NHS Occupational Therapist Hourly Pay 2026/27: What Bands 5, 6 and 7 Earn an Hour

Last updated: 28 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Occupational therapy is one of the few NHS professions where the same job title can sit in an acute hospital, a community team, a school, a mental health ward or a council social care department, and the hourly economics differ in each setting even when the band is identical. This page sets out every occupational therapist hourly rate for 2026/27 in England, step by step, with the weekend, overtime, on-call, London, mileage and part-time figures worked through in full, so you can see what each kind of hour is actually worth before you compare posts or check a payslip.

If you want the annual picture, the occupational therapist salary guide covers the same bands from the yearly side, and the NHS hourly rate calculator will convert any band salary to an hourly rate for you. The rates below are all full-time equivalent for England under Agenda for Change, after the 3.3% award effective 1 April 2026. Occupational therapist is a legally protected title: you must be registered with the Health and Care Professions Council to use it, and the standard route runs through an approved degree, usually a BSc or a pre-registration MSc, with practice placements across NHS and social care settings. Newly qualified therapists start at Band 5, senior or specialist therapists who hold their own caseload sit at Band 6, and team leads or advanced practitioners sit at Band 7, with service management and consultant therapist roles reaching Band 8a and above.

Occupational therapist hourly rates 2026/27 at a glance

The occupational therapy band ladder maps neatly onto career stages, which is why the hourly table reads as a career path. Band 5 is the newly qualified therapist building a general caseload under supervision. Band 6 is the senior or specialist therapist holding a caseload in a defined area, such as stroke, hand therapy, paediatrics or mental health. Band 7 is the team lead or advanced practitioner who carries clinical leadership alongside a caseload, supervises junior staff and shapes the service. The table below gives every step from Band 5 entry to Band 7 top.

Two steps in the table deserve a second look. The move from the top of Band 5 (£19.95 an hour) to the bottom of Band 6 (£20.41) is worth only £0.46 an hour, or £916 a year, because the bands overlap. The move from the top of Band 6 (£24.58) to the bottom of Band 7 (£25.23) is worth £0.65 an hour, or £1,270 a year. Both steps matter more than the hourly gap suggests, because a higher band also changes the value of every enhanced hour that follows, and for acute therapists who work weekends, that second effect adds up fast.

How the NHS hourly rate is worked out

The formula is simple, and it is worth knowing because it lets you check any figure on a payslip in seconds. Take the full-time annual salary, divide it by 52.2, which is the number of weeks in the NHS pay year, and divide again by 37.5, the standard full-time week. That gives the plain-time hourly rate.

Worked example: a Band 6 occupational therapist at the entry step earns £39,959 a year. Divide £39,959 by 52.2 and you get £765.50 a week. Divide £765.50 by 37.5 and you get £20.41 an hour. The same arithmetic gives £16.38 an hour for a Band 5 entrant on £32,073 (£614.43 a week) and £24.58 an hour for a Band 6 therapist at the top of the band on £48,117 (£921.78 a week). Monthly pay is the annual salary divided by 12, so the Band 6 entrant takes £3,329.92 a month gross before deductions.

One common mistake is to divide by 52 weeks instead of 52.2. That small change inflates every hourly rate by a few pence, which is why some online calculators disagree with payroll by a small amount. Another is to use the wrong week: Agenda for Change full time in England is 37.5 hours, not 40. Scotland is the exception, with a 36 hour week from April 2026, and its hourly rates are covered separately near the end of this page.

Band 5 occupational therapist hourly pay in detail

Band 5 is where every occupational therapy career starts. The newly qualified period runs at the entry step, with supervision and a general caseload, and the band has three steps in total. At £16.38 an hour, a new therapist earns £122.85 for a standard 7.5 hour day and £614.43 for a 37.5 hour week. At the intermediate step, £17.67 an hour gives £132.53 a day and £662.68 a week. At the top of Band 5, £19.95 an hour gives £149.63 a day and £747.95 a week.

Band 5 is also where the unsocial hours uplift first shows up in cash terms, though for most therapists it is modest, because community and school-based work runs on weekdays. A Band 5 entrant earns £21.29 for a Saturday or night hour and £26.21 for a Sunday or bank holiday hour. At the top of the band, those figures rise to £25.94 and £31.92. A single 7.5 hour Saturday shift at the entry step is therefore worth £159.68 at the enhanced rate, against £122.85 at the plain rate, a difference of £36.83 for one shift.

