NHS Pay Rise 2027: What We Know So Far

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

By the NHS Bands Pay editorial team

What is confirmed

To be blunt about what is actually known as of 28 September 2026:

• The 2027/28 award has not been announced. No percentage, no flat-rate figure, no structure has been decided or published.
• The pay round process is under way. The annual cycle begins with written evidence from the Department of Health and Social Care, the devolved administrations, NHS trade unions, NHS Employers and other parties to the NHS Pay Review Body (NHSPRB). This evidence phase runs through autumn — for the 2026/27 round, DHSC published its evidence in October 2025, and the round launched two months earlier than the previous one.
• The award will be backdated to 1 April 2027 if one is agreed — that is the effective date of every annual Agenda for Change award.
• The current 2026/27 rates remain in force until any 2027/28 award is announced. Your pay does not change in the meantime: see the 2026/27 pay rise in full and our 2027/28 pay scales explainer for the baseline tables.

The 2027/28 pay round timeline

Based on how recent pay rounds have run, the expected milestones are:

Recent history shows the timetable can shift. The 2026/27 round was deliberately launched earlier to return to timely awards — the recommendation was announced on 12 February 2026 and paid on time in April, with no backpay in England and Wales. The 2025/26 and earlier rounds were announced months late, which is why backpay became a familiar feature of NHS payslips.

How the NHS pay rise is decided

The award is not a negotiation in the normal sense. It follows a fixed process:

1. Evidence. DHSC, NHS England, the Welsh Government, the Northern Ireland Executive, NHS trade unions (RCN, UNISON, Unite, CSP, RCM and others), NHS Employers and other interested parties submit written evidence to the NHSPRB.
2. Recommendation. The Review Body weighs the evidence — affordability, recruitment and retention, staff motivation, wider economic conditions — and publishes a report recommending an award.
3. Decision. The government decides whether to accept the recommendation, in whole or in part. Each nation's administration makes its own decision: the PRB's remit covers the UK, but Scotland, Wales and Northern Ireland choose their own approach.
4. Implementation. NHS Employers publishes the AfC pay circular with the new rates, payroll systems are updated, and trusts apply the uplift.

The PRB covers Agenda for Change staff — nurses, midwives, paramedics, healthcare assistants, admin, estates and most other non-medical NHS staff. Doctors and dentists are covered by a separate body, the DDRB. For the 2026/27 round the PRB published its 39th report; the 2027/28 report will be its 40th.

What happened last time (2026/27)

The 2026/27 award is the useful reference point for expectations:

• 3.3% consolidated uplift, effective 1 April 2026, recommended by the PRB and accepted in full by the government.
• Announced 12 February 2026 — earlier than recent rounds.
• Paid on time in April salaries in England and Wales, so there was no backpay.
• DHSC had planned for around 2.5% without affecting other commitments; the PRB recommended more, and the government funded it from departmental budgets with no additional funding for settlements.
• Union reaction was mixed — several unions described the award as below inflation at the time and a real-terms cut, while the government pointed to forecasts showing it above inflation.

The full detail, including what the 3.3% meant for every band, is on our 2026/27 pay rise page.

What is speculation

You will see percentage figures quoted for the 2027 award in news coverage and on social media. None of them is confirmed. Here is how to sort signal from noise:

• Union pay claims are opening positions in a negotiation, not predictions of the outcome. They are worth reading as statements of intent, not as forecasts.
• Government "affordability" figures in evidence submissions describe what DHSC believes is fundable — the PRB has recommended above those figures before (it did so in 2026/27).
• Inflation forecasts from the OBR and Bank of England shape the context but do not determine the award. The PRB weighs inflation alongside recruitment, retention and affordability.
• Any percentage you see before the PRB report is published (expected early 2027) is, by definition, not the award. We will not publish speculative percentages on this site.

One tool that is legitimate: knowing what each percentage point is worth on current scales, so you can value any figure you see quoted. These are straight arithmetic on the 2026/27 England rates — not predictions:

When will it reach your payslip?

The question staff actually ask: when will the pay rise be in my payslip?

If the award is announced on time (spring 2027, as in 2026/27), the uplift is applied to April 2027 pay and there is no backpay — your April salary simply arrives at the new rate, with the usual one-month payroll lag for any enhancements.

If the announcement is delayed past 1 April, the award is backdated to 1 April 2027 and the arrears are paid as a lump sum in a later month's salary. Backdated awards also trigger recalculations: maternity pay, sick pay and overtime paid during the backdated period are uplifted too, which is why delayed awards produce confusing payslips.

