Stroke Nurse Salary 2026/27

Last updated: 31 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Stroke nurse pay 2026/27: the Band 5 to Band 7 scales

England awarded Agenda for Change staff 3.3% from 1 April 2026, and the award was paid on time in April salaries. The scales below are the 2026/27 England scales for a full-time 37.5-hour week. Hourly rates are annual pay divided by 52.2 weeks and then by 37.5 hours, rounded to the nearest penny, and enhancement and overtime rates on this page are calculated from that rounded hourly rate. Monthly pay is annual pay divided by 12. Weekly pay is annual pay divided by 52.2. For the wider picture at each band, including the roles that share these scales, see the Band 5 salary guide, the Band 6 salary guide and the Band 7 salary guide.

The step structure tells the story of this ladder. Inside each band, the journey is worth £6,970 at Band 5, £8,158 at Band 6 and £7,128 at Band 7. Between bands, the steps are small: £916 from the top of Band 5 to the entry of Band 6, and £1,270 from the top of Band 6 to the entry of Band 7. A nurse who moves from Band 6 top to Band 7 entry gains just over £105 a month in basic pay, which surprises people who expect a promotion to transform their salary. The real gain at Band 7 is the higher ceiling, £56,515 against £48,117, and the different work: coordination, teaching, service development and the most complex patients. The full journey from Band 5 entry to Band 7 top is worth £24,442 a year in basic pay.

One point that trips up newcomers: the band follows the post, not the person and not the job title. A trust can advertise a Band 5 staff nurse post, a Band 6 senior nurse post and a Band 7 specialist nurse post in the same stroke service, with overlapping clinical duties, and pay them from different scales. The job evaluation behind each post decides the band, based on the knowledge, responsibility and effort the post demands. That is why this page quotes bands and steps rather than a single salary figure. Anyone comparing offers should ask for the band and the step, not just the headline annual figure, because the step alone can be worth £2,519 at Band 5, from £32,073 at entry to £34,592 at the intermediate step.

What a stroke nurse actually does

The stroke nurse looks after people whose brains have been injured by a sudden loss of blood supply or a bleed, and the work changes with the stage of care. On a hyper-acute stroke unit, the nurse cares for patients in the first hours and days after a stroke, when monitoring is constant, observations are frequent, and treatment changes fast. The nurse watches for changes in consciousness, speech, movement and swallowing, gives medicines on tight schedules, and escalates at once when a patient deteriorates, because in stroke care a change noticed early can change the outcome. On an acute stroke unit, the nurse cares for patients who are past the first emergency phase and now need careful rehabilitation, prevention of complications, and planning for the next stage of recovery. In a transient ischaemic attack clinic, the nurse assesses people who have had a brief warning event, helps arrange the investigations and prevention plan, and explains in plain words what happened and what to watch for.

Swallowing and communication sit at the centre of daily stroke nursing. Many stroke patients cannot swallow safely at first, and the nurse works with speech and language therapists to keep them safe: nil by mouth until assessed, careful positioning, and feeding plans that change as swallowing recovers. Many patients cannot speak clearly, or cannot understand speech as they used to, and the nurse learns to communicate slowly, with short sentences, gestures and picture boards, and to check understanding rather than assuming it. Families need the same care: a stroke arrives without warning, and relatives want to know what happened, what recovery might look like, and how they can help. A nurse who can explain a frightening diagnosis in plain words, without false promises and without jargon, is worth a great deal on a stroke unit.

Rehabilitation is the long half of the job, and it matters as much as the emergency work. After the first days, patients work on walking, washing, dressing, eating and speaking again, often with physiotherapists, occupational therapists and speech and language therapists alongside the nursing team. The nurse keeps the rehabilitation going between therapy sessions: encouraging a patient to practise standing, helping with the exercises the therapists set, and noticing small gains that the patient misses. Community and early supported discharge teams then carry the work into the home, visiting patients after discharge, checking progress, and catching problems before they become readmissions. A nurse applying for a stroke post should ask how the week splits between hyper-acute, acute, rehabilitation and clinic work, because two posts with the same band and the same title can feel like different jobs.

