Who gets paid what in the NHS?

Who are the best-paid workers in the NHS? And who gets left underpaid and overworked?
Pay illustration

Who are the best-paid workers in the NHS? And who gets left underpaid and overworked?

Picture: Daniel Mitchell

The NHS in England alone employs 1.5 million people, making it the country’s biggest employer.

But who earns what across this huge workforce?

What do nurses earn?

Nurses’ wages are set by Agenda for Change (AfC), the national system for NHS pay, terms and conditions, which is broken down into bands.

The starting point for newly qualified nurses is the bottom of band 5. In England in 2019-20, this comes with a salary of £24,214.

Experienced nurses at top of band 5 earn £30,112 a year.

Band 6 starts at £30,401 and band 7 at £37,570.

Do nurses in all four UK countries earn the same?

All four UK countries use their own versions of AfC, so wages can differ between countries.

In England, Scotland and Wales, nurses are all into the second year of each country’s own three-year pay deal.

Pay is traditionally highest in Scotland. In 2019-20, band 5 in Scotland starts at £24,670, while in Wales the starting point is £24,214. In Northern Ireland, nurses start on £22,795, although they are still on the 2018-19 pay bands, as a pay deal has not been agreed for this year.

How does the pay increase?

Staff progress through their pay band in line with their number of years of experience, moving up in increments roughly every year until they reach the top of their pay band.

Pay will also increase if there is a national pay award.

Does anything else affect take-home pay?

The pay listed on the AfC chart is basic pay.

There are extra payments for living in inner or outer London, or near the capital, and on-call work. Staff in bands 1 to 7 are also entitled to overtime payments.

What about nursing associates?

People in this new regulated role in England (the only country where the role has been introduced) start on band 3, which begins at £18,813, while undertaking two years of training. The expectation is that qualified nursing associates will work at band 4, starting at £21,089.

What do assistant practitioners earn?

Assistant or associate practitioners also generally start at band 3 while training, and will often move onto band 4 once recruited into a role.

Who else uses Agenda for Change?

AfC is used for all NHS staff, including porters, cleaners and allied health professionals, with the exception of doctors, dentists and most senior managers. Practice nurses are employed directly by their general practice, so are not part of the nationally agreed deal. They are generally paid on average the equivalent of AfC band 6.

What about doctors?

Newly qualified foundation year 1 doctors fresh out of medical school start on £27,146, rising to £37,191 two years later when they start their core training as a specialty registrar.

A consultant’s salary in England in 2018-19 starts at £77, 913, and those with 19 years of experience earn £105,042. 

Consultants in England and Wales can also benefit from extra payments in the form of clinical excellence awards, which range from just over £3,000 to more than £77,000. 

A version of this article was published in 2013. It was last updated in November 2019

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