Pension sits on top of these rates rather than inside them. Under the provisional 2026/27 tiers, a Band 5 entrant on £32,073 pays 8.3% of pensionable pay, which is £221.84 a month, and the employer adds 23.7%, which is £633.44 a month. The intermediate step at £34,592 also falls in the 8.3% tier at £239.26 a month, while the top step at £39,043 falls in the 9.8% tier at £318.85 a month. Those tiers are provisional for 2026/27, calculated from the published 2025/26 thresholds, so treat the monthly pension figures as the best current estimate rather than a final published rate.

Band 6 senior and specialist hourly pay in detail

Band 6 is where most career occupational therapists settle. The band runs from £20.41 an hour at entry to £24.58 at the top, with an intermediate step at £21.54. In day terms, that is £153.08, £161.55 and £184.35 for a 7.5 hour day. In weekly terms, it is £765.50, £807.85 and £921.78 for a full 37.5 hour week.

The unsocial hours figures for Band 6 are the ones acute therapists will recognise from their payslips. At the entry step, a Saturday or night hour pays £26.53 and a Sunday or bank holiday hour pays £32.66. At the intermediate step, the figures are £28.00 and £34.46. At the top of the band, they are £31.95 and £39.33. Put those rates against a weekend and the rota effect becomes concrete: a Band 6 entrant working a plain weekday shift of 7.5 hours earns £153.08, a 7.5 hour Saturday shift earns £198.98, and a 7.5 hour Sunday shift earns £244.95. Across one of each, the three shifts total £597.01 for 22.5 hours, which averages £26.53 an hour, well above the plain rate, simply because of the mix of hours.

Band 6 also brings the setting split into focus. An acute Band 6 therapist covering weekend discharges picks up those enhancements regularly. A community Band 6 therapist visiting patients at home works mostly weekdays and picks up few enhancements, but adds mileage instead, covered below. A mental health Band 6 therapist on an inpatient ward picks up shift enhancements, while a community mental health therapist mostly does not. Same band, same hourly rate, very different monthly totals, which is why comparing two Band 6 posts on basic pay alone misses the point.

Band 7 team lead and advanced practitioner hourly pay

Team lead and advanced practitioner roles that carry clinical leadership, supervise junior therapists and shape a service are usually graded Band 7, and the hourly rates reflect that step up. Entry pays £25.23 an hour (£189.23 a day, £946.11 a week), the intermediate step pays £26.53 an hour (£198.98 a day, £994.87 a week), and the top of the band pays £28.87 an hour (£216.53 a day, £1,082.66 a week).

Unsocial hours at Band 7 follow the same Bands 4 to 9 percentages, so a Saturday or night hour pays £32.80 at entry, £34.49 at the intermediate step and £37.53 at the top, while a Sunday or bank holiday hour pays £40.37, £42.45 and £46.19. Overtime at Band 7 pays time and a half, which is £37.85 an hour at entry and £43.31 at the top, and double time on bank holidays, which is £50.46 at entry and £57.74 at the top. Pension at Band 7 is 9.8% at the entry and intermediate steps (£403.33 and £424.11 a month) and 10.7% at the top step (£503.93 a month) under the provisional tiers.

Service management and consultant therapist roles reach Band 8a and above, but they sit outside the scope of this page, which covers the Bands 5 to 7 range where the large majority of NHS occupational therapists work. Staff at Bands 8 and 9 get no contractual overtime pay and take time off in lieu instead, which matters when comparing a Band 7 post with regular overtime against a Band 8a management post.

Unsocial hours: what each kind of hour pays

Unsocial hours under Agenda for Change Section 2 cover weekday nights from 8pm to 6am, all of Saturday, and all of Sunday and public holidays. For Bands 4 to 9, which includes every occupational therapist band, the enhancement is 30% on top of plain time for Saturday and weekday night hours, and 60% on top for Sunday and public holiday hours. The table below gives the resulting hourly rates for the three main therapy bands.

Two points catch people out. First, the enhancement applies to the hour worked, not to the whole shift: a shift that starts in the evening and runs past 8pm earns plain time before 8pm and the enhanced rate after it, unless local arrangements say otherwise. Second, the percentages above are the current Section 2 rates. Older figures still circulate online, including 44% and 88% for Band 2 and 37% and 74% for Band 3, but those are the pre-September 2018 rates and they do not apply to occupational therapists on Bands 5 to 7 in any case. If a calculator or forum post quotes them, it is out of date.

