The NHS Payslip, Explained
NHS payslips are notoriously complicated. From Agenda for Change pay bands to unsocial hours enhancements, tiered pension deductions, and ESR codes — here is everything you need to understand your take-home pay.
NHS Agenda for Change pay bands 2026/27
Nearly all NHS staff (excluding doctors, dentists and VSMs) are paid under Agenda for Change (AfC). Your Band determines your pay range; your pay point within the band increases with experience.
| Band | Pay Range 2026/27 | Typical Roles |
|---|---|---|
| Band 2 | £24,907 – £26,282 | Healthcare Assistant, Porter |
| Band 3 | £25,329 – £27,053 | Senior HCA, Medical Secretary |
| Band 4 | £27,269 – £30,003 | Therapy Assistant, Associate Practitioner |
| Band 5 | £29,970 – £36,483 | Staff Nurse, Physiotherapist, Radiographer |
| Band 6 | £37,338 – £44,962 | Senior Nurse, Senior AHP, Specialist |
| Band 7 | £46,148 – £52,809 | Ward Manager, Advanced Practitioner |
| Band 8a | £53,755 – £60,504 | Consultant AHP, Service Manager |
Pay points within each band increase annually for staff who are not at the top of their band. Progression is now based on a simplified 2-point scale for most bands since the 2023 deal.
NHS Pension contribution rates 2026/27
The NHS Pension Scheme (2015 CARE scheme) is a Defined Benefit pension — one of the most valuable in the UK. Your contribution is deducted before tax (Net Pay Arrangement), which means the actual reduction to your take-home is smaller than the headline rate.
| Actual Pensionable Pay | Employee Rate | What you get |
|---|---|---|
| Up to £13,259 | 5.2% | Defined benefit: 1/54 of pensionable pay per year |
| £13,260 – £26,831 | 6.5% | Plus index-linking to CPI in retirement |
| £26,832 – £32,691 | 8.3% | Plus lump sum option at retirement |
| £32,692 – £49,079 | 9.8% | Plus employer contributes ~23.7% on top |
| £49,080 – £62,924 | 10.7% | Spouse/dependent pension on death |
| £62,925 and above | 12.5% | Ill-health retirement protection |
ESR payslip explained — what each code means
Most NHS payslips are generated by the Electronic Staff Record (ESR) system. Each line item has a short code. Here are the most common ones:
| ESR Code | What it means | Pensionable? |
|---|---|---|
| BASIC | Basic contracted pay for the period | Yes |
| ENH NIGHT | Unsocial hours enhancement — nights (time +30%) | Yes (typically) |
| ENH SUN/BH | Sunday / Bank Holiday enhancement (time +60%) | Yes (typically) |
| ON CALL | On-call availability allowance | Depends on trust |
| NHS PEN | NHS Pension employee contribution deduction | N/A |
| ARREARS | Backdated pay rise / retro pay | Yes |
| SLS | Student Loan repayment deduction | N/A |
| SAL SAC | Salary sacrifice (car, cycle, pension AVC) | Reduces pensionable pay |
| PAYE TAX | Income Tax deducted under PAYE | N/A |
| EMP NI | Employee National Insurance (Class 1) | N/A |
Agenda for Change enhancements explained
Enhancements are additional payments for working unsocial hours under Section 2 of the AfC handbook. The key question for payslip purposes is: which enhancements are pensionable?
- Typically pensionable: Contractual unsocial hours enhancements (nights, Sundays, Bank Holidays), regular on-call payments, high cost area supplements.
- Typically not pensionable: Non-contractual overtime, one-off payments, mileage/travel allowances, uniform allowances, non-recurrent bonuses.
- Check your trust: Individual NHS trusts may have local agreements that differ. Check your contract or ask your payroll department.
Pensionable pay matters because your final NHS pension is based on a Career Average Revalued Earnings (CARE) calculation — every year of pensionable pay adds to your retirement income. Ensuring enhancements are correctly coded as pensionable is worth checking.
NHS pay rise 2026/27 and arrears
NHS pay deals have historically been agreed and implemented months after the April start of the financial year. When a deal is finally agreed:
- Your basic pay is uplifted to the new rate from the implementation date.
- You receive arrears — a lump sum paying the difference between old and new pay for every month from April to the implementation date.
- Arrears appear as a separate line on your payslip (often labeled "ARREARS" or "RETRO PAY").
- Arrears are subject to full PAYE income tax and National Insurance in the month received — the same month, not spread over the year. This can temporarily push you into a higher tax bracket for that payslip period.
- Arrears are usually pensionable under the NHS Pension Scheme, so your pension contribution on the arrears amount will also appear.
Check your AfC take-home pay
See exactly how a band progression, enhancement, or pension contribution change affects your monthly take-home. Or check if back-pay arrears were taxed correctly.