The emotional weight of the job deserves a plain statement. Stroke nurses meet people on the worst day of their lives, and sometimes the outcome is severe disability or death despite fast treatment and skilled care. They also meet people who recover well, who walk out of hospital and return to their families, and the rehabilitation work lets them see that recovery unfold over weeks. Nurses who last in the role tend to be people who stay calm when a monitor alarms, who can explain a frightening diagnosis in plain words, and who can write a note that the next clinician can act on at 3am. The closest neighbouring roles are the intensive care nurse, who cares for critically ill patients on a unit, the heart failure nurse, who specialises in one cardiac condition, and the respiratory nurse, who specialises in lung conditions and ventilation support.

Band 5 versus Band 6 versus Band 7: what actually changes

At Band 5, a stroke nurse carries a bay or a set of patients: observations, medicines, monitoring, documentation and escalation when a patient deteriorates. At Band 6, the nurse carries senior duties on top of the clinical caseload: coordinating the unit on a shift, taking charge when the ward manager is away, teaching Band 5 nurses and students, and looking after the sickest patients, including those fresh from hyper-acute care. At Band 7, the nurse carries specialist responsibility: coordinating the stroke pathway across the service, running clinics, teaching across the multidisciplinary team, auditing practice against national standards, and leading service development. The clinical skills overlap a great deal across the three bands, which is why the pay steps between them are only £916 and £1,270. What changes is accountability: when the unit is short-staffed, when two patients deteriorate at once, or when a junior nurse needs backing for a difficult escalation, the senior nurse is the person expected to hold it together.

That difference matters for anyone planning a move. A Band 5 nurse who loves bedside work and dislikes coordinating a unit may be happier staying at the top of Band 5, where the pay is £39,043 and the week is mostly clinical. A nurse who wants to run a shift, to teach, and to carry the argument for better staffing or safer monitoring on the unit, needs the Band 6 post, even though the first year of it pays only £916 more than the top of Band 5. The payoff comes later in the ladder: Band 7 tops out at £56,515, which is £17,472 above the top of Band 5, and the Band 7 nurse builds pension on that higher figure. For the full scales at each band, see the Band 5 salary guide, the Band 6 salary guide and the Band 7 salary guide, and for the wider specialist ladder, the clinical nurse specialist salary guide.

Experience also shapes where a nurse lands within a band. A nurse moving from a general medical ward into a first stroke post usually starts at Band 5 entry, £32,073, and moves through the steps as experience grows. A nurse with hyper-acute experience, a stroke course, or advanced life support training may be appointed higher in the band or straight into a Band 6 post. Thrombolysis competence is worth asking about in any job description: a nurse who can assess a patient for emergency stroke treatment, prepare and give the treatment, and monitor the patient through the highest-risk hours is more valuable to the service and more likely to land a Band 6 or Band 7 post. It does not automatically change the band, since the band follows the evaluated post, but it strengthens a senior application and it changes the daily work for the better.

Unsocial hours: the round-the-clock rota is where the money is

Hyper-acute stroke units run around the clock, and the rota is the single biggest influence on take-home pay after the band itself. A nurse on a rota with regular weekends and nights earns unsocial-hours enhancements on a large share of hours, while a nurse in a daytime-only clinic earns almost none. Agenda for Change Section 2 pays Bands 4 to 9 time plus 30% for Saturday and weekday night hours (8pm to 6am) and time plus 60% for Sunday and public-holiday hours. The table below applies those percentages to the rounded hourly rates from the scales above. For the full unsocial-hours rules, including overtime and time off in lieu, see the unsocial hours and overtime guide.

