NHS Agenda for Change pay scales 2025-26: Band 5 to Band 7 explained

August 2026 update — The 2025-26 NHS Agenda for Change pay scales have been in force since April 2025, with all backdated arrears paid over the summer. Here is the definitive picture of what nurses, paramedics and midwives now earn — and what changes in 2026-27.

Agenda for Change (AfC) is the pay system that covers around 1.4 million NHS staff in England, excluding doctors, dentists and senior managers. It runs from Band 1 up to Band 9, with each band split into fixed pay points. The 2025-26 award applied a 3.6% uplift across every point, backdated to 1 April 2025.

The figures below are the England scales published by NHS Employers on 22 May 2025.

The mid-band picture: where most staff sit

Band 5 covers newly qualified registered nurses, midwives, paramedics, occupational therapists and other allied health professionals. For 2025-26 it runs from £31,049 (entry) to £37,796 (top of scale after four years).

Band 6 covers senior nurses, specialist practitioners and experienced paramedics. For 2025-26 it runs from £39,205 (entry) to £47,084 (top of scale).

Band 7 covers advanced nurse practitioners, ward managers, senior midwives and clinical specialists. For 2025-26 it runs from £47,810 (entry) to £54,710 (top of scale).

What this looks like for nurses

A typical newly qualified nurse starts on Band 5 at £31,049. After two years they progress to £33,617; after four years they reach the top of Band 5 at £37,796. Moving to Band 6 as a senior staff nurse or specialist adds roughly £1,400 in the first year and up to £9,000 at the top of the band.

Our UK nurse salary guide by region for 2026 shows how these headline figures interact with London weighting, high-cost area supplements and specialty premia across every English region.

What this looks like for paramedics

Newly qualified paramedics also start on Band 5 at £31,049 following the 2021 uplift decision. Progression is typically fast for paramedics — most reach Band 6 as an emergency medical technician team lead within three to five years.

Our UK paramedic salary guide by region for 2026 covers how ambulance trust structures affect base pay and unsocial hours enhancements.

What this looks like for midwives

Newly qualified midwives sit on Band 5 at £31,049. Most midwives progress to Band 6 within two to three years, and to Band 7 as an experienced practitioner, consultant midwife or team lead. Our UK midwife salary guide by region for 2026 has region-by-region ranges including maternity unit uplifts.

Unsocial hours: often overlooked

Base pay is only part of the AfC picture. Night, weekend and Bank Holiday shifts attract percentage-based uplifts under Section 2 of the AfC handbook. For Band 5 staff, weekend and night shift enhancements can add £3,000 to £6,000 in gross annual earnings depending on rota pattern — a material addition that headline scale figures do not capture.

What changes in 2026-27

The 2026-27 pay scales were published on 12 February 2026 and take effect from 1 April 2026. Under the new scales, Band 5 runs £32,073 to £39,043, and Band 7 runs £49,387 to £56,515. If you are reading this after April 2026 and your payslip is on the new scale, use these figures rather than the 2025-26 ones.

Methodology and source

All pay-point figures in this article are drawn from NHS Employers, Pay scales 2025/26 (published 22 May 2025), and the Department of Health and Social Care announcement NHS Pay Award 2025 to 2026: Agenda for Change staff (27 May 2025). Scale points are for England only; Scotland, Wales and Northern Ireland operate separate AfC arrangements. Data is used under the Open Government Licence v3.0.