NHS Sick Pay 2026/27: Entitlement by Length of Service
Last updated: 26 September 2026 · Figures verified against the Agenda for Change handbook (Section 14) for the 2026/27 pay year.
How NHS sick pay works
Unlike statutory minimums, the NHS occupational sick pay scheme is generous: it pays your full salary for an initial period, then half salary, with the length of each period growing with your continuous NHS service. Entitlement is measured over a rolling 12-month period — the 12 months immediately before your absence begins.
| Continuous NHS service | Full pay | Half pay |
|---|---|---|
| Less than 1 year | 1 month | 2 months |
| 1 to 2 years | 2 months | 2 months |
| 2 to 3 years | 4 months | 4 months |
| 3 to 5 years | 5 months | 5 months |
| Over 5 years | 6 months | 6 months |
The maximum is therefore 6 months at full pay followed by 6 months at half pay — a full year of supported absence for staff with over five years' service. (For year 3, some trust documents show a 4+5 variant; the AfC handbook table above is the national position, but check your trust's policy to be certain.)
Worked example: 3 years' service on Band 4
Take a healthcare worker at the top of Band 4: £31,157 a year (England, 2026/27 rates), with 3 years' continuous NHS service. That gives 4 months at full pay plus 4 months at half pay.
- Monthly full pay: £31,157 ÷ 12 = £2,596.42
- 4 months at full pay: 4 × £2,596.42 = £10,385.67
- Monthly half pay: £2,596.42 ÷ 2 = £1,298.21
- 4 months at half pay: 4 × £1,298.21 = £5,192.83
Total occupational sick pay across the 8-month absence: £15,578.50. Statutory Sick Pay is included in these figures, not paid on top — your trust offsets any SSP against the occupational amount. Part-time staff receive the same structure pro rata to their contracted hours.
The rolling 12-month rule, explained
"Rolling 12 months" is the part most people misunderstand. It does not mean you get a fresh entitlement every calendar year. Instead:
- Take the date your current absence starts.
- Look back 12 months from that date.
- Any occupational sick pay already paid in that window is deducted from your entitlement.
Example: with 5+ years' service (6+6 entitlement), if you had 2 months at full pay six months ago, a new absence today gives you 4 months at full pay, then 6 months at half pay. Once 12 months have passed since the earlier absence, that entitlement "rolls" back into availability.
Statutory Sick Pay and fit notes
- Self-certification: you can self-certify sickness for the first 7 calendar days (SC2 form or your trust's own form).
- Fit notes: from day 8 you need a fit note (formerly sick note) from your GP or other healthcare professional, and you must keep them current throughout the absence.
- SSP is payable from the 4th day of absence for up to 28 weeks at the statutory weekly rate (check GOV.UK for the current figure), provided your earnings are above the lower earnings limit. It is included within — not added to — your occupational pay.
- Reporting: follow your trust's reporting procedure (usually notifying your manager before your shift starts). Failure to report correctly can delay or affect pay, so know your local policy.
What counts as reckonable service
Entitlement is based on continuous NHS service, which means:
- Service with any NHS employer counts — moving between trusts does not reset your entitlement, as long as employment is continuous.
- Previous NHS service generally counts even after a break, but long breaks can affect reckonable service — ask HR to confirm your reckonable service date.
- Bank or agency shifts do not normally build reckonable service in the same way as substantive employment.
Long-term sickness and injury at work
For extended absences, trusts will typically involve occupational health, agree a return-to-work plan, and may consider reasonable adjustments or phased returns. Long-term absence can eventually lead to a capability (ill-health) process, so keep in touch with your manager and seek advice from your union representative early.
Injury at work is treated separately under Section 22 of the handbook (injury allowance), which can top up sick pay where absence results from a work-related injury or disease. This is distinct from the Section 14 table above — ask HR whether your circumstances qualify.
Common pitfalls
- Treating entitlement as annual. It is a rolling 12 months, not a calendar-year reset — earlier absence in the window reduces what remains.
- Assuming a trust move resets service. Continuous NHS service transfers with you between NHS employers.
- Late fit notes. Gaps in certification can interrupt pay; submit each fit note before the previous one expires.
- Forgetting SSP is included. Your half-pay figure already contains SSP — do not expect it on top.
- Part-time confusion. Periods are the same length but pay is pro rata to contracted hours.
- Not reporting properly. Know your trust's first-day reporting rule; repeated failures can be treated as unauthorised absence.
Frequently asked questions
How much sick pay do I get on the NHS?
It depends on continuous NHS service: under 1 year 1 month full + 2 months half pay; 1–2 years 2+2; 2–3 years 4+4; 3–5 years 5+5; over 5 years 6 months full + 6 months half — all within a rolling 12-month period.
How is the rolling 12-month period calculated?
Count back 12 months from the first day of your current absence. Any occupational sick pay already received in that window is deducted from your entitlement for the new absence.
Does Statutory Sick Pay come on top of NHS sick pay?
No. SSP is included within your occupational sick pay figures — your trust offsets it, so the headline full/half pay amounts are what you receive in total.
How long can I self-certify sickness?
7 calendar days. From day 8 you need a fit note, and you must keep certification continuous for the whole absence.
Does moving to another NHS trust reset my sick pay entitlement?
No. Continuous NHS service counts across NHS employers, so your reckonable service — and therefore your entitlement band — moves with you.
What happens if I am injured at work?
Work-related injury or disease may qualify for injury allowance under Section 22 of the Agenda for Change handbook, which is separate from standard sick pay. Speak to HR about eligibility.
Can I be dismissed for long-term sickness absence?
Possibly, through a formal capability (ill-health) process — but only after occupational health involvement, reasonable adjustments and proper procedure. Get union advice at the earliest stage.
Sources
- NHS Terms and Conditions of Service Handbook (Agenda for Change), Section 14 (sickness absence) and Section 22 (injury allowance) — via NHS Employers, nhsemployers.org
- GOV.UK — Statutory Sick Pay, gov.uk/statutory-sick-pay
- RCN — Sickness absence advice, rcn.org.uk
This is an independent guide published by NHS Bands Pay. It is not affiliated with the NHS, NHS Employers or NHSBSA, and it is not financial or legal advice. Figures were verified against the Agenda for Change handbook on 26 September 2026. Trust policies add local detail on reporting and certification, so confirm your individual position with your trust's HR team or your union representative.