NHS Pay Scales by Country 2026/27: England, Scotland, Wales and Northern Ireland Compared

Last updated: 29 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Agenda for Change is a UK-wide framework, but pay itself is devolved. Each nation takes the Pay Review Body recommendation and puts it into practice through its own government, its own pay circular and, in Scotland, its own working week. The result is four pay stories from one framework, and the differences are large enough to change a job decision. This page puts the verified 2026/27 figures side by side so staff can see exactly where their nation stands, and where it does not.

Read the tables with one caution in mind. A headline percentage is not a payslip. Scotland pairs a higher percentage with fewer hours, which lifts hourly pay twice over. Wales pairs the same percentage as England with a wage floor, which helps the lowest bands most. Northern Ireland pairs a recommendation with no implementation date, which means the percentage is worth nothing until it lands. The sections below separate those effects instead of blending them into a single ranking.

The 2026/27 awards at a glance

England and Wales moved first and cleanest. Both awards took effect on 1 April 2026 and were paid on time in April salaries, so staff in those nations saw no backpay lump sums and no arrears to budget around. Scotland agreed a two-year deal a year earlier, which set the pattern for 2026/27 in advance. Northern Ireland is the outlier: the recommendation exists, the money does not, and the delay itself has become the story, with a Royal College of Nursing ballot over pay running through the autumn.

Scotland deserves a closer look because its deal runs over two years. The 2025/26 rise was 4.4%, including an inflation-guarantee uplift, and the 2026/27 rise is 3.75%. Both years carry the same guarantee: rises at least one percentage point above average calendar-year CPI, with a check in early 2027 for the 2026/27 figure. That guarantee is why Scotland can sit ahead of England two years running, and why the early 2027 check is the date Scottish staff should watch next.

For the nation-by-nation detail behind this comparison, see the NHS Scotland pay guide, the NHS Wales pay guide and the NHS Northern Ireland pay guide, and the Agenda for Change explainer for how the framework itself works.

Band 5 compared: the clearest single comparison

Band 5 is the biggest Agenda for Change workforce and the band where the nation gap is easiest to measure, because verified step figures exist for all three nations that have implemented their awards. England pays £32,073 at entry, £34,592 at the intermediate step and £39,043 at the top. Wales pays £32,557, £35,114 and £39,631. Scotland pays £34,494 at entry and £42,977 at the top. The Scotland intermediate step is not quoted here because the verified figures used on this page give the Scotland entry and top figures only; the full Scotland scale is in the Scotland pay guide.

The chart above plots the entry step only, because that is the figure every nation has published in the verified set. Northern Ireland is left out of the chart on purpose: with no implemented award, there is no 2026/27 Northern Ireland figure to plot, and plotting the recommended figure would mislead.

In cash terms, Wales sits £484 a year ahead of England at Band 5 entry, £522 ahead at the intermediate step and £588 ahead at the top. Month by month, that is £40.33, £43.50 and £49.00. Scotland sits further ahead: £2,421 a year ahead of England at entry and £3,934 ahead at the top, or £201.75 and £327.83 a month. A Band 5 nurse weighing England against Wales is therefore choosing between a small but real annual difference, while a nurse weighing England against Scotland is choosing between two different pay levels altogether.

Hourly pay widens the Scotland gap further. England works a 37.5-hour week, so Band 5 entry works out at £16.38 an hour and the top at £19.95 an hour. Scotland works a 36-hour week, so Band 5 entry works out at £18.36 an hour and the top at £22.87 an hour. The hourly gap at entry is £1.98 an hour, larger than the annual figures alone suggest, because the Scottish salary is spread over fewer hours. For a newly qualified nurse comparing first posts, the hourly figure is the honest comparator: it is what each hour of work is actually worth.

Band 5 is also the band where the full England scale is worth seeing in context. The Band 5 salary guide carries the step-by-step picture, and the 2026/27 pay rise guide tells the announcement story behind the England and Wales awards.