For the full unsocial hours rules, including how the enhancements interact with part-time hours, see the unsocial hours and overtime guide. The setting matters here more than in most professions: acute therapists covering weekend discharges and urgent assessments earn these enhancements as a routine part of the job, while community, paediatric and school-based therapists, whose work runs on weekdays, may earn none at all.

Overtime hourly rates for occupational therapists

Overtime under Section 3 pays time and a half for Bands 1 to 7, and double time on bank and public holidays. Overtime only starts above 37.5 hours in a week. Part-time staff earn plain time, plus any unsocial enhancement that applies, for hours above their contracted hours up to 37.5, and overtime rates only kick in beyond that point. You cannot claim overtime and an unsocial enhancement for the same hour, and staff may elect time off in lieu instead of payment.

Worked example: a Band 6 occupational therapist at the top of the band who works four overtime hours in a normal week earns 4 times £36.87, which is £147.48 on top of the normal week's pay. The same four hours on a bank holiday at double time earn 4 times £49.16, which is £196.64. If those overtime hours fall on a Sunday, the choice is between the overtime rate and the unsocial rate for the same hours, not both added together. The overtime calculator runs the same maths for any combination of hours and enhancements.

Weekend cover and on-call: where they apply in occupational therapy

On-call is far less central to occupational therapy than to nursing or laboratory work, and that difference is worth stating plainly, because job adverts sometimes imply otherwise. Most occupational therapy posts carry no on-call at all. The exceptions sit in acute hospitals, where weekend discharge cover and urgent assessment rotas exist, and in a small number of specialist services with out-of-hours cover.

Where on-call does exist, Agenda for Change pays an availability payment for the on-call period plus call-out payments at overtime rates when you attend. The call-out maths is fixed, but the availability payment is set locally, so two Band 6 posts in different hospitals can pay very differently in practice even when their basic rates match. Worked example: an occupational therapist at Band 6 entry, on £20.41 an hour, called in for three hours earns 3 times £20.41 times 1.5, which is £91.85 for the call-out, plus the availability payment for the on-call period.

Before accepting an acute post, ask for the weekend and on-call policy in writing: which weekends are rostered, the availability payment, the minimum call-out period, and how often call-outs actually happen on that rota. A post that looks identical on basic pay can differ by hundreds of pounds a month once weekend cover is counted, and the difference is invisible in the annual salary table. Community, paediatric and school-based therapists should instead ask about mileage and lease car terms, which is where their extra earnings usually sit.

London occupational therapist hourly rates with HCAS

High Cost Area Supplement is a percentage of basic pay, subject to a minimum and a maximum, and it is pensionable. 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. Where the percentage gives less than the minimum, the minimum applies, and where it gives more than the maximum, the supplement is capped.

How the table is built, so you can check it: a Band 5 entrant on £32,073 earns a 20% inner supplement of £6,414.60, giving a total of £38,487.60 a year, which is £19.66 an hour. The outer minimum of £4,870 applies instead of 15%, because 15% of £32,073 is £4,810.95, below the minimum, giving £36,943 a year or £18.87 an hour. The fringe rate is 5%, which is £1,603.65, giving £33,676.65 a year or £17.20 an hour. At the top of Band 6, the inner supplement is capped: 20% of £48,117 is £9,623.40, above the £8,746 maximum, so the total is £56,863 a year or £29.05 an hour. The London weighting guide explains the zones and the caps in full.

Community mileage: the extra community therapists actually earn

For community occupational therapists, mileage is often worth more than any unsocial hours enhancement, because home visits are the job. Under Agenda for Change Section 17, car mileage pays 59p a mile for the first 4,500 miles in the mileage year and 36p a mile beyond that, with motorcycle at 30p, pedal cycle at 20p, a passenger allowance of 5p a mile and a reserve rate of 30p. Mileage is an expense reimbursement, not pay: it is not pensionable and it does not count towards the hourly rate, but it lands in the bank all the same.

Worked example: a community therapist driving 5,000 business miles in a year claims 4,500 miles at 59p, which is £2,655, plus 500 miles at 36p, which is £180, a total of £2,835 for the year. That is £236.25 a month on average, before any lease car or travel time arrangements the trust may offer. Note the review caveat: Section 17 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 the 59p figure for a new post. The mileage rates guide carries the full Section 17 table and the worked examples.

