NHS Neonatal Care Leave: Pay, Rules and How to Claim It

Last updated: 11 November 2026 · Figures verified against the statutory family pay rates for 2026/27.

By the NHS Bands Pay editorial team

What neonatal care leave is

Neonatal care leave is a new statutory right for parents whose baby spends time receiving neonatal care after birth. It covers babies born on or after 6 April 2025, and it applies in Great Britain only: England, Scotland and Wales. The leave exists because the first weeks of a baby's life do not always go to plan. A baby born early, or born with a condition that needs specialist care, can spend days or weeks in a neonatal unit. The parents in that situation were previously expected to use their maternity or paternity leave to cover the hospital stay, which ate into the time they would have had at home with the baby afterwards. Neonatal care leave fixes that. It is extra leave, added on top of everything else, so the hospital weeks do not come out of your maternity or paternity entitlement.

The leave and the pay are two separate things, and they have different qualifying rules. That split catches people out, so it is worth holding in mind from the start. The leave itself is a day-one right: you can take it from your first day with your employer, with no minimum length of service. The pay is Statutory Neonatal Care Pay, and that does need 26 weeks' continuous service and earnings at or above the Lower Earnings Limit. If you meet the leave test but not the pay test, you can still take the time off; it is simply unpaid. The sections below take the leave rules first, then the pay, then the notice rules, which change depending on when you take the leave.

Neonatal care leave is not the same as unpaid parental leave, and it is not the same as carer's leave. Unpaid parental leave gives 18 weeks per child, unpaid, usable until the child turns 18. Carer's leave covers time off to care for a dependant with a long-term need. Neonatal care leave is narrower and more specific: it is tied to a baby's neonatal care in the first weeks of life, it is paid at the statutory rate when you qualify, and it comes with its own notice rules. If your situation spans more than one of these, read the guides together and plan the blocks in order.

Who qualifies: leave is day one, pay needs service and earnings

The leave test is the generous one. Neonatal care leave is a day-one employment right in Great Britain. There is no qualifying period, no minimum number of weeks with your trust, and no requirement to have been employed on a particular date. If you are the baby's parent and your baby receives neonatal care that starts within 28 days of the birth, the right to the leave arises. That matters for staff who have recently joined the NHS, moved between trusts, or started a new post shortly before the birth. Your length of service does not affect the leave at all.

The pay test is stricter, and it has two parts. First, you need 26 weeks' continuous service with your employer up to the relevant week. Second, your average weekly earnings must be at or above the Lower Earnings Limit, which is £129 a week in 2026/27 (it was £125 a week in 2025/26). Both parts must be met. If your earnings fall below the limit, there is no Statutory Neonatal Care Pay, even if you have the service. The leave is still yours to take; the pay is not. This is the same shape of test used for other statutory family pay, and it is the reason low-paid and part-time staff should check their average earnings early rather than assuming the pay will follow.

Part-time staff should take particular care with the earnings test. The Lower Earnings Limit is a weekly figure, so it is your average weekly earnings that count, not your annual salary. A part-timer working short hours can be under the £129 a week line even on a reasonable hourly rate. If you are close to the line, ask payroll to work out your average weekly earnings for you before you plan around the pay. And remember that the test is about the pay only. A part-time parent under the earnings limit still has the full day-one right to the leave itself.

One more boundary to note: the scheme is Great Britain only. NHS staff in Northern Ireland are outside it, because employment law is devolved there. If you work in Northern Ireland, do not rely on the figures on this page. Ask your local HR team what arrangements apply instead.

How much leave you get: 7 days of care earns 1 week

The leave is earned in whole weeks, and each week is earned by 7 full continuous days of neonatal care. The care must start within 28 days of the birth. The maximum is 12 weeks, which means 84 days of care earns the full entitlement. The table below shows the full scale.