Band 2 compared: where Wales closes the gap

At the bottom of the scale the story flips. Wales, not Scotland, is the nation to watch, because the Welsh living-wage floor does its work exactly where pay is lowest. England pays a Band 2 spot rate of £25,272. Wales pays £26,300, which is £1,028 a year more, or £85.67 a month. For a healthcare assistant or porter at the bottom of the scale, that monthly difference covers a real bill, and it comes from a deliberate policy choice rather than from the headline percentage: both nations awarded 3.3%, but Wales applied a £13.45 an hour floor to the bottom of its scale on top of it.

Scotland Band 2 is not quoted in this comparison because the verified figures used on this page give a Scotland Band 5 example only, not a full Scotland scale. Northern Ireland Band 2 is not quoted either, because no implemented 2026/27 figure exists. Readers who need those numbers should use the nation guides, which carry the fuller scales, and treat any Band 2 figure for Northern Ireland as unconfirmed until the award is implemented.

The Band 2 comparison also shows why a single headline percentage hides the real story. England and Wales both awarded 3.3%, yet a Band 2 worker in Wales earns £1,028 a year more than the same worker in England, while a Band 5 worker in Wales earns only £484 more at entry. The floor lifts the bottom by more than the percentage lifts the middle. Staff at the lowest bands should therefore look at the cash figure for their own band, not at the percentage in the press release. The Band 2 salary guide carries the England picture in full.

The working week: 36 hours changes the maths

Scotland moved to a 36-hour full-time week in April 2026 with no cut to annual salaries. England kept the 37.5-hour week. That single change ripples through every calculation that uses hours. A full-time year is 1,879.2 hours in Scotland against 1,957.5 hours in England, a difference of 78.3 hours a year, or roughly two working weeks. A Scottish nurse is therefore paid more per hour and works fewer hours for it, which is why the Scotland hourly figures in the Band 5 section sit so far above the England figures.

Part-time maths changes with the week too. A 0.6 whole-time equivalent post is 21.6 hours a week in Scotland against 22.5 hours in England. A 0.8 post is 28.8 hours in Scotland against 30 hours in England. Staff moving nations on a part-time contract should recheck their contracted hours, not just their salary, because the same fraction buys a different week in each nation.

The overtime threshold moved with the week in Scotland: hours above 36 a week now count as overtime there, where the threshold was previously 37.5 hours. This page quotes no Scotland overtime premium rates, because the verified figures used here state the threshold change without a Scotland-specific premium table. For England, the position is clear from Agenda for Change Section 3: overtime means hours above 37.5 a week, Bands 1 to 7 are paid at time and a half with double time on bank and public holidays, Bands 8 and 9 get time off in lieu instead of overtime pay, and overtime and unsocial-hours enhancement cannot both be claimed for the same hours. The unsocial hours and overtime guide works through the England rules in full.

Pension: the same scheme family, different tiers

England and Wales share pension contribution tiers, so a move between those two nations does not change the tier structure, only the salary the tiers apply to. The published 2025/26 tiers run from 5.2% on pay up to £13,259 to 12.5% on pay above £65,191. The 2026/27 tiers are provisional, calculated from those thresholds, and run from 5.2% up to £13,259 to 12.5% above £67,669, with the middle bands at 6.5% to £28,854, 8.3% to £35,155, 9.8% to £52,778 and 10.7% to £67,668. The employer adds 23.7% on top in England and Wales. Treat the provisional thresholds as the best current estimate, not final published rates.

Scotland runs a different structure with nine tiers from 5.7% to 12.7% of pensionable pay. The tier thresholds for Scotland are not part of the verified figures used on this page, so this comparison quotes no monthly Scotland pension example and no Scotland take-home figure. That gap matters for anyone comparing net pay across the border: gross Scotland salaries look higher, and they are, but the pension deduction that comes off them follows a different tier table, and income tax in Scotland follows Scottish bands. Compare take-home, not just gross, before deciding a move. The pension contributions guide carries the England and Wales tiers in full.

