Guide To NHS Pay (Agenda for Change) 2023/2024

 

Pay for nurses, occupational therapists, psychologists and most other staff other than doctors in the NHS is set according to a set pay scale called Agenda for Change (AfC). 

This was introduced in December 2004 as an attempt to create a consistent and fair pay structure and has remained largely unaltered. It consists of 9 pay bands with lower and upper limits. Band 8 is subdivided into a, b, c and d.

Initially, a set of national job profiles was agreed to assist in the process of matching posts to pay bands and staff were matched to a national job profile, or their job was evaluated locally.

In theory, AfC was designed to evaluate the job rather than the person in it, and to ensure equity between similar posts in different areas.

In reality it has been implemented differently in different places, and some posts have been graded very differently from similar jobs elsewhere.

New profiles are introduced and roles are evaluated as required by the Job Evaluation Group, a subgroup of the NHS Staff Council, which oversees the pay system.

As part of the 2018 pay deal, Band 1 was closed to new entrants, overlapping pay points between bands were removed, and automatic annual progression ended. However, the AfC pay scale includes minimum periods before staff are eligible to move to higher pay points within each band. 

The tables below show standard AfC pay bands for annual salaries across the UK, and hourly rates for England. 

 

England (staff outside London)

The AfC basic pay bands apply to staff working outside London and the surrounding areas.

 

 

 

Source: Pay scales for 2023/24. NHS terms and conditions annual, hourly and HCAS pay values scales for 2023/24. (Accessed 3 May 2022).

 

England (London)

Staff working in London and some surrounding areas receive a high cost area supplement (HCAS) intended to compensate for the additional costs of living in London and the surrounding areas.

There are three separate bands: Inner, Outer and Fringe. The supplements are applied as a percentage of basic salary as follows: inner (+20%); outer (+15%); and fringe (+5%). The calculation includes the basic AfC salary plus any long-term recruitment and retention premium, subject to a minimum and maximum level of extra pay.

The HCAS is pensionable but does not count as basic pay for the purposes of calculating the rate of overtime payments, unsocial hours payments, on-call availability payments or any other payment, excluding sick pay.

The value of the supplement is reviewed annually, based on the recommendations of the NHS Pay Review Body (NHSPRB).

The inner, outer and fringe zones are based on 2005 primary care trust (PCT) geographical boundaries as follows: 

Inner London includes 11 PCTs (Hammersmith & Fulham; Kensington & Chelsea; Westminster; Camden; Islington; City & Hackney; Tower Hamlets; Lambeth; Lewisham; Southwark; and Wandsworth).

Outer London includes 20 PCTs (Brent; Ealing; Harrow; Hillingdon; Hounslow; Barnet; Enfield; Haringey; Barking & Dagenham; Havering; Newham; Redbridge; Waltham Forest; Bexley; Bromley; Greenwich; Croydon; Kingston; Richmond & Twickenham; and Sutton & Merton).

Fringe includes 22 PCTs (Dartford, Gravesham & Swanley; Basildon; Billericay, Brentwood & Wickford; Epping Forest; Harlow; Thurrock; Dacorum; Hertsmere; Royston, Buntingford & Bishop Stortford; South East Hertfordshire; St Albans & Harpendon; Watford & Three Rivers; Welwyn, Hatfield; Bracknell Forest; Slough; Windsor, Ascot & Maidenhead; Wokingham; East Elmbridge & Mid Surrey; East Surrey; Guildford & Waverley; North Surrey; and Surrey Heath and Woking).

Employers who employ staff in more than one high cost area zone may agree locally a harmonised rate of payment across their organisation.

The tables below show AfC pay bands for annual salaries and hourly rates in London and some surrounding areas.

 

 

 

Source: Pay scales for 2023/24. NHS terms and conditions annual, hourly and HCAS pay values scales for 2023/24. (Accessed 3 May 2022)

 

Scotland

These pay bands apply to all AfC staff working in Scotland.

 

 

Source: Scottish Government. NHS pay rise delivered in April. (Accessed 3 May 2023)

 

Wales

These pay bands apply to all AfC staff working in Wales.

 

 

Source: Agenda for Change (AFC) agreement in Wales. (Accessed 16 July 2024)

 

Northern Ireland

AfC staff working in Northern Ireland have been offered a pay deal for 2023/24 which will increase band rates by 5% and on call and sleeping in allowances by 5.2%. The deal, which has yet to be accepted by all health unions, pays the following rates. 

 

Agenda for Change: Annual rates for salary bands in Northern Ireland 2023/24
	Entry	Top	Intermediate
Band 1	£22,383	n/a	n/a
Band 2	£22,383	£22,383	n/a
Band 3	£22,816	£24,336	n/a
Band 4	£25,147	£27,596	n/a
Band 5	£28,407	£34,581	£30,639
Band 6	£35,392	£42,618	£37,350
Band 7	£43,742	£50,056	£45,996
Band 8a	£50,952	£57,349	n/a
Band 8b	£58,972	£68,525	n/a
Band 8c	£70,417	£81,138	n/a
Band 8d	£83,571	£96,376	n/a
Band 9	£99,891	£114,949	n/a
These pay rates are effective from 1 April 2023. Allowances: On-Call Availability £29.14; Sleeping In £37.97. All staff will also receive a non-consolidated payment of £1,505.

 

Source: Agenda for Change Pay Offer for 2023/24 in Northern Ireland, February 2024. (Accessed 16 July 2024)

 

Minimum periods to move to higher pay points within a band

The AfC pay scale includes minimum periods before staff are eligible to move to higher pay points within each band. These are shown in the table below.

 

 

Source: Pay scales for 2023/24. NHS terms and conditions annual, hourly and HCAS pay values scales for 2023/24. (Accessed 3 May 2022)