NHS Pay Scale – Agenda for Change (AfC) is a single pay and grading system for all NHS staff in England and Wales, except for doctors and dentists. It was introduced in 2004 to replace the many different pay systems that existed at the time.
AfC staff are graded into nine bands, with each band having a number of pay steps. Staff progress through the pay steps within their band based on their experience and performance.
The current AfC pay rates for 2023/24 are as follows:
NHS Pay Scale (Band – Salary – Roles)
| Band | Experience | Salary | Examples of Roles |
|---|---|---|---|
| 1 | – | £22,383 | Domestic support worker, housekeeping assistant, driver, nursery assistant. |
| 2 | < 2 years | £22,383 | Same as Band 1, plus domestic team leader, security officer, secretary/typist, healthcare assistant. |
| 3 | < 2 years | £22,816 | Emergency care assistant, trainee clinical coder, estates officer, occupational therapy support worker. |
| 3 | 2+ years | £24,336 | |
| 4 | < 3 years | £25,147 | Assistant practitioner, audio-visual technician, pharmacy technician, dental nurse, theatre support worker. |
| 4 | 3+ years | £27,596 | |
| 5 | < 2 years | £28,407 | Operating department practitioner (ODP), podiatrist, learning disability nurse, therapeutic radiographer, physiotherapist, ICT test analyst. |
| 5 | 2-4 years | £30,639 | |
| 5 | 4+ years | £34,581 | |
| 6 | < 2 years | £35,392 | School nurse, experienced paramedic, health records manager, clinical psychology trainee. |
| 6 | 2-5 years | £37,350 | |
| 6 | 5+ years | £42,618 | |
| 7 | < 2 years | £43,742 | Communications manager, estates manager, high-intensity therapist, advanced speech and language therapist. |
| 7 | 2-5 years | £45,996 | |
| 7 | 5+ years | £50,056 | |
| 8a | < 5 years | £50,952 | Consultant prosthetist/orthotist, dental laboratory manager, project and programme management, modern matron (nursing), nurse consultant (mental health nursing). |
| 8a | 5+ years | £57,349 | |
| 8b | < 5 years | £58,972 | Strategic management, head of education and training, clinical physiology service manager, head orthoptist. |
| 8b | 5+ years | £68,525 | |
| 8c | < 5 years | £70,417 | Head of human resources, consultant clinical scientist (molecular genetics/cytogenetics), consultant paramedic. |
| 8c | 5+ years | £81,138 | |
| 8d | < 5 years | £83,571 | Consultant psychologist (8c-8d), estates manager, chief nurse, chief finance manager. |
| 8d | 5+ years | £96,376 | |
| 9 | < 5 years | £99,891 | Podiatric consultant (surgery), chief finance manager, director of estates and facilities. |
| 9 | 5+ years | £114,949 |
High Cost Area Supplements (1 April 2023):
| Area | Level | Supplement |
|---|---|---|
| Inner London | 20% of basic salary | Min £5,132, Max £7,746 |
| Outer London | 15% of basic salary | Min £4,314, Max £5,436 |
| Fringe | 5% of basic salary | Min £1,192, Max £2,011 |
- Band 1 is closed to new entrants.
Staff who work in high cost areas, such as London, receive a higher salary supplement.
The AfC pay rates are reviewed each year by the NHS Pay Review Body. The review body takes into account a number of factors, including the cost of living, the financial position of the NHS, and the pay of other public sector workers.
In recent years, the AfC pay rates have not kept up with the cost of living. This has led to a decline in real wages for NHS staff. As a result, many NHS staff are feeling overworked and underpaid.
There have been calls for the government to increase NHS pay rates. The government has said that it is committed to paying NHS staff fairly. However, it has not yet announced any plans to increase pay rates.
The NHS is facing a number of challenges, including a shortage of staff and rising costs. It is important that the government invests in the NHS to ensure that it can continue to provide high-quality care. One way to do this is to increase NHS pay rates to attract and retain staff.
Summary: NHS Agenda for Change (AfC) pay system:
- Covers all staff except doctors, dentists, and very senior managers.
- Has nine pay bands, each with multiple pay points.
- Staff normally progress to the next pay band after the required number of years, until they reach the top of the pay band.
- In addition to basic pay, there is also extra pay for staff who work in high cost areas such as around London.