Annual leave: England first, Wales reported, Scotland not covered here

England annual leave under Agenda for Change Section 13 runs at 27 days on appointment, 29 days after five years of service and 33 days after ten years, plus 8 bank holidays in each case, with part-time staff receiving the same entitlement pro rata. Those tiers are the verified figures used on this page, and they are the baseline most readers will recognise from their own contracts.

Wales is reported to grant one extra day at each tier: 28 days on appointment, 30 after five years and 34 after ten years, plus 8 bank holidays. That extra day is reported, not verified in the figures used here, so Welsh staff should confirm their exact entitlement with their health board rather than treating it as settled. Scotland leave tiers are not covered in this comparison at all, because the verified figures used here hold the England tiers only. The annual leave guide covers the England entitlement in detail, including part-time pro rata maths.

London weighting: an England figure, not a four-nation one

High Cost Area Supplement is the London weighting on the England scale, and it is worth stating plainly because London posts attract staff from every nation. Inner London pays 20% of basic pay, between a minimum of £5,794 and a maximum of £8,746. Outer London pays 15%, between £4,870 and £6,137. The fringe zone pays 5%, between £1,346 and £2,270. A Band 5 nurse at entry in inner London therefore adds £6,414.60 to the £32,073 basic, since 20% of £32,073 sits inside the inner range and neither the minimum nor the maximum binds.

Those supplement figures belong to the England London scale. They are not part of the devolved-nation comparisons on this page, and staff in Scotland, Wales or Northern Ireland should not add them to a devolved salary. The caps also bite as salaries rise: at higher bands the flat maximum replaces the percentage, which is why senior London staff gain less in percentage terms than junior staff. The London weighting guide works through the caps band by band.

Doctors and dentists sit outside this comparison

Medical and dental pay is not Agenda for Change pay, and it follows a different set of awards, so it is kept separate here rather than folded into the band tables. Doctors and dentists received a 3.5% DDRB award announced on 25 March 2026 and effective from 1 April 2026. Consultant basic pay in England runs from £113,565 at threshold 1 to £150,569 at threshold 4. The consultant ranges quoted for the devolved nations run from £115,331 to £153,247 in Scotland and from £114,099 to £166,585 in Wales. Full-time consultant work is 10 programmed activities, with each extra activity worth roughly a tenth of basic pay. Readers who need medical pay in full should use the doctor pay scales hub, which ties the medical pages together.

Moving between nations: what actually changes

A move across the border changes more than the salary line, and the checklist below is the honest way to compare two offers. First, the scale itself: your new employer pays its own national scale, so the same band can mean a different annual figure. Second, the week: Scotland works 36 hours, England 37.5, and part-time fractions follow the local week. Third, pension tiers: England and Wales share a tier structure, Scotland does not. Fourth, leave: England tiers are verified here, Wales is reported to add a day per tier, and Scotland tiers need checking locally. Fifth, tax: Scotland sets its own income tax bands, so gross comparisons overstate or understate the real difference depending on salary. Sixth, supplements: London weighting is an England London figure and does not travel with you to a devolved post.

None of that means one nation is right for everyone. A Band 5 nurse chasing the highest hourly rate will look hard at Scotland. A Band 2 worker chasing the highest monthly cash will look hard at Wales. A worker with family ties or a training post in one nation will weigh those against a pay gap that, at Band 5, runs to a few hundred pounds a month at most. The point of this page is to put the verified numbers in front of that decision, not to make it.

What to watch next

Three dates matter after this page is published. Early 2027 brings the Scotland inflation-guarantee check, which will confirm whether the 3.75% figure for 2026/27 stands or needs an uplift. Any month could bring Northern Ireland implementation, which would turn the 3.3% recommendation into paid salaries with arrears backdated to 1 April. And the next pay round will reopen the whole comparison, with structural reform talks and a possible multi-year deal on the table. This page will be updated when any of those land, and the nation guides carry the latest position in the meantime.

Frequently asked questions

Which UK nation pays Band 5 nurses the most in 2026/27?

