Northern Ireland health pay is a year behind. Band 5 is £512 short.

The Northern Ireland Fiscal Council published a discussion paper on public sector pay on 22 September. It is written about budgets. Here is the same thing on a payslip: a band 5 at the bottom of the band is paid £31,049 a year in Northern Ireland, while the same band 5 in England is on £32,073. That is £85 a month, and by the end of September it will have come to £512 gross.

What the gap is worth

Northern Ireland’s Health and Social Care staff are still on the 2025/26 rates. Those took effect on 1 April 2025 and were not paid until February 2026 — ten months late, with the arrears landing in one payslip.

England moved to the 2026/27 rates on 1 April 2026. Northern Ireland has not. The NHS Pay Review Body recommended 3.3% from 1 April 2026, and the Health Minister, Mike Nesbitt, said in February that he wanted to proceed with that figure for Agenda for Change staff. What is missing is the money. He said he could only deliver on those commitments “when clear about my budgetary position”, and no funding for the award had been settled on his department.

Band	Northern Ireland now	England 2026/27	Gap, April to September
Band 2	£24,852	£25,272	£210
Band 5, entry	£31,049	£32,073	£512
Band 6, entry	£38,682	£39,959	£639
Band 7, entry	£47,810	£49,387	£789

Every figure there is gross, before tax, National Insurance and pension. The last column is six months, not a year: over twelve months the band 5 gap is £1,024.

One row does not follow the pattern. Band 2 in Northern Ireland is a flat £24,852, which is higher than England’s 2025/26 rate of £24,465 — so the bottom of the Northern Ireland scale is not simply England’s old figure, even though bands 3, 5, 6 and 7 match England’s 2025/26 rates to the pound. The full table is on our Northern Ireland pay scales page, and the NHS pay calculator will show what a figure looks like once deductions come off.

Why it is late

The Fiscal Council’s answer is not the one people expect. Its chair, Sir Robert Chote, said the Council’s “initial analysis suggests that the challenge is not primarily about public sector workers in Northern Ireland being paid more than their counterparts elsewhere.” The pressure is the size of the bill, not the level of the rates.

The paper puts the pay bill for services comparable with England at roughly 35% to 45% higher per head of population, against funding about 24% higher. That is the squeeze, and Chote’s account of what follows from it is the part that reaches a payslip: “When funding generated by pay awards in England is insufficient to cover the cost of matching those awards in NI, the Executive faces difficult choices.”

It is a discussion paper rather than a decision, and it puts forward no pay figure of its own.

What happens when it lands

If the 2025/26 award is the guide, the money will not arrive as a corrected monthly rate. It will arrive as one backdated lump. The Health and Social Care payroll service was blunt about that award: full arrears in February 2026, and “there is no option for pay arrears to be spread over a period of time.”

That matters twice over. A single large payment can push one month’s tax higher than the year’s figures justify — it corrects itself later, but not in that payslip. And backdated pension contributions come out of the same lump. The payroll service said so plainly last time: where the rise means higher contributions, those are backdated to 1 April and any money owed is “recouped from your arrears”. It added that moving to a higher contribution tier means owing money on the pension, deducted from the same arrears. In Northern Ireland the tier applies to your whole pay, not just the slice above the line. Our pension contributions page sets out the tiers.

One caution on the figures above. Nothing here is owed yet, because the 2026/27 award has not been agreed for Northern Ireland. What the table shows is what the England rate is worth, month by month, while the decision sits unmade. If it is agreed and backdated to 1 April 2026, that is the moment it becomes arrears.

How we check figures is set out on methodology, and every document behind this story is listed on sources.

Where these figures come from

• Sustainability Report 2026: Special Focus - Public Sector Pay — Northern Ireland Fiscal Council
• Stormont faces ‘difficult choices’ over size of public sector, watchdog says — The Irish News
• Pay Bands in Health & Social Care — HSC Northern Ireland
• Pay scales for 2026/27 — NHS Employers
• AFC February 2026 Pay Award — PSC Payroll Query, HSCNI
• Health Minister Reaffirms Commitment to On Time Pay Settlement for Health Staff — Department of Health (Northern Ireland)

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.