Two details in that table deserve attention. First, part weeks do not count. Six days of care earns no leave at all, and 13 days earns one week, not two. Only complete blocks of 7 full continuous days count, so the entitlement grows in steps, not smoothly. Second, the 28-day start rule is about when the care begins, not when it ends. Care that starts within 28 days of the birth keeps earning leave even if it runs on for weeks afterwards. Care that first starts more than 28 days after the birth does not earn neonatal care leave, however long it lasts.

The 12-week maximum is a hard cap. A baby who spends 100 days in neonatal care earns the same 12 weeks as a baby who spends 84 days. There is no extra leave for a longer stay, and there is no way to carry unused neonatal care leave beyond the window the scheme allows. Which brings us to the deadline: every week of neonatal care leave must be taken within 68 weeks of the birth. That is a little over 15 months. The window is generous, and it is what makes the Tier 2 rules below workable, but it is still a deadline. Leave not taken inside the 68 weeks is lost.

How much the pay is: £194.32 a week in 2026/27

Statutory Neonatal Care Pay is £194.32 a week in 2026/27, or 90% of your average weekly earnings if that is lower. It is paid for each week of neonatal care leave you take, up to the 12-week maximum. The table below shows the total for every number of weeks, and the chart underneath plots the same figures.

The most you can receive is £2,331.84 for the full 12 weeks. The rate rose from £187.18 a week in 2025/26, an increase of £7.14 a week, or about 3.8%. The same 12 weeks in 2025/26 paid £2,246.16, so the 2026/27 rate adds £85.68 over the full entitlement. One warning about sources: the employee-facing GOV.UK neonatal page still showed the old £187.18 figure in autumn 2026. The HMRC employer rates figure of £194.32 is the correct one for 2026/27, and it is the figure your payroll will use. If a page or a colleague quotes £187.18 for 2026/27, they are looking at last year's rate.

The 90% rule matters for lower earners. If your average weekly earnings are below £194.32, your Statutory Neonatal Care Pay is 90% of those earnings instead of the flat rate. Take a parent whose average weekly earnings are £150. Their pay is 90% of £150, which is £135 a week. Four weeks of leave at that rate pays £540.00 in total. The flat rate only helps you if your earnings are high enough to reach it; below that line, the pay tracks your actual earnings. This is also why the Lower Earnings Limit matters so much. At average earnings under £129 a week there is no statutory pay at all, and the leave is unpaid.

Statutory Neonatal Care Pay is paid through your normal payroll, in the same way as other statutory family pay, with the usual tax and National Insurance deductions. It is not a lump sum and it is not paid by the government direct to you. Your trust pays it and reclaims it through the usual statutory pay mechanism. Check your payslip in the first month it is paid: the weekly rate should read £194.32, or 90% of your average weekly earnings if that is lower, and the number of weeks paid should match the weeks of leave you took.

Tier 1 and Tier 2: the notice rules change as time passes

The notice rules split into two tiers, and the tier you are in depends on when you take the leave. Tier 1 covers the period while your baby is still receiving neonatal care, and for 7 days after the care ends. Tier 2 covers everything after that, up to the end of the 68-week window. The rules are deliberately looser in Tier 1, because nobody can predict a neonatal stay in advance, and tighter in Tier 2, when there is time to plan.

In Tier 1 you can take the leave in separate weeks, which fits the reality of a neonatal stay. You might take one week while the baby is in the unit, return to work for a few days, then take another week. The notice for a Tier 1 week is light: tell your employer before the first day of absence in that week, or as soon as reasonably practicable if that is not possible. In practice that means telling your manager as soon as you know, even if it is the same morning. Do it in writing where you can, even a short message, so there is a record of when you gave notice.

Tier 2 is different. Once the Tier 1 period has passed, the leave must be taken as one single continuous block. You cannot split it into separate weeks any more. The notice is also longer: 15 days' notice for a single week, and 28 days' notice for two or more weeks. The reason is straightforward. By Tier 2 the emergency has passed, the baby is home, and your trust needs time to arrange cover. Give the notice in writing, state the start and end dates, and keep a copy. If you are planning a Tier 2 block, work backwards from the 68-week deadline so the block and its notice period both fit inside the window.