Scotland, on the verified figures used on this page. A Band 5 nurse in Scotland earns £34,494 at entry and £42,977 at the top of the band, against £32,073 and £39,043 in England and £32,557 and £39,631 in Wales. Scotland also works a 36-hour week, so the hourly gap is wider still: £18.36 an hour at entry and £22.87 at the top in Scotland, against £16.38 and £19.95 in England. Northern Ireland cannot be ranked here because its 3.3% recommendation had not been implemented as of late August 2026.

Why is NHS pay different in Scotland, Wales and Northern Ireland?

Agenda for Change is a UK-wide framework, but pay awards are devolved. Each nation takes the Pay Review Body recommendation and implements it through its own government and its own pay circular, so the percentage, the timing and the working week can all differ. Scotland negotiated a two-year deal with its own scale and a 36-hour week. Wales applied the same 3.3% headline as England but added a Real Living Wage floor at the bottom of its scale. Northern Ireland received the same 3.3% recommendation but had not implemented it as of late August 2026.

Has Northern Ireland had the 2026/27 NHS pay rise?

No, not as of late August 2026. The NHS Pay Review Body recommended 3.3%, but the Department of Health in Northern Ireland had not implemented it, so staff there remained on the previous scale. Do not budget on the 3.3% until implementation is confirmed, and check the Northern Ireland pay guide for the latest position. If the award lands, standard practice is for it to be backdated to 1 April, with arrears paid as a lump sum.

How does the Scotland 36-hour week change pay?

Annual salaries in Scotland were not cut when the week shortened, so the same annual pay now buys fewer hours: 1,879.2 hours a year on a 36-hour week against 1,957.5 hours on a 37.5-hour week, a difference of 78.3 hours a year. That lifts the hourly rate at every step. It also moves the overtime threshold: hours above 36 a week now count as overtime in Scotland, where the threshold was previously 37.5 hours. Part-time hours change too: 0.6 whole-time equivalent is 21.6 hours a week in Scotland against 22.5 hours in England.

Is Band 2 pay higher in Wales than in England?

Yes. Wales lifted its Band 2 spot rate to £26,300 under the £13.45 an hour Real Living Wage floor, which is £1,028 a year more than the £25,272 spot rate in England, or £85.67 a month. The floor applies to the bottom of the Welsh scale, so the Welsh advantage is largest at the lowest bands and narrows higher up: at Band 5 the Welsh lead over England is £484 a year at entry, £522 at the intermediate step and £588 at the top.

Does London weighting apply in Scotland, Wales and Northern Ireland?

The High Cost Area Supplement figures on this page are the London supplement quoted for England: 20% of basic pay in inner London, 15% in outer London and 5% in the fringe zone, each with a minimum and a maximum. They are not part of the devolved-nation comparisons on this page. If you work in Scotland, Wales or Northern Ireland, your employer will confirm what, if anything, applies locally, and the nation guides linked from this page give the local position.

Do NHS pension contributions differ by nation?

England and Wales share the same contribution tiers: six tiers from 5.2% to 12.5% of pensionable pay, with the 2026/27 thresholds provisional and calculated from the published 2025/26 thresholds. The employer adds 23.7% on top in England and Wales. Scotland runs a different structure with nine tiers from 5.7% to 12.7%, and the tier thresholds for Scotland are not part of the verified figures used on this page, so no monthly Scotland pension example is quoted here.

If I move from England to Scotland, does my salary change?

Your band usually transfers within Agenda for Change, but your pay follows your new employer's scale, hours and terms. Moving to Scotland in 2026/27 means the Scottish scale, a 36-hour full-time week and Scottish pension tiers, while moving to Wales means the Welsh scale with its living-wage floor at the bottom. Take-home also depends on income tax, and Scotland sets its own income tax bands, so compare net pay, not just the headline salary, before accepting a move. Check the new contract and confirm the step you will start on, since starting steps are not automatic.

Sources

• NHS Employers pay award 2026 (Agenda for Change pay circular 2026/27)
• NHS Pay Review Body 39th Report 2026, accepted in full
• NHS Employers unsocial hours payments guidance (Agenda for Change Section 2)
• Agenda for Change Terms and Conditions Handbook, Sections 2, 3 and 13