NHS pay · four nations · 2026/27
NHS pay across the UK's four nations
Does NHS pay differ across the UK?
Yes — and by more than most people realise. All four nations use the same Agenda for Change band framework, but each negotiates its own pay deal. England and Wales share the same base pay points (Wales adds a 1.5% premium). Scotland pays more on a separate, higher scale with a two-year deal. Northern Ireland pays the least, and its deals can lag behind. Only England has London weighting.
Verified 12 August 2026
The headline: same band, different nation
Because Scotland and Northern Ireland run genuinely separate pay scales — not just a percentage tweak on England's — we show verified headline figures below and link you to each nation's official circular for the complete, current tables. We only publish numbers we can verify against a primary source; NHS pay is too important to guess.
🏴 England
The base Agenda for Change scale. Band 5 (nurse) runs £31,049–£37,796. Adds London weighting (5–20%) for staff in and around the capital.
2025/26 award: 3.6% · See every band
🏴 Wales
Uses the same base pay points as England, plus a 1.5% Welsh Government premium on all points. No London weighting. So a Band 5 nurse starts around £31,515 (vs £31,049 in England).
Illustrative Band 6 entry: £39,262 · Band 7 entry: £48,527
🏴 Scotland
A separate, higher scale — not England's numbers. Scottish staff received a higher award (4.4% for 2025/26) and have a confirmed two-year deal. From April 2026, Scotland moves to a 36-hour week with no loss of pay. No London weighting.
Scotland pays more at every band — a top-of-band Band 5 is several thousand pounds higher than England. For the full current scale, see the Scottish Government AfC circular.
🇬🇧 Northern Ireland
Also uses Agenda for Change, but on a lower scale, and pay deals have historically lagged behind the rest of the UK. A top-of-band Band 5 in NI is around £3,000 less than in England.
For the confirmed NI scale, see the DoH Northern Ireland pay circular.
Why the differences exist
Agenda for Change is a UK-wide framework — the same nine bands, the same progression logic, the same unsocial-hours structure. But pay itself is devolved: each nation's government negotiates its own annual award with the health unions. Over the past few years Scotland has consistently settled higher, which is why the gap has widened. The pension scheme rules and the unsocial-hours percentages are broadly consistent across nations, so the main difference you'll feel is in the basic pay points themselves.
Which figures we compute, and which we source
Our NHS calculator and per-band pages use the verified England Agenda for Change scale, because that's published by NHS Employers and covers the largest share of NHS staff. Wales tracks England plus the 1.5% premium. For Scotland and Northern Ireland, we link you to each nation's official circular rather than reproduce figures we can't verify to the penny — accuracy matters more than completeness. As the official Scotland and NI tables are confirmed, we'll fold them into the calculator directly.
Information, not financial advice. England figures: NHS Employers AfC pay circular 2025/26. Wales premium: Welsh Government AfC circular. Scotland and NI: see linked official sources. Verified 12 August 2026.