Part-time occupational therapist hourly pay

Part-time work does not change the hourly rate. An occupational therapist on 0.6 whole time equivalent works 22.5 hours a week and earns the same rate per hour as a full-time colleague on the same band and step. The annual salary and the monthly pay are scaled by the fraction, and so is the weekly total.

At Band 5 entry, £16.38 an hour gives £368.55 a week at 22.5 hours (£19,243.80 a year) and £491.40 a week at 30 hours (£25,658.40 a year). At Band 6 top, £24.58 an hour gives £553.05 a week at 22.5 hours (£28,870.20 a year) and £737.40 a week at 30 hours (£38,493.60 a year). Part-time staff also accrue annual leave pro rata, and hours above contracted hours up to 37.5 are paid at plain time plus any unsocial enhancement, as set out in the overtime section above. The part-time pay guide works through the leave and pension effects in detail. Occupational therapy has a large part-time workforce, and job shares, compressed hours and term-time arrangements are common in community and paediatric teams.

NHS versus council occupational therapist pay

This is the comparison occupational therapy applicants ask about most, because a large share of occupational therapists work for local authorities rather than the NHS. Council occupational therapists are usually paid on local government pay scales, not Agenda for Change, so the band numbers on this page do not apply, and headline salaries are set by each council's grading. Council posts are often pitched near the NHS Band 5 level to stay competitive, but that varies by council, and this page quotes no council figure because no single verified council scale exists to quote.

The structural differences that matter are the pension schemes, NHS pension with a 23.7% employer contribution against the Local Government Pension Scheme, which is also defined benefit but on different contribution and accrual terms, and working patterns, with council work mostly on weekdays and NHS acute work carrying weekend enhancements. Therapists move between the two sectors regularly, but service in one does not always transfer neatly to the other's pay scale, so negotiate the starting grade explicitly. The pension contributions guide explains what you would be leaving or joining.

Career progression in hourly terms

Progression through occupational therapy bands is usually driven by the post rather than by time served: a newly qualified post is Band 5, a senior or specialist post is Band 6, and a team lead or advanced practitioner post is Band 7. In hourly terms, the full journey from Band 5 entry (£16.38) to Band 7 top (£28.87) is worth £12.49 an hour, or £24,442 a year full time. The single biggest step in the journey is inside Band 6, from entry (£20.41) to top (£24.58), worth £4.17 an hour or £8,158 a year.

That progression also changes the value of every enhanced hour. A Sunday hour rises from £26.21 at Band 5 entry to £32.66 at Band 6 entry, £39.33 at Band 6 top and £46.19 at Band 7 top. For an acute therapist working regular weekends, the band step therefore matters twice: once in the plain rate and again in every unsocial hour that follows. Specialist routes within the profession, such as hand therapy, stroke rehabilitation, paediatrics and mental health, generally progress through the same Bands 6 and 7 structure rather than through a separate pay ladder. The Band 6 pay guide and the Band 5 pay guide set out the full salary tables for the two bands where most occupational therapists sit.

Scotland, Wales and Northern Ireland

Scotland agreed a two-year deal with a 3.75% award from 1 April 2026 and moved to a 36 hour week, which changes the hourly calculation: the divisor becomes 52.2 times 36, or 1,879.2 hours a year, instead of 1,957.5. The published Scotland Band 5 range of £34,494 to £42,977 therefore works out at £18.36 to £22.87 an hour. The full Scotland step-by-step scale is not in the verified data used for this page, so this page gives the range endpoints only and does not invent intermediate steps.

Wales applied the 3.3% award from 1 April 2026 with a real living wage floor of £13.45 an hour for the lowest bands. Welsh Band 5 steps of £32,557, £35,114 and £39,631 give hourly rates of £16.63, £17.94 and £20.25 on the standard 37.5 hour week, slightly above the England equivalents at each step. Northern Ireland is the exception to the whole 2026/27 picture: the 3.3% award was recommended but had not been implemented at the last check, and staff there should not budget on rates that have not yet been paid. The Scotland pay guide and the Wales pay guide carry the nation-level detail.

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

Frequently asked questions

What is the hourly rate for an NHS occupational therapist in 2026/27?

