If you work in the NHS under Agenda for Change terms, you might know your pay band — but do you actually know how much money lands in your bank account each month? The gap between your gross salary and your take-home pay can be surprisingly large, and understanding exactly where your money goes is essential for financial planning, comparing job offers, or deciding whether to change your contracted hours.
This guide walks through every deduction that affects your NHS salary, explains how London weighting works, and shows you how to calculate your actual take-home pay step by step. Whether you're a newly qualified Band 5 nurse, a Band 2 healthcare assistant, or a Band 8 manager, the same principles apply.
What is Agenda for Change?
Agenda for Change (AfC) is the pay system used by the NHS across England, Wales, Scotland, and Northern Ireland. It covers the vast majority of NHS staff — nurses, midwives, allied health professionals, healthcare assistants, admin workers, porters, cleaners, pharmacists, and many more. The only roles not covered are doctors, dentists, apprentices, and very senior managers.
Under AfC, every role is assigned a pay band from Band 1 to Band 9, based on the NHS Job Evaluation Scheme. Within each band, there are multiple pay points (also called increments or spine points). You typically move up one pay point each year as you gain experience, until you reach the top of your band.
For the 2025/26 financial year (April 2025 to March 2026), the pay scales have been updated to reflect the latest pay award. Our take-home pay tool uses these exact figures to give you an accurate estimate.
NHS pay bands and salaries for 2025/26
Here's a summary of the current AfC pay scales for England. Scotland, Wales, and Northern Ireland have slightly different rates:
- Band 2: £24,465 to £25,212
- Band 3: £24,938 to £26,598
- Band 4: £27,485 to £30,162
- Band 5: £31,049 to £37,796
- Band 6: £38,682 to £46,580
- Band 7: £47,809 to £54,710
- Band 8a: £55,690 to £62,682
- Band 8b: £64,455 to £74,896
- Band 8c: £76,964 to £88,683
- Band 8d: £91,342 to £105,776
- Band 9: £109,179 to £125,637
These figures represent full-time gross annual salaries for staff working the standard 37.5-hour week. If you work part-time, your salary is calculated on a pro-rata basis — more on that below.
Understanding your deductions
Your gross salary is the headline figure, but it's not what you receive each month. Several mandatory deductions are taken before your pay reaches your bank account. Let's break each one down.
Income tax (PAYE)
Income tax is collected through Pay As You Earn (PAYE) by HMRC. For the 2025/26 tax year, the thresholds are:
- Personal Allowance: The first £12,570 of your income is tax-free
- Basic rate (20%): Earnings from £12,571 to £50,270
- Higher rate (40%): Earnings from £50,271 to £125,140
- Additional rate (45%): Earnings above £125,140
Most NHS staff fall within the basic rate band. However, if you're in Band 7 or above — particularly at the top of the band or with London weighting — you may start paying higher-rate tax on part of your earnings. This is why moving from Band 6 to Band 7 doesn't always feel like as big a pay rise as the headline figures suggest.
For a Band 5, Point 1 nurse earning £31,049, the income tax calculation is straightforward: (£31,049 − £12,570) × 20% = £3,695.80 per year, or roughly £308 per month.
National Insurance contributions
National Insurance (NI) funds the state pension, NHS, and certain benefits. For employees in 2025/26:
- 8% on earnings between £12,570 and £50,270 per year
- 2% on earnings above £50,270
Using the same Band 5 example: (£31,049 − £12,570) × 8% = £1,478.32 per year, or about £123 per month.
NI is often overlooked when people compare job offers, but it's a significant deduction — especially for staff in the middle bands.
NHS pension contributions
The NHS Pension Scheme is one of the best workplace pensions in the country. It's a defined benefit scheme, meaning your pension is based on your salary and length of service rather than investment performance. However, the contributions are tiered and can feel steep:
- Earnings up to £13,762: 5.2%
- £13,763 to £27,820: 6.5%
- £27,821 to £33,890: 8.0%
- £33,891 to £50,894: 8.5% (approximately)
- £50,895 to £65,291: 9.7%
- Above £65,291: 12.5% (approximately)
For our Band 5 nurse on £31,049, the pension contribution rate is 8.0%, giving an annual contribution of £2,483.92. That's over £200 per month — a significant deduction, but one that funds a very valuable pension.
The pension is almost always worth keeping. Your employer contributes an additional 20.6% on top of your contribution, making the total investment in your pension substantial. Opting out saves you money now but costs you far more in retirement. For a deeper look at how pension tiers work, read our guide on NHS pension contribution rates.
Putting it all together — a worked example
Let's calculate the full take-home pay for a Band 5, Point 1 staff member working full-time (37.5 hours/week) outside London:
- Gross salary: £31,049.00
- Income tax: −£3,695.80
- National Insurance: −£1,478.32
- NHS pension (8.0%): −£2,483.92
- Annual take-home: £23,390.96
- Monthly take-home: £1,949.25
That means roughly 24.7% of gross pay goes on deductions. For higher bands, this percentage increases because more income falls into higher tax and pension brackets.
Rather than doing this manually every time, use our take-home pay tool to instantly see your breakdown for any band, pay point, and hours combination.
How part-time pay works
If you work fewer than 37.5 hours per week, your pay is calculated pro-rata. The formula is simple:
(Your weekly hours ÷ 37.5) × full-time salary = your gross annual pay
For example, a Band 6 nurse on Point 2 (£41,386 full-time) working 22.5 hours per week would earn: 22.5 ÷ 37.5 × £41,386 = £24,831.60 gross per year.