The 68-week window: plan the order of your leave

Every week of neonatal care leave must fall within 68 weeks of the birth. That window is the same whether you take the leave in Tier 1, in Tier 2, or in a mix of both. Most parents will use some Tier 1 weeks during the hospital stay itself, then take the rest as a Tier 2 block later. That is exactly how the scheme is designed to work. The trap is leaving the Tier 2 block too late. A block that starts inside the window but runs past it does not work: the weeks beyond the 68-week line are not neonatal care leave.

Put the dates on a calendar early. Note the birth date, add 68 weeks, and write that end date down. Then work out how many weeks you have earned from the care so far, and when you want to take the rest. If you are also taking maternity, paternity or shared parental leave, map the whole sequence in one place. The 68-week deadline is the one that bites first, because the other family-leave schemes have their own windows, and it is easy to plan a neat sequence that quietly runs past it.

How neonatal care leave fits with other family leave

Neonatal care leave sits on top of your other family leave. Taking it does not reduce your maternity, paternity, adoption or shared parental leave, and it does not reduce the pay attached to those schemes. It is an extra entitlement for a specific situation, and it is used in addition to the leave you already have. That is the single most important thing to understand about it. Parents who treat it as part of their maternity or paternity leave, and subtract it from those entitlements, are giving up leave they are owed.

Our NHS maternity pay guide sets out the occupational maternity rates, and our NHS paternity pay guide covers the two paid weeks around the birth. Statutory paternity pay uses the same flat rate as neonatal care pay: £194.32 a week in 2026/27, or 90% of average weekly earnings if lower. If you are sharing leave with a partner, read our adoption pay and shared parental leave guide as well. The comparison below shows how the statutory rates line up.

Shared parental leave deserves a closer look, because it is the scheme most likely to overlap with a neonatal stay. Up to 50 weeks of leave and 37 weeks of pay can be shared between two parents in the child's first year, at the same £194.32 a week flat rate. The employee test is 26 weeks' service to the qualifying week plus the Lower Earnings Limit, and the partner test is 26 weeks worked with £390 earned in at least 13 weeks within the 66 weeks before the expected week. If you are considering shared parental leave, remember that it involves curtailment: giving up some maternity or adoption leave so the balance becomes shared leave and pay. Neonatal care leave involves no such mechanism. It is independent, it is not curtailed, and it does not touch your shared parental entitlement. Get the order right: sort the neonatal care leave first, because its 68-week window and Tier 1 notice rules are the tightest, then fit the shared parental blocks around it.

Adoption has its own structure. Statutory Adoption Pay runs for 39 weeks: the first 6 weeks at 90% of average weekly earnings with no cap, then weeks 7 to 39 at £194.32 a week or 90% if lower. The service test is 26 weeks ending with the matching week, plus the Lower Earnings Limit test. If your baby was adopted rather than born to you, the neonatal care rules still turn on the same facts: care starting within 28 days of the birth, 7 full continuous days earning a week, and the 68-week window running from the birth.

Annual leave keeps running alongside all of this. Our NHS annual leave guide sets out the full Agenda for Change entitlement. The practical point is that neonatal care leave does not eat into your annual leave, and you should not be asked to use annual leave to cover a neonatal stay. If a manager suggests that, point to the neonatal care leave entitlement and ask for the request to be recorded under it.

Does the NHS top up neonatal care pay?

Short answer: no verified top-up exists, so this guide quotes no top-up figure. Statutory Neonatal Care Pay of £194.32 a week is the statutory floor, and it is the only figure this guide can stand behind. Agenda for Change enhances several types of family leave pay, which is why many NHS staff expect a top-up to be there. But no verified NHS occupational neonatal top-up has been published, and inventing one would mislead parents who are budgeting for weeks away from work.

