The UK government has confirmed a 3.3% NHS pay rise for 2026/27, starting from April. The increase will apply to more than 1.4 million NHS workers under the Agenda for Change (AfC) contract in England, Wales, and Northern Ireland. Ministers say the award is above the official inflation forecast, but health unions argue it still falls short of real living costs.
This guide explains who qualifies, when payments start, what unions are saying, and how the NHS pay rise 2026 affects nurses and other health workers.
What Is the NHS Pay Rise for 2026?
The government accepted in full the recommendation from the NHS Pay Review Body and approved a 3.3% salary increase for most NHS staff on Agenda for Change contracts.
According to Health and Social Care Secretary Wes Streeting:
- The rise takes effect from April 2026
- It will appear in pay packets from April for the first time in six years
- It is based on a pay review process submitted earlier than in previous years
- It is described by government as a real-terms pay rise based on inflation forecasts
The Office for Budget Responsibility forecast inflation at 2.2% for 2026–27, which is lower than the 3.3% award. However, the most recent recorded inflation figure was 3.4%, which unions use to argue the rise is below real cost increases.
Who Will Get the 3.3% NHS Pay Increase?
The pay rise applies to staff on Agenda for Change contracts, including:
- NHS nurses
- Healthcare assistants
- Allied health professionals
- Ambulance staff
- Porters and support staff
- Occupational therapists
- Many hospital-based clinical and non-clinical workers
It covers staff in:
- England
- Wales
- Northern Ireland
Separate pay arrangements apply in Scotland.
Will All Nurses Receive the NHS Pay Rise?
Not all nurses will automatically receive this increase.
Covered:
- NHS nurses employed under Agenda for Change contracts in hospitals and community services
Not automatically covered:
- Many general practice (GP) nurses
- Practice nurses employed directly by GP surgeries
- Some salaried primary care staff
GP and dental pay is decided through a different body, the Doctors’ and Dentists’ Review Body (DDRB). Its 2026/27 report has not yet been published.
This difference has caused concern among primary care nurses who say exclusion could hurt recruitment and retention.
Agenda for Change Pay Structure Reforms
Alongside the 3.3% increase, the government says it will work with unions on funded reforms to the Agenda for Change pay structure.
Officials say:
- Talks will continue on pay band reform
- There may be extra increases for some bands
- Any agreed structural changes will be backdated to April 2026
- Funding for reforms will be provided separately
Key focus areas include:
- Low-paid staff
- Graduate professional pay bands
- Band 5 nurse career progression
- Possible multi-year pay arrangements
However, unions say there is still not enough detail.
Government Position on the 2026 NHS Pay Award
Wes Streeting says the earlier decision process means staff will receive their increase on time. He said delayed pay awards in past years created hardship and uncertainty.
Government points include:
- Pay award delivered earlier than previous years
- Recommendation accepted in full
- Award described as above affordability limits
- Commitment to making the NHS a stronger employer
Ministers say faster pay decisions are part of wider NHS workforce reform plans.
Union Reaction to the NHS Pay Rise 2026
Major health unions strongly criticized the 3.3% award.
UNISON Response
UNISON says NHS staff will be “downright angry” and calls the award below inflation in real terms. Key concerns include:
- Living costs rising faster than pay
- Lowest paid workers gaining little real benefit
- Part of the increase being absorbed by minimum wage adjustments
- Long-promised pay structure reform still not delivered
- Continued use of the pay review body instead of direct negotiations
UNISON argues that NHS wage value has been eroded over the past decade and needs restoration, not small uplifts.
Royal College of Nursing (RCN) Response
The RCN described the award as “an insult.”
The union warns:
- If inflation stays high, this becomes a real pay cut
- Nursing morale is already at historic lows
- Poor pay and conditions are pushing nurses out of the NHS
- The union will compare this award with other public sector settlements before deciding next steps
Impact on Lower-Paid NHS Workers
Union leaders say many workers at the bottom of the pay scale will see limited gains because:
- Pay floors must be lifted to match the legal minimum wage
- Part of the 3.3% increase is effectively used just to stay compliant
- Real take-home improvement may be small
This is a major concern for support staff and entry-level roles.
When Will the New NHS Pay Rates Be Paid?
The government says the new pay rates will be:
- Effective from 1 April 2026
- Included in April pay packets
- Not delayed like in several previous years
If additional pay band reforms are agreed later, any extra increases linked to them are expected to be backdated to April 2026.
What Happens Next?
Several issues are still unresolved:
- Final details of Agenda for Change pay structure reform
- DDRB pay decisions for GPs and related staff
- Possible union ballots or industrial action responses
- Whether further negotiated increases will follow
More technical pay tables and band breakdowns are expected to be released after the full pay documentation is published.
Summary: NHS Pay Rise 2026 Key Points
- NHS pay rise for 2026/27 set at 3.3%
- Applies to 1.4 million Agenda for Change staff
- Starts April 2026
- Government says it is above forecast inflation
- Unions say it is below real living cost increases
- GP and some primary care nurses are not automatically included
- Further pay band reforms may bring extra increases
- Union reaction has been strongly negative