All deductions — tax, NI, and pension — are then calculated on this pro-rata figure. Because the reduced gross often falls into lower tax and pension tiers, part-time staff sometimes retain a higher percentage of their gross pay than full-time colleagues on the same band.
Our pay tool includes a contracted hours selector so you can model any combination instantly.
London weighting explained
NHS staff working in and around London receive an additional payment known as the High Cost Area Supplement (HCAS). This recognises the higher cost of living in the capital and surrounding areas. The supplement is calculated as a percentage of your basic salary, with minimum and maximum caps:
- Inner London: 20% of basic salary (minimum £5,414, maximum £8,172)
- Outer London: 15% of basic salary (minimum £4,551, maximum £5,735)
- Fringe: 5% of basic salary (minimum £1,258, maximum £2,122)
How the caps work
The percentage is applied to your basic salary first. If the result falls below the minimum, you receive the minimum. If it exceeds the maximum, you receive the maximum. This means lower-paid staff receive a proportionally larger supplement, while higher-paid staff hit the cap.
For example, a Band 5 nurse on £31,049 working in Inner London: 20% × £31,049 = £6,209.80. This falls between the minimum (£5,414) and maximum (£8,172), so the nurse receives the full £6,209.80 per year — roughly £517 per month before deductions.
A Band 8a on £62,682 in Inner London: 20% × £62,682 = £12,536.40. This exceeds the £8,172 cap, so the supplement is capped at £8,172 per year.
Is London weighting pensionable?
Yes. HCAS counts as pensionable pay, which means it increases both your pension contributions and your eventual pension benefit. It's also subject to tax and NI. Our take-home pay tool factors this in automatically when you select a London zone.
How pay points and increments work
Within each pay band, you progress through incremental pay points based on your years of experience in that band. You typically move up one point each year on the anniversary of your start date in the band (or on a fixed date, depending on your trust's policy).
Key things to know about pay progression:
- Progression is not automatic in all cases — some trusts require you to meet basic competency and conduct standards
- Starting a new band resets your pay point — if you're promoted from Band 5 to Band 6, you start at Band 6 Point 1 regardless of where you were in Band 5
- The top of band is a ceiling — once you reach the highest pay point, your salary only increases through national pay awards
- Pay protection may apply if a restructure moves you to a lower-graded role
The number of pay points varies by band. Band 2 has just 2 points, while Band 5 has 4 and Band 8 sub-bands have 3 each. This means your pay growth potential is limited within a band — which is why many staff pursue promotion to the next band once they've reached the top of theirs.
Common mistakes when estimating NHS pay
When staff try to work out their take-home pay, several common errors lead to inaccurate estimates:
- Forgetting pension deductions: The NHS pension takes a much larger bite than many people expect — up to 12.5% for the highest earners
- Using the wrong tax code: The standard code is 1257L, but yours may differ if you have additional income, benefits in kind, or an adjusted Personal Allowance
- Ignoring NI: National Insurance is a real cost that reduces take-home pay by 8% on most earnings
- Not accounting for London weighting caps: The percentage-based supplement is capped, so high earners in London don't receive as much as they might expect
- Confusing gross and net: When comparing NHS roles to private sector offers, always compare take-home pay — the NHS pension deduction makes gross comparisons misleading
How the 2025/26 pay award affects your pay
The 2025/26 pay award increased Agenda for Change salaries across all bands. The exact percentage varies by band and pay point, but the uplift typically ranges from 3% to 5% depending on where you sit in the structure.
This is applied to your basic salary before deductions. However, because the tax and NI thresholds haven't increased by the same amount, a portion of your pay rise may be absorbed by higher deductions. This is sometimes called 'fiscal drag' — where inflation-matching pay rises push more of your income into higher tax brackets without genuinely increasing your purchasing power.
To see the exact impact of the pay award on your take-home pay, use our Pay Rise Calculator to compare your old and new figures side by side.
Student loan repayments
The deductions above don't include student loan repayments, but they're worth factoring in if they apply to you. Repayment thresholds for 2025/26 are:
- Plan 1: 9% on earnings above £22,015
- Plan 2: 9% on earnings above £27,295
- Plan 4 (Scotland): 9% on earnings above £27,660
- Plan 5: 9% on earnings above £25,000
- Postgraduate loan: 6% on earnings above £21,000
If you're on Plan 2 earning £31,049, your annual repayment would be: (£31,049 − £27,295) × 9% = £337.86 per year, or about £28 per month. Not huge, but worth knowing about when budgeting.
Salary sacrifice and voluntary deductions
Some trusts offer salary sacrifice schemes — most commonly for childcare vouchers, cycle-to-work schemes, or additional pension contributions (via Additional Voluntary Contributions or AVCs). These reduce your gross pay before tax and NI are calculated, which means you pay less in deductions but your headline salary is lower.
If you're using any salary sacrifice arrangements, these will affect your take-home pay beyond what the figures above show. Check with your trust's payroll team for the specific impact.
Work out your take-home pay now
Understanding your pay is about more than curiosity — it's about making informed decisions. Whether you're choosing between a Band 5 and Band 6 role, considering going part-time, weighing up a move to London, or just trying to budget, accurate take-home pay figures are essential.
Use our take-home pay tool to get your personalised breakdown in seconds. Select your band, pay point, contracted hours, and London zone — and see exactly what you'll take home each month after tax, NI, and pension.
For a side-by-side comparison of two different bands, try the Salary Comparison Tool. And if you're curious about your leave entitlement alongside your pay, the Annual Leave Calculator shows your exact days based on your service length and hours.