Worked example: a Band 7 stroke nurse at entry works a Saturday shift of 7.5 hours. Plain time for the shift would be £189.23 (7.5 hours at £25.23). At time plus 30%, the same shift pays £246.00 (7.5 hours at £32.80). The enhancement alone is worth £56.77 for that one shift. A nurse on a full seven-day rota will see a payslip well above the basic monthly figure, and a nurse whose post is mainly weekday daytime work will see a payslip close to it. That is why two nurses on the same band and step can take home different amounts, and why asking about the rota matters as much as asking about the band.

Overtime: time and a half, double on bank holidays

Overtime in Agenda for Change is paid at time and a half for hours above the standard week, and at double time for hours worked on a public holiday, subject to the usual conditions on the service. For a stroke nurse, overtime usually means staying past the end of a shift because a patient has deteriorated, covering a colleague's sickness absence, or working an extra shift when the unit is full. The hourly overtime rates below are calculated from the rounded plain-time rates.

Worked example: a Band 7 stroke nurse at the top works 4 extra hours in a week at time and a half. That is 4 hours at £43.31, or £173.24, against £115.48 at plain time, an extra £57.76 for the week. Overtime is not a reliable part of the salary, and services vary in how much they offer. A nurse budgeting on overtime every week is budgeting on something the service may withdraw, so the figures above are best read as the value of an occasional extra shift, not as a second salary.

Hyper-acute on-call: the figure this page does not quote

On-call is the one part of stroke nurse pay that cannot be quoted nationally, and this page does not pretend otherwise. Centres that run a round-the-clock hyper-acute service need a stroke team available overnight and at weekends, and their nurses take turns being on call. Some trusts pay an on-call availability payment for being contactable out of hours, plus a payment for each call-out. Others fold on-call into a rota allowance, and smaller centres may run a daytime-only service, with out-of-hours stroke patients transferred to a regional centre instead. The frequency matters as much as the rate: a centre that calls its team out several times a weekend pays very differently from a centre that calls once a month, even on the same availability payment. The only figure that counts for a specific post is the one in that trust's local terms. Ask for it in writing before accepting a post, along with the rota pattern, the expected call-out frequency, and how travel time for call-outs is treated. The on-call allowance guide covers the closest parallel rules, and the theatre nurse salary guide covers another role where emergency on-call works in a similar way.

London weighting: what HCAS adds

High Cost Area Supplement is paid on top of basic pay for staff working in London and the fringe zone. In 2026/27, inner London pays 20% of basic pay (minimum £5,794, maximum £8,746), outer London pays 15% (minimum £4,870, maximum £6,137) and the fringe zone pays 5% (minimum £1,346, maximum £2,270). The cap binds at the top of this ladder: a Band 7 nurse at the top in inner London receives the £8,746 maximum, not 20% of £56,515, for a total of £65,261, and the same nurse in outer London receives the £6,137 maximum, for a total of £62,652. For the full HCAS rules, see the London weighting guide.

The outer London minimum rarely binds at these bands, and the caps do the work instead. A Band 5 nurse at entry in outer London receives £4,870, which is the minimum, not 15% of the basic, for a total of £36,943. The same nurse in the fringe zone receives £1,603.65, which is 5% of the basic, above the £1,346 minimum, for a total of £33,676.65. At the top of the ladder the fringe cap binds: a Band 7 nurse at the top receives £2,270 in the fringe zone, not 5% of £56,515, for a total of £58,785. These small rules are the ones that catch people out when they estimate London pay from a percentage alone, so the table above gives totals, not just percentages.

Pension: what comes off the payslip

NHS pension contributions are the largest regular deduction after tax for most stroke nurses, and they are also the most valuable part of the package. Under the provisional 2026/27 England and Wales tiers, Band 5 nurses pay 8.3% at entry and the intermediate step, £221.84 and £239.26 a month, and 9.8% at the top, £318.85 a month. Band 6 nurses pay 9.8% at every step, from £326.33 a month at entry to £392.96 a month at the top, with £344.39 a month at the intermediate step. Band 7 nurses pay 10.7% at every step, from £440.37 a month at entry to £503.93 a month at the top, with £463.06 a month at the intermediate step. The employer contributes 23.7% on top of pensionable pay, which is £13,394.06 a year at the top of Band 7. The tiers are provisional, calculated from the published 2025/26 tiers, and have not yet been formally published, so a nurse should check the final tiers when they are confirmed. For the full tier table, see the pension contributions guide.

