £244.92. With the 30% enhancement it is worth £318.36, an extra £73.44 for the same twelve hours. The same nurse on a 12 hour Sunday shift earns £391.92. Over a year, a rota with one weekend in three can add several thousand pounds to annual earnings without any change to the basic hourly rate, which is why two district nurses on the same band and step can report very different monthly pay.

Unsocial hours and overtime cannot be claimed for the same hours: a nurse chooses the higher entitlement where both could apply, and may elect time off in lieu instead of payment. The full rules are in our unsocial hours and overtime guide.

Overtime hourly rates for district nurses

Overtime is hours above 37.5 a week for full-time staff. Part-time district nurses are paid at plain time, plus any unsocial enhancement that applies, for hours above their contracted hours up to 37.5; only hours above 37.5 attract overtime rates. Bands 1 to 7 earn time and a half for overtime, and double time on bank holidays. The table gives the overtime hourly rate at each district nurse step.

Extra shifts are the fastest way for a district nurse to lift monthly pay without changing jobs, but the gain is capped by the working-time rules and by fatigue. A Band 6 nurse at the top of the band who picks up one extra 7.5 hour shift at time and a half earns £276.53 for that shift, against £184.35 at plain time. Community services also use bank staff, and the bank hourly rate for a substantive post is a separate question from overtime: bank work is paid for the shift worked, usually without the pension and leave accrual that come with a substantive contract.

London district nurse hourly rates with HCAS

High Cost Area Supplement is a percentage of basic pay with a minimum and a maximum in each zone. Inner London pays 20%, with a minimum of £5,794 and a maximum of £8,746. Outer London pays 15%, with a minimum of £4,870 and a maximum of £6,137. The fringe pays 5%, with a minimum of £1,346 and a maximum of £2,270. At Band 6 and Band 7 the percentage amounts sit above the minimums in every zone, so the minimums do not affect the figures below. The maximums do affect them: every row except Band 6 entry is capped in at least one zone, as the notes under the table explain.

Read the capped rows with care. Band 6 entry is the only row where no cap binds: 20% of £39,959 is £7,991.80, 15% is £5,993.85 and 5% is £1,997.95, all inside their zone minimums and maximums. From the top of Band 6 upward, every zone cap binds. Band 6 top in inner London is £48,117 plus the capped £8,746, not the full 20% of £9,623.40. Band 7 top in outer London is £56,515 plus the capped £6,137, giving £62,652, not the full 15% of £8,477.25. The fringe cap of £2,270 binds from Band 6 top upward as well. The practical result is that the London premium shrinks in percentage terms as basic pay rises, and the gap between inner and outer London narrows at the top of the scale. For the full zone rules, see our London weighting guide.

Part-time district nurse hourly pay

Community nursing has a large part-time workforce, and the hourly arithmetic is reassuring: the rate does not fall when hours fall. A district nurse at the top of Band 6 on 0.6 whole-time equivalent, which is 22.5 hours a week, earns £28,870.20 a year, or £2,405.85 a month, at the same £24.58 an hour as a full-time colleague. A Band 7 nurse at the entry step on 0.8 whole-time equivalent, 30 hours a week, earns £39,509.60 a year, or £3,292.47 a month, at £25.23 an hour.

What part-time work does change is everything calculated from annual pay. Pension contributions are a percentage of actual pensionable pay, so they fall in cash terms. Annual leave is pro rata: the England tiers are 27, 29 and 33 days plus 8 bank holidays by length of service, and a part-time nurse gets the same tiers scaled to contracted hours. Overtime rules also shift: hours above contracted hours up to 37.5 are paid at plain time, not at time and a half. Our part-time pay guide works through the full pro rata maths.

Mileage: the driving element district nurses cannot ignore

A district nurse's car is a second workplace, and mileage is the part of the package most often underestimated by nurses moving from hospital wards. Under Agenda for Change Section 17, business mileage in a private car is paid at 59p a mile for the first 4,500 miles in the mileage year, then 36p a mile. Motorcycles are paid 30p a mile, pedal cycles 20p, and a passenger allowance of 5p a mile applies where a colleague travels as a passenger.

Worked example: a district nurse drives 6,000 business miles in the mileage year. The first 4,500 miles at 59p give £2,655, and the remaining 1,500 miles at 36p give £540, a total of £3,195. That money reimburses fuel, wear and insurance costs; it is not salary, it is not pensionable, and it should never be added to the hourly rate when comparing jobs. A rural patch with long drives can generate far more mileage than an urban patch, which is one reason two district nurse posts on identical bands can feel very different in the pocket. Our mileage rates guide gives the full Section 17 table, including the HMRC benchmark of 55p a mile for the first 10,000 miles and how to claim relief on any shortfall.