That does not mean no trust ever pays more. Some trusts may have a local policy that adds to the statutory rate, and local policies change. The only safe course is to ask your trust's HR team, in writing, what your local policy says about neonatal care pay, and to get the answer before you plan your finances around it. Do not assume full pay, do not assume the occupational maternity or paternity top-up carries across, and do not budget on a figure nobody has confirmed for you. If your trust does have an enhancement, the written confirmation is what protects you if payroll queries it later.

The budgeting point is a real one. Twelve weeks at £194.32 a week is £2,331.84, which is a long way below twelve weeks of full NHS pay at any band. For a parent on Band 5, a single week of full pay is several times the statutory weekly rate. That gap is the reason to plan early: check whether your trust tops the pay up, look at whether a Tier 2 block can be timed to follow paid leave rather than sitting on its own, and talk to payroll about how the statutory pay will appear on your payslip. The leave is a genuine gain for parents in this situation. The pay, at the statutory rate alone, is modest, and parents should go in with their eyes open.

Pension, annual leave and your other rights

Your contract continues during neonatal care leave, except for pay. That is the standard position for statutory family leave: the leave counts towards your continuous service, your pay-step progression is not interrupted, and you return to the same job. Annual leave continues to accrue exactly as if you were at work, including bank-holiday entitlement. If you fall ill during neonatal care leave, the leave does not convert into sick leave. Read our NHS sick pay guide for how sick pay works when the timings are reversed.

Pension follows your actual pay. NHS pension contributions are deducted from what you are actually paid, so during weeks when you receive Statutory Neonatal Care Pay, contributions are taken from that pay, and during any unpaid weeks nothing is deducted. An unpaid stretch can therefore leave a gap in pensionable service. It is a small gap for most parents, a few weeks, but it is worth knowing about before the leave starts rather than discovering it at retirement. Ask your trust's pensions administrator whether contributions for an unpaid period can be arranged, and keep the answer with your leave paperwork.

Being treated badly for asking for or taking neonatal care leave is unlawful, as it is for other statutory family leave. If a request is questioned, keep the exchange in writing, note the dates, and speak to your union representative or HR team. Most trusts handle these requests well, because the entitlement is clear and the numbers are small. The problems, where they arise, usually come from a manager who has not seen the new scheme before, not from a policy of refusing it.

How to claim it: the steps in order

• Note the dates. Write down the birth date, the date the neonatal care started, and the date it ended. Your entitlement is worked out from those dates, and the 68-week deadline runs from the birth.
• Count your weeks. Divide the care into blocks of 7 full continuous days. That is your leave entitlement, up to 12 weeks. Part weeks do not count.
• Tell your manager early. In Tier 1, notice before the first day of absence in that week is enough, or as soon as reasonably practicable. Do it in writing, even if it is a short message, and keep a copy.
• Check the pay tests. Ask payroll to confirm your 26 weeks' service and your average weekly earnings against the £129 a week Lower Earnings Limit, so you know before the leave starts whether the £194.32 a week will be paid.
• Plan any Tier 2 block in writing. Give 15 days' notice for one week and 28 days for two or more weeks, state the start and end dates, and check the block ends inside the 68-week window.
• Ask about any local top-up. Get your trust's position on neonatal care pay in writing. Do not budget on a top-up nobody has confirmed.
• Check your payslip. In the first month the pay is due, confirm the weekly rate is £194.32, or 90% of your average weekly earnings if lower, and that the number of weeks paid matches the leave you took.
• Keep the paperwork. Keep your notice, the agreed dates, and the payslips together. If anything is queried later, the paper trail settles it.

Worked examples

Example 1: 21 days of care. A baby spends 21 days receiving neonatal care. That is 3 full blocks of 7 days, so the parent earns 3 weeks of neonatal care leave. At £194.32 a week, the statutory pay for those 3 weeks is £582.96. The leave can be taken in separate weeks while the care is ongoing, under the Tier 1 rules.