Pensionable pay is basic pay plus any pensionable allowances, and for most stroke nurses that means basic pay alone, since unsocial-hours enhancements and overtime are not pensionable. That distinction matters when comparing a stroke payslip with a ward payslip: a nurse who earns a lot of unsocial-hours money takes home more in the month, but builds pension on the basic only. The pension itself is a career average scheme, so each year's pensionable pay adds a slice to the retirement pension, and the slices from higher-band years are worth more than the slices from lower-band years. A nurse who spends the last years of a career at Band 7 retires on a pension built from those years at their full value, which is one reason the Band 7 ceiling matters beyond the monthly pay.

Part-time work, annual leave, mileage and uniform relief

Part-time pay in Agenda for Change is pro rata to the whole-time equivalent fraction. A Band 6 stroke nurse at entry on a 0.8 whole-time equivalent contract earns £31,967.20 a year, a Band 7 stroke nurse at entry on a 0.8 contract earns £39,509.60 a year, and a Band 7 stroke nurse at the top on a 0.6 contract earns £33,909 a year. Unsocial-hours percentages and HCAS apply to the pro rata basic in the same way as to a full-time basic, and pension contributions are calculated on the actual pensionable pay, not the whole-time equivalent figure. Stroke services often offer part-time posts, because rehabilitation clinics and follow-up sessions can be split, but the on-call commitment of a part-time hyper-acute post should be checked, since some services expect part-time nurses to take a full share of the rota.

Annual leave follows the Agenda for Change tiers: 27 days on joining, 29 days after five years of service and 33 days after ten years, plus eight bank holidays, with part-time leave calculated pro rata in hours. A nurse who works weekends will take some of those bank holidays as working days and receive the unsocial-hours enhancement instead, which is the standard trade in seven-day services. For the full leave rules, see the annual leave guide.

Mileage is occasional money for unit-based stroke nurses who travel between hospital sites, and regular money for community stroke nurses whose patch covers clinics and home visits. Under Agenda for Change Section 17, a car user is paid 59p a mile for the first 4,500 miles in a year and 36p a mile after that. A nurse driving 5,000 miles in a year receives £2,835, and a nurse driving 4,000 miles receives £2,360. Mileage is an expense reimbursement, not pay, and it is kept separate from salary in every example on this page. For the full rates and more worked examples, see the mileage rates guide. Nurses who wear a uniform can also claim flat-rate tax relief for laundry: £125 a year for nurses, worth £25 a year at the 20% tax rate and £50 a year at the 40% rate. It is a small sum, but it is claimed through the tax code and costs nothing to ask for.

Stroke nurse versus intensive care nurse: two different kinds of intensity

The stroke nurse and the intensive care nurse both work with critically ill patients, and newcomers often mix them up. The intensive care nurse cares for patients whose breathing, circulation or organs need machine support, on a unit where one nurse looks after one or two patients. The stroke nurse cares for patients whose brains have been injured, on a unit where one nurse looks after a bay, and where rehabilitation and communication matter as much as monitoring. Both need calm under pressure and sharp observation, but the stroke nurse spends more of the week on rehabilitation, swallowing, speech and family support, while the intensive care nurse spends more of the week on ventilation, infusions and invasive monitoring. The intensive care nurse salary guide covers that ladder in full, and its Band 5 to Band 7 shape will look familiar, since both ladders use the same Agenda for Change scales.