Rates are reviewed twice a year, and the October 2026 review may change rates from 1 January 2027. Treat the 59p and 36p figures as current for the 2026/27 mileage year and re-check them before relying on them for a new post.

On-call in community nursing

On-call is the least standardised element of district nurse pay. Unlike unsocial hours and overtime, which have national percentage rules, on-call availability payments and call-out payments are set locally, and the detail varies by trust and service. Some services pay a flat availability payment for the on-call period plus payment for each call-out attended; others fold on-call into a rota allowance. There is no national on-call hourly rate to publish, and any guide that quotes one for district nurses is inventing it.

What can be stated exactly is the value of the hours themselves under the national rules. A call-out hour on a weekday night for a Band 6 nurse at the entry step is worth £26.53, and a Sunday call-out hour is worth £32.66, before any local on-call payment. A nurse considering a community post should ask for the on-call policy in writing: how often on-call falls, what the availability payment is, how call-outs are paid, and whether travel time counts. Those answers, not the basic hourly rate, often decide whether a district nurse job is sustainable.

Pension and payslip in hourly terms

Pension contributions take a visible slice of the hourly rate. Under the provisional 2026/27 England and Wales tiers, a Band 6 district nurse at the entry step on £39,959 pays 9.8%, which is £326.33 a month. At the top of Band 6 on £48,117, the same 9.8% tier gives £392.96 a month. A Band 7 nurse at the entry step on £49,387 also sits in the 9.8% tier, paying £403.33 a month, while a Band 7 nurse at the top on £56,515 sits in the 10.7% tier, paying £503.93 a month. The employer contributes a further 23.7%: £789.19 a month at Band 6 entry and £1,116.17 a month at Band 7 top. The tiers are provisional, calculated from the 2025/26 published tiers, not yet published as final 2026/27 tiers, so treat the percentages as the best current basis rather than a confirmed circular.

Those pension figures explain why gross hourly rates flatter take-home pay. A Band 6 nurse at £20.41 an hour gross keeps considerably less after pension, income tax and National Insurance, and the exact net figure depends on student loan plan, tax code and any salary sacrifice. The detailed band-by-band contribution table is in our pension contributions by band guide, and the hourly rate calculator converts any band salary into an hourly rate on the same formula used here.

Career progression in hourly terms

The district nurse ladder in hourly terms runs from Band 5 community staff nurse at £16.38 an hour at entry, £17.67 an hour at the intermediate step and £19.95 an hour at the top, through Band 6 at £20.41 to £24.58 an hour, to Band 7 at £25.23 to £28.87 an hour. The specialist qualification that unlocks Band 6 is the district nursing specialist practitioner qualification, and the step from Band 5 to Band 6 is the move from supporting a caseload to holding one. The step from Band 6 to Band 7 is the move from holding a caseload to leading the team that holds them.

Sideways moves keep the hourly rate but change the working pattern. Health visitors sit mainly on Band 6 with a similar hourly range but a clinic and visiting pattern built around families rather than general caseloads. Palliative care nurses span Bands 5 to 7 with the same national rates and a heavier unsocial hours element from end-of-life on-call work. Comparing posts by hourly rate alone misses those pattern differences, which is why this guide separates plain time, unsocial hours, overtime, mileage and on-call rather than blending them into one number.

Scotland, Wales and Northern Ireland

Scotland awarded 3.75% from 1 April 2026 under a two-year deal, and moved to a 36 hour week from April 2026. That shorter week changes the hourly divisor: a Scottish salary divided by 36 hours and 52.2 weeks gives a higher hourly rate than the same salary on a 37.5 hour week. Scotland has its own pay scale, and this page does not quote Band 6 or Band 7 Scotland steps because the verified data file holds the 3.75% award, the 36 hour week and a Band 5 range only. For scale, the Scotland Band 5 range of £34,494 to £42,977 works out at £18.36 to £22.87 an hour on the 36 hour basis. Scotland also has nine pension tiers from 5.7% to 12.7%, a different structure from England and Wales. See our Scotland pay guide for the national picture.

Wales implemented the 3.3% award on 1 April 2026, paid on time. The Welsh scale differs slightly from England: Band 5 in Wales is £32,557, £35,114 and £39,631, which is £16.63, £17.94 and £20.25 an hour. No verified Band 6 or Band 7 Wales steps are quoted here, because the data file holds the award, the Real Living Wage floor of £13.45 an hour and the Band 5 example only. The floor itself does not affect district nurse rates, which sit far above it. See our Wales pay guide.

