NHS band reform was promised backdated to April. Five months on, nothing.

Fourteen unions wrote to the Health Secretary, Yvette Cooper, on 11 September. Between them they represent more than 1.2 million NHS staff on Agenda for Change — the pay system covering nurses, midwives, physiotherapists, radiographers, porters and healthcare assistants. Their message was that talks on reforming that system have stopped, and need restarting.

The reform was promised with any agreed increases backdated to 1 April 2026, and more than five months past that date nothing has been agreed, so there is nothing to backdate.

What came with the 3.3 per cent

Staff got 3.3 per cent from 1 April 2026, following the NHS Pay Review Body’s recommendation. That was only half the package. NHS Employers set out the rest: the Department of Health and Social Care would open “fast-paced discussions” with unions and employers through the NHS Staff Council on funded improvements to the pay structure, with priorities including raising pay at the lowest bands and for graduates. Anything agreed would be backdated to 1 April 2026.

Talks did open in April. The unions say progress then stalled through two changes of Health Secretary — Wes Streeting left in May, James Murray held the job for about ten weeks, and Yvette Cooper took it in July. The unions add that the 2027/28 award must now be settled in the same talks.

That second point matters more than it looks. One delayed negotiation has quietly become two, running together.

Structure is not the same thing as a pay rise

Agenda for Change was built two decades ago. A band is not a single rate — it is a set of pay points you move up over time. Structure talks are about that shape: how many points a band holds, how long it takes to reach the top of one, and whether the band a job sits in still matches the skill and responsibility the job takes.

The Royal College of Midwives puts a figure on the drift. It says a midwife at the top of Band 6 in Scotland earns £3,673 more than a colleague doing the same job in England, and that competitiveness against other graduate professions falls by 29 per cent within ten years of qualifying — roughly the point many reach the top of Band 6 and stop moving up.

The gap is now wider than that. On the scales in force since 1 April 2026, the top of Band 6 is £52,679 in Scotland and £48,117 in England, a difference of £4,562. Nor is it like for like: Scotland’s full-time week fell to 36 hours on 1 April 2026 against 37.5 hours in England, so the Scottish salary is paid for fewer hours.

The thing most people will get wrong

A restructure is not a rise laid on top of the one you already had. It can change where you sit, how fast you climb, and what the top of your band is worth. Two people on the same band today can come out of the same agreement differently.

Nothing on your September payslip reflects any of it, because nothing has been agreed. There is no form, no claim, no deadline and nothing to chase. What exists is a promise with a start date attached, and the start date is getting further away every month.

Our NHS pay rise page holds the 3.3 per cent award as it was actually applied. Pay scales hold every band and point for all four nations, Scotland’s separate scale included, and the pay calculator turns a band and a nation into take-home pay.

Where these figures come from

• RCM urges Health Secretary to restart NHS pay talks or risk losing more midwives — Royal College of Midwives
• End delays to Agenda for Change reform, unions urge — Nursing Times
• 14 unions urge Health Secretary to fix ‘second-class treatment’ NHS pay — Morning Star
• NHS nurse pay talks ‘stall’ amid change in health secretaries — Nursing in Practice
• NHS PRB pay award announcement 2026 — NHS Employers
• Pay scales for 2026/27 — NHS Employers
• NHS pay rates — Scottish Government
• NHS Scotland Agenda for Change staff - working week reduction: Fairer Scotland Duty Assessment — Scottish Government

Every figure traces to a dated document — the line this section is named after. If one here is wrong, tell us and it gets fixed publicly. Work out your own figures.