Pay differs between the two mainly through working pattern, not through basic pay. Both earn the same basic for the same band and step, and both earn the same HCAS for the same zone. The stroke nurse on a hyper-acute rota may earn on-call money that a daytime intensive care nurse never sees, while the intensive care nurse on a one-to-one rota earns unsocial-hours money on almost every night shift. A nurse choosing between the two should weigh the work honestly: stroke nursing offers a long rehabilitation relationship with patients and families, intensive care offers minute-by-minute critical care. The intensive care nurse salary guide gives the numbers for that comparison, and the respiratory nurse salary guide covers the closest neighbouring specialism.

Private-sector comparison, kept qualitative as it should be: private hospitals and clinics do employ nurses with stroke and rehabilitation skills, and their pay is set by the employer rather than by a national scale, so it varies by provider, region and role. Some private posts pay above the NHS basic for the same experience, and some pay below it once pension, leave and sick pay are counted. The NHS package at Band 5 to Band 7 includes the career average pension with a 23.7% employer contribution, Agenda for Change leave tiers, and nationally set unsocial-hours rates, which are hard to match post for post in a private contract. A nurse comparing an NHS stroke post with a private offer should compare the whole package, including pension and leave, not just the headline annual figure.

Scotland, Wales and Northern Ireland

Scotland has a 3.75% award from 1 April 2026 and a 36-hour week, which changes the hourly maths even where the annual figure looks close to England. The shorter week is worth real money in hourly terms, and it also changes the overtime threshold, since overtime in Scotland starts above 36 hours rather than 37.5. Scotland Band 5 pays £34,494 to £42,977, which is £18.36 to £22.87 an hour on the 36-hour week. Wales has a 3.3% award implemented 1 April 2026, and Wales Band 5 pays £32,557 at entry, £35,114 at the intermediate step and £39,631 at the top, which is £16.63, £17.94 and £20.25 an hour. Northern Ireland has a 3.3% recommendation for 2026/27 that has not been implemented, so no 2026/27 Northern Ireland figure is quoted here. No Scotland or Wales Band 6 or Band 7 salary figures are quoted on this page, because the data file does not hold them, and this page does not fill the gap by guessing.

The honest picture: what stroke nurse pay does and does not do

Stroke nurse pay is solid, transparent and nationally set, which is its strength. A nurse can look up the band scale, add the unsocial-hours percentage for the rota, add HCAS for London, and know the gross figure within a few pounds. There are no hidden bonuses and no negotiation over the basic: the scale is the scale. The ceiling is the weakness. Band 5 tops out at £39,043, and a nurse who wants more must move to Band 6, which means a unit to coordinate, not simply more years in the same job. Hyper-acute on-call pay, which can be a meaningful part of a stroke income in centres that run a round-the-clock service, is set locally and varies, so the national scales alone do not tell the whole story for this specialty. The job itself is the reason to take it: the chance to catch a deterioration early, to help a patient through a stroke and back to a fuller life, and to support families through the hardest weeks of their lives. The pay is fair for the band. The rota, the call-out frequency, and the split between hyper-acute, acute, rehabilitation and clinic work are what should decide the choice between two stroke posts at the same band.

Frequently asked questions

What band is a stroke nurse?

Most stroke nurses on acute stroke units sit at Band 5, senior stroke nurses and charge nurses sit at Band 6, and stroke nurse specialists, coordinators and advanced practitioners sit at Band 7. In England in 2026/27, Band 5 pays £32,073 at entry, £34,592 at the intermediate step and £39,043 at the top, Band 6 pays £39,959 at entry, £42,170 at the intermediate step and £48,117 at the top, and Band 7 pays £49,387 at entry, £51,932 at the intermediate step and £56,515 at the top. The band follows the post, not the job title, so one stroke service can employ a Band 5 staff nurse, a Band 6 senior nurse and a Band 7 specialist nurse on the same unit, with the specialist carrying coordination, teaching and the most complex patients.

How much does a stroke nurse earn a month?