Northern Ireland is the exception to every figure on this page. The 3.3% award has been recommended but not implemented, so Northern Ireland district nurses should not budget on the England rates until implementation is confirmed. The position is under active dispute, with a ballot over the unpaid award. Staff in Northern Ireland should check their trust payroll position rather than applying this page's tables.

Frequently asked questions

What is the hourly rate for a district nurse in 2026/27?

In England in 2026/27, a district nurse on Band 6 earns £20.41 an hour at the entry step, £21.54 an hour at the intermediate step and £24.58 an hour at the top of the band. A Band 7 district nurse team lead earns £25.23 an hour at entry, £26.53 an hour at the intermediate step and £28.87 an hour at the top. Those are plain-time rates for a 37.5 hour week, before night, weekend, overtime, London weighting or on-call payments.

How is the NHS hourly rate worked out?

Divide the full-time annual salary by 52.2, the number of weeks in the NHS year, and then by 37.5, the standard full-time week. A Band 6 district nurse on £39,959 a year therefore earns £39,959 divided by 52.2 divided by 37.5, which is £20.41 an hour. The same formula gives every hourly rate on this page. Enhancements in the tables below are worked out from the rounded hourly rate, which is how the site's other hourly guides present them.

Do district nurses get paid more for nights and weekends?

Yes. Under Agenda for Change Section 2, Bands 4 to 9 get 30% on top of plain time for Saturday and weekday night hours, and 60% on top for Sunday and bank holiday hours. A Band 6 district nurse at the entry step therefore earns £26.53 an hour on a Saturday or a weekday night, and £32.66 an hour on a Sunday or bank holiday. Unsocial hours are paid for the hours actually worked, so a rota heavy in weekends pays noticeably more than the plain hourly rate suggests.

What is the Band 7 district nurse hourly rate?

Band 7 district nurse pay in England in 2026/27 is £25.23 an hour at the entry step, £26.53 an hour at the intermediate step and £28.87 an hour at the top of the band. With the 30% Saturday and night enhancement, those become £32.80, £34.49 and £37.53 an hour. With the 60% Sunday and bank holiday enhancement, they become £40.37, £42.45 and £46.19 an hour.

Does London weighting change the hourly rate?

Yes, for staff in London. Inner London weighting is 20% of basic pay, capped at £8,746 a year. A Band 6 district nurse at the entry step in inner London earns £47,950.80 a year, which is £24.50 an hour. A Band 6 nurse at the top of the band hits the cap, so the total is £56,863 a year, or £29.05 an hour, rather than the full 20%. Outer London pays 15% and the fringe pays 5%, each with its own minimum and maximum. At Band 6 and Band 7 the percentage amounts sit above the minimums, so the minimums do not change these figures.

Does part-time work change the hourly rate?

No. The hourly rate stays the same. Part-time pay is the full-time salary multiplied by the contracted fraction, so a district nurse at the top of Band 6 on 0.6 whole-time equivalent earns £28,870.20 a year, which is £2,405.85 a month, at the same £24.58 an hour as a full-time colleague on the same step. What changes is the total: fewer hours means less annual pay, less pensionable pay and pro rata annual leave.

Is mileage paid on top of the hourly rate?

Yes, mileage is separate from pay. District nurses who use their own car for visits claim business mileage under Agenda for Change Section 17: 59p a mile for the first 4,500 miles in the mileage year, then 36p a mile. A district nurse driving 6,000 business miles in the year claims £2,655 for the first 4,500 miles and £540 for the remaining 1,500 miles, £3,195 in total. Mileage is reimbursement for running a car, not salary: it is not pensionable and it does not raise the hourly rate. Rates are reviewed twice a year, and the October 2026 review may change rates from 1 January 2027, so check the current rate before relying on these figures.

Are district nurses paid for on-call?

On-call arrangements in community nursing are set locally, so there is no single national on-call hourly rate to quote. Some trusts pay a flat on-call availability payment plus payment for call-outs actually attended, and the detail varies by service. What this page can say with certainty is the plain-time value of the hours: a call-out hour on a weekday night for a Band 6 nurse at the entry step is worth £26.53 under the unsocial hours rules, and a Sunday call-out hour is worth £32.66. Ask for the local on-call policy in writing before accepting a community post, because on-call is where two otherwise identical district nurse jobs can differ most.

Source: NHS Employers unsocial hours payments. Pay rates also published by Health Careers NHS.