One thing a pay rise changes immediately is your NHS pension contribution tier if the uplift moves your whole-time-equivalent pensionable pay across a threshold — worth checking when the new rates land.

The four nations

The PRB's remit is UK-wide, but each administration decides its own award:

• England: the DHSC decision sets the headline award most coverage follows.
• Wales: has matched the England award in recent rounds (3.3% in 2026/27, paid on time) — see NHS Wales pay.
• Scotland: negotiates separately through the Scottish Government; the 2026/27 deal was 3.75% from 1 April 2026 with an inflation guarantee, alongside a 36-hour week — see NHS Scotland pay.
• Northern Ireland: the 2026/27 recommendation of 3.3% was still awaiting implementation at the time of writing, with industrial action balloting under way — see NHS Northern Ireland pay and our strike pay explainer.

Multi-year deal and AfC reform

Two longer-term stories could shape the 2027 round. First, structural reform of Agenda for Change is under discussion between the parties, including a review of Band 5 nursing roles — any structural changes would land alongside, not instead of, the annual award. Second, a multi-year pay deal covering 2027/28 and beyond has been raised as a possibility. Neither has been agreed or announced. If a multi-year deal emerges, it would change this timeline substantially — this page will be updated the moment anything is confirmed.

What to do while you wait

The months between the remit letter and the award announcement are when rumours do the most damage to household budgets. A few practical rules for the waiting period:

• Do not budget on a rumoured percentage. Until the government accepts the PRB recommendation, any figure in the press is speculation. The 2026/27 award was 3.3%, but each year's settlement reflects that year's evidence — not a pattern.
• Watch your April and May payslips, not the headlines. The award is effective from 1 April whether or not payroll has processed it; any delay is corrected through arrears, which appear as a separate back-pay line rather than a permanently higher monthly figure.
• Check your pay step date. If your increment falls between April and the award landing, your progression increase and the award arrears are calculated separately — do not assume a single uplift covers both (see NHS pay step dates).
• Keep this page bookmarked. It is updated at every milestone in the timeline above, so it will always reflect what is actually confirmed rather than what is merely reported.

Frequently asked questions

Has the NHS pay rise for 2027 been announced?

No. As of 28 September 2026 the 2027/28 award has not been announced, and no percentage has been decided. The pay round is in its evidence-gathering phase; the NHS Pay Review Body reports in early 2027 and the government announces the award in spring 2027, effective from 1 April 2027.

When will the NHS pay rise 2027 be in my payslip?

If the award is announced on time in spring 2027, it should be applied to April 2027 pay with no backpay — as happened in 2026/27. If the announcement is delayed, the uplift is usually backdated to 1 April and paid as arrears in a later month's salary.

Who decides the NHS pay rise?

The NHS Pay Review Body (NHSPRB) takes evidence from the government, unions, NHS Employers and others, then recommends an award. The government decides whether to accept the recommendation. Each UK nation then makes its own decision on implementation.

What was the NHS pay rise in 2026/27?

3.3% consolidated, effective 1 April 2026, recommended by the PRB's 39th report and accepted in full. It was announced on 12 February 2026 and paid on time in April salaries, so there was no backpay in England and Wales.

Could there be a multi-year NHS pay deal?

It has been discussed: structural reform of Agenda for Change is under negotiation and a multi-year deal covering 2027/28 and beyond is a possibility. Nothing has been agreed or announced — treat any figures attached to that idea as speculation until confirmed.

Does the pay rise apply to all NHS staff?

The PRB covers Agenda for Change staff (nurses, midwives, paramedics, admin, estates and most other non-medical staff). Doctors and dentists are covered by a separate body (DDRB). Each nation's government decides its own award, so Scotland, Wales and Northern Ireland can differ from England.

Will the 2027 pay rise include backpay?

Only if the announcement comes after 1 April 2027. The award is always backdated to 1 April, so a delayed announcement means arrears paid in a later month. An on-time announcement means the uplift appears in April pay with no backpay.

How can I stay updated on the 2027 pay award?

The milestones to watch are the PRB report (expected January to February 2027) and the government announcement (expected February to March 2027). This page is updated as each stage lands.

Sources and independence

Source: GOV.UK — DHSC evidence to the NHSPRB, pay round 2026/27.

Source: NHS Pay Review Body 39th Report 2026 (via the PDA).

Source: NHS Employers 2026/27 pay award.

NHS Bands Pay is an independent information website. It is not affiliated with, endorsed by, or acting on behalf of the National Health Service, the Department of Health and Social Care or the NHS Pay Review Body. This page deliberately contains no speculative percentages; it is updated when each stage of the pay round is confirmed.