NHS Orthoptist Salary 2026/27

Last updated: 26 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

What NHS orthoptists earn in 2026/27: the Band 5 and Band 6 salary ranges, hourly rates, unsocial hours and overtime, London weighting, pension contributions, and how the role differs from optometry and ophthalmology.

An NHS orthoptist works with the way the two eyes move and work together. A child whose eye turns inwards, an adult seeing double after a stroke, a teenager whose lazy eye was missed at school screening: these are the patients who fill an orthoptic clinic. The work is measurement-heavy and unhurried by hospital standards. Eye movements are tested in different directions of gaze, vision is checked with and without glasses, and the findings are recorded precisely enough for an ophthalmologist to act on. A morning might run from a new paediatric squint assessment to a follow-up for a child on patching treatment to a double-vision clinic for adults, with notes, referrals and liaison with schools and other eye professionals between patients.

This guide sets out the NHS pay picture in full: the 2026/27 salary at every step of Bands 5 and 6, the hourly rates, unsocial hours and overtime, London weighting, pension contributions, what the job actually involves day to day, and the position in Scotland, Wales and Northern Ireland. All figures are the England Agenda for Change rates for 2026/27, which include the 3.3% consolidated award effective 1 April 2026.

NHS orthoptist salary 2026/27

The 2026/27 Agenda for Change rates for NHS orthoptist posts in England, full-time at 37.5 hours a week, with 2025/26 for comparison:

Source: NHS Employers Agenda for Change pay circular 2026/27 (England, full-time 37.5 hours a week). Hourly rates are annual salary divided by 52.2 weeks and 37.5 hours. The 2026/27 figures include the 3.3% consolidated award effective 1 April 2026.

Band 5 is the qualified orthoptist post: the orthoptist who assesses eye movement and binocular vision, treats squints and lazy eye, and follows patients up in an eye service. Band 6 is the specialist level: the orthoptist carrying complex caseloads, leading clinics, working in paediatric, stroke or neuro-ophthalmology services, and often supervising junior orthoptists and students. The step from Band 5 to Band 6 is the main pay jump in the profession: Band 6 entry at £39,959 sits just above Band 5 top at £39,043, so the move is worth £916 a year at the point of promotion, before any further progression through Band 6 itself.

Monthly pay before deductions gives a clearer sense of the money. A Band 5 orthoptist at entry takes £2,672.75 a month in basic pay, rising to £3,253.58 at top. At Band 6, monthly basic runs from £3,329.92 at entry to £4,009.75 at top. Those are gross figures, before tax, National Insurance, pension and any student loan deduction. Part-time orthoptists are paid pro rata: a 0.6 whole-time-equivalent Band 5 orthoptist at entry, for example, earns 60% of £32,073, which is £19,243.80 a year. For the pro rata maths in detail, see our part-time pay guide.

What NHS orthoptists do

Orthoptics sits inside the allied health professions, and the clinic day reflects that. The core work is assessment: how each eye moves, how the two eyes work together, whether a squint is present and in which direction, and how good the vision is in each eye. A squint assessment takes time because the answer depends on gaze direction, on distance and near vision, and on whether glasses change the picture. The orthoptist records the angle of the squint, the type of eye movement problem, and the vision in each eye, and that record is what the ophthalmologist uses to decide on treatment.

Treatment is the second half of the job. For a child with a lazy eye, treatment usually means patching the stronger eye so the weaker eye is forced to work, or glasses, or both, with regular follow-up to check progress. For double vision, treatment may mean prisms in glasses, exercises, or referral for surgery, depending on the cause. For adults after stroke or with neurological conditions, the orthoptist assesses how the eye movement problem affects daily life, from reading to walking safely, and works with the wider rehabilitation team. Children need a different approach again, with play-based testing, patience, and close work with parents, schools and health visitors. A child who will not sit still for a formal test can still be assessed well by an orthoptist who knows how to turn the test into a game.

There is also work that never appears in an appointment count. School vision screening, liaison with ophthalmology and optometry colleagues, referral letters, clinic lists, and the follow-up of children on patching treatment all take time. Orthoptic services carry long follow-up caseloads, because squint and lazy eye treatment runs over months and years rather than being settled in one visit. When you look at a post, ask about the balance between new assessments, follow-ups and specialist clinics, and about whether the service covers paediatric, adult or stroke work. The answer tells you more about the job than the salary alone.

