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Guide to NHS pay outside London (Agenda for Change) 2021/2022

Published on: 10 Feb 2022


Pay for nurses, occupational therapists, psychologists and most other staff in the NHS is set according to a set pay scale called Agenda for Change (AfC). The basic pay bands apply to all such staff working outside London and the surrounding areas.

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.

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 no longer occurs.

The tables below show standard AfC pay bands for annual salaries and hourly rates outside London. Staff working in London and some surrounding areas receive a high cost area supplement (HCAS). Details of AfC pay scales in London can be found here.

Table 1

Table 2

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.

Table 3


1 - National Job profiles. NHS Employers. 13 December 2021. (Accessed 3 February 2022)