The landscape of National Health Service (NHS) pay for the 2026/27 financial year is currently a focal point for healthcare professionals across the United Kingdom.
As the independent pay review process moves forward, staff and unions are closely monitoring government evidence and economic forecasts.
Current Status of the 2026/27 Pay Award
The pay award process for the 2026/27 financial year, which begins on April 1, 2026, is currently in the evidence-gathering stage.
In late October 2025, the Department of Health and Social Care (DHSC) submitted its formal written evidence to the NHS Pay Review Body (NHSPRB).
This document serves as the government’s opening position and outlines the fiscal constraints within which the pay award must be decided.
Government Proposals and Affordability
The government has proposed a pay uplift of up to 2.5% for NHS staff in England for the 2026/27 round.
Ministers have emphasized that this award must be funded from within existing departmental budgets, with no additional treasury funding allocated specifically for pay.
The DHSC has stated that any recommendation from the NHSPRB that exceeds this 2.5% threshold would require “tough trade-offs” and could potentially impact frontline service delivery and the 10-year health plan.
Union Responses and Industrial Pressure
The 2.5% proposal has met with significant resistance from health unions, including UNISON and the Royal College of Nursing (RCN).
Labor representatives argue that a 2.5% increase is effectively a real-terms pay cut, especially when compared to private sector pay growth, which is currently averaging around 3%.
Unions are calling for an above-inflation settlement to address years of wage stagnation and to combat the ongoing recruitment and retention crisis.
Expected Timeline for Implementation
The government has expressed a commitment to a more timely process than in previous years to avoid the long delays seen in the 2024/25 and 2025/26 rounds.
| Milestone | Estimated Timing |
| Review Body Recommendations | Spring / Summer 2026 |
| Government Decision | Late Summer 2026 |
| Payroll Implementation | Autumn / Winter 2026 |
| Backdating Effective Date | April 1, 2026 |
If an agreement is reached by late summer, staff should see the new rates reflected in their pay packets by late 2026, with a lump sum to cover back pay from April.
Projected Pay Scales (Based on 2.5% Proposal)
If the government’s 2.5% proposal were implemented without change, the following base salaries for Agenda for Change (AfC) staff in England would be expected:
| Band | Current (2025/26) | Projected (2026/27) |
| Band 2 (Top) | £24,465 | £25,077 |
| Band 5 (Entry) | £31,049 | £31,825 |
| Band 5 (Top) | £37,796 | £38,741 |
| Band 6 (Top) | £46,580 | £47,745 |
| Band 7 (Top) | £54,710 | £56,078 |
Note: These figures are projections based on the government’s 2.5% submission and are subject to change following the independent review body’s final recommendations.
Variations Across the UK
The pay situation differs significantly in Scotland, where a multi-year deal is already in place.
NHS Scotland staff are guaranteed a minimum 3.75% increase for the 2026/27 year.
This deal also includes an “inflation guarantee,” which ensures that the pay rise remains at least one percentage point above CPI inflation, potentially leading to a higher final figure.
Minimum Wage and Reform
A major concern for the 2026/27 round is the National Living Wage.
Current projections suggest that without a meaningful uplift, the lowest pay points in Band 2 could fall dangerously close to, or even below, the legal minimum wage by April 2026.
Additionally, the government has tasked the NHS Staff Council with exploring structural reforms to the AfC framework, with changes potentially taking effect from April 2026
The final 2026/27 pay award will be determined by the interaction of several key variables.
- Inflation Trends: If CPI remains higher than projected, pressure for a larger award will increase.
- Private Sector Comparisons: Wide gaps between NHS and private sector raises exacerbate retention issues.
- Independent Recommendations: The NHSPRB may recommend a figure closer to 3% or 3.5%, challenging the government’s budget.
- Industrial Action: The possibility of strikes remains a factor if unions feel the final offer is insufficient.
While the government’s 2.5% proposal is the current baseline, history suggests that the final recommendation from the independent review body often falls slightly higher, usually between 3% and 4%.