One boundary worth knowing: orthoptists are not optometrists, although both work in eye care and both test vision. Optometrists test sight, prescribe glasses and contact lenses, and check eye health. Orthoptists specialise in eye movement and binocular vision. Ophthalmologists are doctors who diagnose and treat eye disease and carry out eye surgery. In a hospital eye service the three work side by side, and a patient may see all three in one visit, but they are different professions with different training and different pay structures.

Orthoptist, optometrist and ophthalmologist: the pay picture

The comparison matters because patients and applicants often confuse the three roles, and the pay follows the training route. Hospital optometrists in the NHS are also Agenda for Change staff, but community optometrists in high-street practice are usually employed or self-employed outside Agenda for Change, so their pay is set by the practice, not by a national scale. Ophthalmologists are doctors, outside Agenda for Change entirely, paid on medical scales that start far higher and carry a different structure. An orthoptist comparing offers should therefore compare like with like: an NHS orthoptist post against another NHS allied health profession post at the same band, not against a high-street optometry salary or a medical salary.

Within the NHS, the fairest comparison is with other small allied health professions at Bands 5 and 6. A Band 5 orthoptist, a Band 5 physiotherapist and a Band 5 podiatrist all start at £32,073 in 2026/27, because Agenda for Change pays the band, not the profession. The differences sit in the extras: unsocial hours, on-call, London weighting and the availability of Band 6 and Band 7 posts in the service. Orthoptic services are small, so senior posts are fewer than in nursing or physiotherapy, and progression to Band 6 may mean moving to a larger eye service or taking on a specialist caseload. For the wider allied health picture, see our guides to physiotherapist pay and podiatrist pay.

Unsocial hours and overtime

Most NHS orthoptists work daytime weekday hours, so unsocial-hours pay is a small part of the package. The exceptions are services that run Saturday clinics and evening appointments, and orthoptists who support urgent referrals, where local arrangements apply. Under Agenda for Change Section 2, Bands 4 to 9 receive time plus 30% for Saturdays and weekday nights (8pm to 6am) and time plus 60% for Sundays and bank holidays.

In hourly terms, that means a Band 5 orthoptist at entry earns £21.29 an hour for a Saturday or a weekday night hour and £26.21 an hour for a Sunday or bank holiday hour, against a plain-time rate of £16.38. At Band 5 top, the rates are £25.94 and £31.92 an hour. At Band 6 entry, they are £26.53 and £32.66 an hour, and at Band 6 top, £31.95 and £39.33. These enhancements apply only to hours actually worked in the unsocial windows, and they cannot be claimed for the same hours as overtime pay.

Overtime rules are straightforward at these bands. At Bands 5 and 6, overtime above 37.5 hours a week is paid at time and a half, and at double time on bank holidays. A Band 5 orthoptist at entry on £16.38 an hour therefore earns £24.57 an hour for weekday overtime, and a Band 6 orthoptist at top on £24.58 earns £36.87 an hour. Part-time orthoptists are paid at plain time for hours above their contracted hours up to 37.5, with overtime rates only above that threshold. For the full overtime and unsocial rules, see our guide to unsocial hours and overtime pay.

London weighting (HCAS)

Orthoptists in London trusts receive the High Cost Area Supplement on top of basic pay: 20% in inner London, 15% in outer London and 5% in the fringe zone, each subject to a minimum and a maximum. The inner London minimum is £5,794 and the maximum is £8,746. The outer London minimum is £4,870 and the maximum is £6,137. The fringe minimum is £1,346 and the maximum is £2,270.

Worked examples show how the zones work in practice. A Band 5 orthoptist at entry in inner London earns £32,073 + £6,414.60 = £38,487.60 a year, because 20% of £32,073 sits inside the cap. The same orthoptist in outer London would get 15% of £32,073, which is £4,810.95, but the outer London minimum is £4,870, so the supplement rises to the minimum and the total is £32,073 + £4,870 = £36,943. In the fringe zone, the same orthoptist earns £32,073 + £1,603.65 = £33,676.65. At Band 6 top, 20% of £48,117 would be £9,623.40, so the supplement is capped at £8,746 and the total is £48,117 + £8,746 = £56,863. For the full zone rules, see our London weighting (HCAS) guide.

Pension contributions

Orthoptists in the NHS Pension Scheme pay a tiered member contribution based on whole-time equivalent pensionable pay, and the employer contributes a further 23.7% of pensionable pay. The 2026/27 tiers used here are provisional, calculated from the published tier boundaries rather than yet published as final, so treat them as the best current guide and check your payslip against them.