In England in 2026/27, a Band 5 stroke nurse earns £2,672.75 a month at entry, £2,882.67 at the intermediate step and £3,253.58 at the top, before tax, National Insurance and pension deductions. A Band 6 stroke nurse earns £3,329.92 a month at entry, £3,514.17 at the intermediate step and £4,009.75 at the top. A Band 7 stroke nurse earns £4,115.58 a month at entry, £4,327.67 at the intermediate step and £4,709.58 at the top. Those are gross figures for a full-time 37.5-hour week, before any unsocial-hours enhancement, on-call payment or London weighting.

Do stroke nurses get unsocial-hours pay?

Yes, when the hours are worked. Agenda for Change Section 2 pays Bands 4 to 9 time plus 30% for Saturday and weekday night hours (8pm to 6am) and time plus 60% for Sunday and public-holiday hours. A Band 5 stroke nurse at entry earns £21.29 an hour on a Saturday or at night and £26.21 on a Sunday or bank holiday, against £16.38 plain time. At the top of Band 7, £28.87 an hour becomes £37.53 and £46.19. Hyper-acute stroke units run around the clock, so most stroke nurses earn these enhancements for a real share of their hours.

Do stroke nurses get on-call pay?

Stroke nurses on a hyper-acute rota often do, but there is no national on-call rate to quote. Some trusts pay an availability payment for being contactable out of hours plus a payment for each call-out, and others fold on-call into a rota allowance. The frequency matters as much as the rate: a centre that runs a round-the-clock hyper-acute service calls its nurses out far more often than a centre that runs a daytime-only service with overnight cover from another site. Ask for the local terms in writing before accepting a post, along with the rota pattern, the expected call-out frequency, and how travel time for call-outs is treated.

Do stroke nurses get London weighting?

Yes, in London. High Cost Area Supplement in 2026/27 is 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 stroke nurse at entry in inner London earns £38,487.60 in total, and a Band 7 stroke nurse at the top in inner London earns £65,261, because the 20% supplement is capped at £8,746. A Band 7 nurse at the top in outer London earns £62,652 in total.

What pension contribution does a stroke nurse pay?

Under the provisional 2026/27 England and Wales tiers, Band 5 stroke nurses pay 8.3% of pensionable pay at entry and the intermediate step, £221.84 and £239.26 a month, and 9.8% at the top, £318.85 a month. Band 6 stroke nurses pay 9.8% at every step, from £326.33 a month at entry to £392.96 a month at the top. Band 7 stroke nurses pay 10.7% at every step, from £440.37 a month at entry to £503.93 a month at the top. The employer contributes 23.7% on top, which is £13,394.06 a year at the top of Band 7. The 2026/27 member tiers are provisional, calculated from the published 2025/26 tiers, and have not yet been formally published.

Can a stroke nurse work part-time?

Yes. Part-time pay in Agenda for Change is pro rata to the whole-time equivalent fraction. A Band 6 stroke nurse at entry on a 0.8 whole-time equivalent contract earns £31,967.20 a year, and a Band 7 stroke nurse at the top on a 0.6 contract earns £33,909 a year. Unsocial-hours percentages and High Cost Area Supplement apply to the pro rata basic in the same way as to a full-time basic, and pension contributions are calculated on the actual pensionable pay, not the whole-time equivalent figure. The on-call share of a part-time hyper-acute post should be checked before accepting it, since some services expect part-time nurses to take a full share of the rota.

How does stroke nurse pay differ in Scotland, Wales and Northern Ireland?

Scotland has a 3.75% award from 1 April 2026 and a 36-hour week, which changes the hourly maths and the overtime threshold, since overtime in Scotland starts above 36 hours rather than 37.5. Scotland Band 5 pays £34,494 to £42,977, which is £18.36 to £22.87 an hour on the 36-hour week. Wales has a 3.3% award implemented 1 April 2026, and Wales Band 5 pays £32,557 at entry, £35,114 at the intermediate step and £39,631 at the top, which is £16.63, £17.94 and £20.25 an hour. Northern Ireland has a 3.3% recommendation for 2026/27 that has not been implemented, so no 2026/27 Northern Ireland figure is quoted here.