In England in 2026/27, an NHS occupational therapist on Band 5 earns £16.38 an hour at the entry step, £17.67 an hour at the intermediate step and £19.95 an hour at the top of the band. A senior or specialist occupational therapist on Band 6 earns £20.41 an hour at entry, £21.54 an hour at the intermediate step and £24.58 an hour at the top. A team lead or advanced practitioner on Band 7 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 weekend, night, overtime, London weighting or mileage payments.

How is the NHS occupational therapist 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 occupational therapist 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.

What is the hourly rate for a newly qualified occupational therapist?

A newly qualified occupational therapist starts at the bottom of Band 5: £32,073 a year, which is £16.38 an hour and £2,672.75 a month before tax, National Insurance and pension. The post requires registration with the Health and Care Professions Council, and the standard route runs through an approved occupational therapy degree, usually a BSc or a pre-registration MSc, with practice placements in NHS and social care settings. The next Band 5 steps pay £17.67 an hour (£34,592 a year) and £19.95 an hour (£39,043 a year), and Band 6 is the normal step up once you hold a senior or specialist caseload.

Do NHS occupational therapists get paid more for weekends and nights?

Yes, where the rota includes unsocial hours. Under Agenda for Change Section 2, Bands 4 to 9 get 30% on top of plain time for Saturday and weekday night hours, from 8pm to 6am, and 60% on top for Sunday and bank holiday hours. A Band 6 occupational therapist at the entry step therefore earns £26.53 for a Saturday or night hour and £32.66 for a Sunday or bank holiday hour, against a plain rate of £20.41. Occupational therapy is less shift-heavy than nursing, so most of the weekend work sits in acute hospitals, covering weekend discharges and urgent assessments, rather than in community or school-based teams.

What is occupational therapist overtime pay per hour?

Overtime for Bands 1 to 7 pays time and a half, and double time on bank and public holidays. A Band 5 occupational therapist at the entry step earns £24.57 an overtime hour and £32.76 on a bank holiday, while a Band 6 occupational therapist at the top of the band earns £36.87 and £49.16. Overtime only starts above 37.5 hours a week, and you cannot claim overtime and an unsocial hours enhancement for the same hour. Part-time staff earn plain time, plus any unsocial enhancement that applies, for hours above their contracted hours up to 37.5, and overtime rates only kick in beyond that point.

Do occupational therapists get on-call pay?

Some do, but on-call is far less central to occupational therapy than to nursing or laboratory work. Where a service runs on-call cover, Agenda for Change pays an availability payment for the on-call period plus call-out payments at overtime rates when you attend. An occupational therapist at Band 6 entry, on £20.41 an hour, called in for three hours would earn about £91.85 for the call-out itself, which is 3 times £20.41 times 1.5, plus the availability payment. The availability payment and the exact call-out terms vary by trust and by local policy, so this page quotes no fixed on-call amount beyond the call-out maths. Community, paediatric and school-based occupational therapists rarely carry on-call at all.

What is the London occupational therapist hourly rate with HCAS?

High Cost Area Supplement is a percentage of basic pay, subject to a minimum and a maximum, and it is pensionable. 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, and the fringe pays 5% with a minimum of £1,346 and a maximum of £2,270. A Band 5 occupational therapist at the entry step therefore earns £19.66 an hour in inner London, £18.87 in outer London and £17.20 in the fringe, against a basic rate of £16.38. At the top of Band 6, the inner supplement is capped at £8,746, giving £29.05 an hour.

Do Scotland and Wales pay different occupational therapist hourly rates?

Yes. Scotland agreed a 3.75% award from 1 April 2026 and moved to a 36 hour week, which changes the hourly calculation: the divisor becomes 52.2 times 36, or 1,879.2 hours a year, instead of 1,957.5. The published Scotland Band 5 range of £34,494 to £42,977 therefore works out at £18.36 to £22.87 an hour. Wales applied the 3.3% award with a £13.45 an hour living wage floor, and Welsh Band 5 steps of £32,557, £35,114 and £39,631 give £16.63, £17.94 and £20.25 an hour on the standard 37.5 hour week. Northern Ireland had not implemented the 3.3% recommendation at the last check, so do not budget on it. Council-employed occupational therapists in England are a separate case: they sit on local government scales, not Agenda for Change, so the band rates on this page do not apply to them.