Example 2: 49 days of care. A baby spends 49 days in neonatal care, which earns 7 weeks of leave. The statutory pay for 7 weeks is £1,360.24. The parent might take 3 weeks during the stay and the remaining 4 weeks as a single Tier 2 block after the baby comes home, giving 28 days' notice for the block.

Example 3: 84 days or more of care. A baby spends 12 weeks or longer in neonatal care. The parent earns the maximum 12 weeks of leave, and the statutory pay for the full entitlement is £2,331.84. In 2025/26 the same 12 weeks would have paid £2,246.16, so the 2026/27 rate is worth £85.68 more over the full entitlement.

Example 4: a lower earner. A parent whose average weekly earnings are £150 a week qualifies for the pay, because £150 is above the £129 Lower Earnings Limit. But their Statutory Neonatal Care Pay is 90% of £150, which is £135 a week, not the £194.32 flat rate. Four weeks of leave at that rate pays £540.00. The 90% rule, not the flat rate, sets their pay.

Frequently asked questions

How much is Statutory Neonatal Care Pay in 2026/27?

Statutory Neonatal Care Pay is £194.32 a week in 2026/27, or 90% of your average weekly earnings if that is lower. It is paid for each week of neonatal care leave you take, up to the 12-week maximum, so the most you can receive is £2,331.84. In 2025/26 the rate was £187.18 a week.

How many weeks of neonatal care leave can I take?

Up to 12 weeks. You earn one week of leave for every 7 full continuous days of neonatal care that starts within 28 days of your baby's birth. Fewer than 7 full days earns no week, and part weeks do not count: 13 days of care earns one week, 14 days earns two. All of the leave must be taken within 68 weeks of the birth.

Do I need a minimum length of service to take neonatal care leave?

Not for the leave itself. Neonatal care leave is a day-one right in Great Britain, so you can take it from your first day with your employer. The pay is different: Statutory Neonatal Care Pay needs 26 weeks' continuous service up to the relevant week, and average weekly earnings at or above the Lower Earnings Limit of £129 a week.

What counts as neonatal care for this leave?

The leave is earned by days on which your baby receives neonatal care, where that care starts within 28 days of the birth. Each block of 7 full continuous days of care earns one week of leave, up to 12 weeks. Keep a note of the dates the care started and ended, because your trust will work the entitlement out from them.

How much notice do I have to give for neonatal care leave?

It depends on when you take it. While your baby is still receiving neonatal care, and for 7 days after the care ends, you can take the leave in separate weeks and you only need to give notice before the first day of absence in that week, or as soon as reasonably practicable. After that period the leave must be taken as one continuous block, with 15 days' notice for one week and 28 days' notice for two or more weeks.

Can I take neonatal care leave after maternity or paternity leave?

Yes. Neonatal care leave sits on top of your other family leave: it does not use up any of your maternity, paternity, adoption or shared parental leave. The one hard limit is the 68-week window. Every week of neonatal care leave must fall within 68 weeks of the birth, so plan the order of your leave blocks with that deadline in mind.

Does the NHS top up Statutory Neonatal Care Pay?

No NHS occupational top-up for neonatal care pay has been verified, so this guide quotes no top-up figure. Statutory Neonatal Care Pay of £194.32 a week is the statutory floor. Some trusts may have a local policy that adds to it, so ask your trust's HR team what your local policy says rather than assuming full pay.

Does neonatal care leave apply in Northern Ireland?

No. The scheme applies in Great Britain only: England, Scotland and Wales. NHS staff in Northern Ireland are outside the scheme, so check with your local HR team what arrangements apply there instead of relying on the figures on this page.

Sources and independence

Source: GOV.UK: Neonatal care leave and pay.

Source: GOV.UK: Neonatal care leave and pay for employers (HMRC statutory rates).

This is an independent guide and is not affiliated with the NHS. Statutory neonatal care leave and pay rules are set in UK employment law and applied locally; trusts implement them through local policies, so confirm notice procedures and any enhanced local arrangements with your employer. Always check your ESR record for your actual entitlement.