The tier boundary explains the jump at Band 5 top: the 8.3% tier runs to £35,155, and the 9.8% tier runs from £35,156 to £52,778, so Band 5 intermediate at £34,592 still pays 8.3% while Band 5 top at £39,043 pays 9.8%. Employer contributions are substantial: at Band 6 top, the employer pays 23.7% of £48,117, which is £11,403.73 a year into the scheme. For the full tier table, see our guide to NHS pension contributions. Orthoptists are registered with the Health and Care Professions Council, and professional fees are tax-deductible where membership is required for the job; this guide quotes no specific fee amount. Therapists, including orthoptists, fall in the £125 a year flat-rate expense category for uniforms where the employer provides no laundry service or allowance, worth £25 at the basic tax rate or £50 at the higher rate.

Pay in Scotland, Wales and Northern Ireland

The figures above are the England rates. Scotland agreed a two-year deal with 3.75% from 1 April 2026 and a 36-hour week from April 2026, which changes the hourly maths and the overtime threshold for Scottish staff. Wales implemented 3.3% from 1 April 2026, with a Real Living Wage floor of £13.45 an hour applied to the lowest bands. Northern Ireland is the exception: the 3.3% award has been recommended but not yet implemented, so Northern Ireland staff should not budget on the new rates until implementation is confirmed. For the national pictures, see NHS Scotland pay, NHS Wales pay and NHS Northern Ireland pay. Annual leave follows the England Section 13 tiers of 27, 29 and 33 days plus 8 bank holidays by length of service; see our annual leave guide for the part-time pro rata rules.

Frequently asked questions

How much does an NHS orthoptist earn?

In 2026/27, NHS orthoptists in England typically earn £32,073 to £39,043 a year at Band 5, for a full-time 37.5-hour week under Agenda for Change. Specialist orthoptists, including those leading clinics and carrying complex caseloads, typically sit at Band 6, at £39,959 to £48,117 a year.

What band is an NHS orthoptist?

Most NHS orthoptist posts sit at Band 5 on qualification, for orthoptists assessing and treating eye movement and binocular vision problems in eye clinics. Specialist orthoptists, including those working in paediatric, stroke and neuro-ophthalmology services and those leading clinics, typically sit at Band 6. The band follows the scope, complexity and responsibility of the post, not the orthoptist's qualifications alone.

What does an NHS orthoptist do?

NHS orthoptists assess and treat problems with eye movement and binocular vision: squints, lazy eye (amblyopia), double vision and eye movement problems after stroke or neurological illness. Much of the work is clinic-based, with children and adults, and involves detailed eye movement testing, vision testing, patching and prism treatment, and close work with ophthalmologists, optometrists and orthoptic colleagues.

What is the hourly rate for an NHS orthoptist?

In 2026/27, the Band 5 hourly rates in England are £16.38 at entry, £17.67 at the intermediate step and £19.95 at top, for a 37.5-hour week. At Band 6, the hourly rates are £20.41 at entry, £21.54 at the intermediate step and £24.58 at top. Unsocial hours add 30% for Saturdays and weekday nights and 60% for Sundays and bank holidays.

Do NHS orthoptists get London weighting?

Yes. Orthoptists in London trusts receive the High Cost Area Supplement: 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 5 orthoptist at entry in inner London earns £32,073 + £6,414.60 = £38,487.60 a year; at Band 6 top, inner London pay is capped at £48,117 + £8,746 = £56,863.

What pension do NHS orthoptists pay?

Orthoptists in the NHS Pension Scheme pay a tiered member contribution based on whole-time equivalent pensionable pay. On the provisional 2026/27 tiers, Band 5 orthoptists pay 8.3% at entry and the intermediate step (£221.84 to £239.26 a month) and 9.8% at top (£318.85 a month). Band 6 orthoptists pay 9.8% at every step (£326.33 to £392.96 a month). The employer contributes a further 23.7% of pensionable pay.

Is an orthoptist the same as an optometrist?

No. Orthoptists specialise in eye movement and binocular vision: squints, lazy eye and double vision. Optometrists test sight, prescribe glasses and contact lenses, and check eye health. Ophthalmologists are doctors who diagnose and treat eye disease and carry out eye surgery. The three professions work together in eye services, but they are different jobs with different training and different pay structures.

Do NHS orthoptists work nights and weekends?

Most NHS orthoptists work daytime weekday hours in eye clinics. Some services run Saturday clinics and evening appointments, and some orthoptists support urgent referrals, where local arrangements apply. Where the Section 2 enhancements apply, Bands 5 and 6 receive time plus 30% for Saturdays and weekday nights and time plus 60% for Sundays and bank holidays.