Almost all NHS staff in England — nurses, paramedics, midwives, allied health professionals and more — are paid on the Agenda for Change (AfC) scale. It is a set of bands, each with a few pay points you move up with experience. From 1 April 2026 every point rose by 3.3%.
The Agenda for Change bands (2026/27)
| Band | Salary range |
|---|---|
| Band 2 | £25,272 |
| Band 3 | £25,760 – £27,476 |
| Band 4 | £28,392 – £31,157 |
| Band 5 | £32,073 – £39,043 |
| Band 6 | £39,959 – £48,117 |
| Band 7 | £49,387 – £56,515 |
| Band 8a–8d | £57,528 – £108,814 |
| Band 9 | £112,782 – £129,783 |
A newly qualified nurse typically starts at Band 5; an experienced specialist nurse or paramedic is often Band 6 or 7. (Staff in London also get a High Cost Area Supplement on top, which we don't yet include.)
The NHS pension is tiered
The NHS Pension Scheme is one of the best workplace pensions around, but it takes a meaningful slice of pay. Your contribution rate is tiered — the more you earn, the higher the percentage, charged on your whole pensionable pay:
| Pensionable pay | Contribution |
|---|---|
| Up to £13,259 | 5.2% |
| £13,260 – £28,854 | 6.5% |
| £28,855 – £35,155 | 8.3% |
| £35,156 – £52,778 | 9.8% |
| £52,779 – £67,668 | 10.7% |
| £67,669 and above | 12.5% |
So a Band 6 nurse on £39,959 contributes 9.8% — about £3,916 a year.
Why it reduces your tax but not your NI
The NHS pension is a net-pay arrangement. Your contribution comes off your salary before Income Tax is worked out, so you automatically get tax relief at your highest rate — a basic-rate taxpayer effectively pays 80p for each £1 that goes into the pension. But it is taken after National Insurance, so it does not reduce your NI. That is different from a salary-sacrifice pension, which saves both.
What it means for take-home
For a Band 6 nurse on £39,959, the order is: gross pay, minus the 9.8% pension (before tax), then Income Tax on what's left, then National Insurance on the full salary. The result is a take-home of around £2,430 a month — comfortably more than the headline 9.8% + tax + NI would suggest, because the pension itself is buying you a valuable guaranteed retirement income. Our NHS take-home calculator works it out for any band and pay point, with the right pension tier applied automatically.
In short
NHS pay runs on the Agenda for Change bands (up 3.3% for 2026/27), and the NHS Pension takes a tiered 5.2%–12.5% on top. Because it is a net-pay scheme, the contribution cuts your Income Tax but not your National Insurance. Teachers have a similar set-up — see the teacher calculator.