NHS Agenda for Change (AfC) · England · 2026/27
NHS Band 7 salary
£49,387 to £56,515 a year, 5 years from bottom to top. Up £1,577 on last year under England’s 3.3% award. Scotland, Wales and Northern Ireland set their own.
- Salary a year £49,387 – £56,515 3 steps · 5 years from bottom to top
- Hourly wage £25.26 – £28.90 Derived from a 37.5-hour week — not published
- Take-home at the entry step £35,206.74 England, in the pension scheme · work out yours
The pay points
| Step | 2026/27 | 2025/26 | Hourly | Time to next step |
|---|---|---|---|---|
| Entry | £49,387 | £47,810 | £25.26 | 2 years |
| Intermediate | £51,932 | £50,273 | £26.56 | 3 years |
| Top | £56,515 | £54,710 | £28.90 | — |
Hourly figures are derived — how, and why they are not published.
What work sits in band 7
19 published profiles score into band 7 from the physiotherapy and radiography and occupational therapy and ambulance service and midwifery and nursing job families — these are the profiles a physiotherapist’s or radiographer’s or occupational therapist’s or ambulance service worker’s or midwife’s or nurse’s post is matched to. A post is banded by matching it to one of these, not by its job title, which is why two jobs with the same title can sit in different bands.
Physiotherapy Team Manager
Job evaluation score 466–515
- Provides physiotherapy assessment and treatment for specific group(s)
- Provides day to day management to a team of staff
Radiographer Advanced
Job evaluation score 467–533
- Carries out a specialist practitioner role e.g. dosimetry planning, simulation, reporting on films within radiotherapy or diagnostic imaging, or role which pertains to clinical pathways e.g. head and neck, paediatric specialist
- Assesses and or treats own specialist workload of patients, maintains associated records
- May participate in Research and Development Activity
- Supervises and teaches recently qualified radiographers, radiologists, students and assistants
Radiographer Specialist (Reporting Sonographer)
Job evaluation score 467–485
- Assesses & reports on own specialist workload of patients/clients (for ultrasound scans), maintains associated records
- Supervises recently qualified Radiographers/assistants/students working with postholder
- May participate in departmental research, clinical trials, equipment testing
Specialist Physiotherapist (Community)
Job evaluation score 469–492
- Assesses, plans and develops specialist physiotherapist treatment programmes for patients/ clients with a wide variety of complex physical needs in a community setting.
- Supervises less experienced physiotherapists/assistants/ students working with post holder
Occupational Therapist Team Manager
Job evaluation score 470–523
- Assesses & treats own specialist caseload of patients/clients in a variety of settings
- Provides specialist OT advice to other disciplines
- Manages specialist team of OT’s and support workers: supervises staff/students
Radiographer Team Manager
Job evaluation score 470–510
- Manages an Imaging or Radiotherapy service in a discrete unit
- Manages staff, resources & activity
- Provides specialist advice in, for example, nuclear medicine, breast imaging, ultrasound, brachytherapy
- Undertakes clinical duties
Paramedic Team Leader
Job evaluation score 473–504
- Responds to emergencies, urgent and routine calls; provides advanced clinical interventions, including drug therapies at scene; may work as sole practitioner; may administer medication within PGD (Patient Group Directive) guidelines.
- Undertakes emergency driving.
- Provides day to day management of team of other paramedics.
Midwifery 7ii
Job evaluation score 473–502
- Undertakes or co-ordinates formal midwifery research, education, and practice development activities
- Ensures that midwifery practices are grounded in an evidence based, research culture
- Advises other midwives in clinical matters
- Supports the education and development needs of all staff
Nursing: 7ii
Job evaluation score 474–536
- Provide leadership and management to registered and non- registered staff and students in a range of settings
- Assess patients/clients; plans, implements care; provides highly specialist advice; maintains associated records.
- May liaise with other agencies in planning programmes of care and/or health and education programmes.
Physiotherapy Specialist (Respiratory Problems)
Job evaluation score 474
- Takes lead role in physiotherapy assessment and treatment of acutely ill patients, mainly those with respiratory problems
- Teaches physiotherapists and other medical personnel
Midwifery 7iii
Job evaluation score 475–520
- Day to day management of a defined area or section of the service e.g. ante natal/post-natal, obstetric theatre, community, perinatal mental health, bereavement care
- Provides midwifery advice and expertise
- Performs clinical midwifery duties
Occupational Therapist Advanced
Job evaluation score 476–519
- Assesses & treats own workload of patients/clients, individually and/or in groups, as part of multi-disciplinary team, in a variety of settings
- Leads in specialist area; contributes to development of specialist service and related policies.
- Supervises/manages students and other staff working in own specialist area
- Leads clinical audits, undertakes research
Clinical advice team manager
Job evaluation score 478–502
- Provides specialised clinical assessment, advice and health information to patients/callers including liaison with and referral other healthcare services and professionals e.g. Out of Hours or Primary Care services and other specialist services e.g. dental services
- Undertakes follow up calls to patients with complex medical needs and ensures patient safety through welfare and re-assessment calls to service users
- Provides specialised clinical advice and support to colleagues within the call centre and manages clinical advisers
- Manages team including performance standards and policies. Manages surge demand and call stack /risk management
Physiotherapist Advanced
Job evaluation score 478–532
- Assesses & treats own specialist caseload of patients/clients
- Acts as clinical physiotherapy lead for specialist area of work
- Provides specialist physiotherapy advice within the trust and to other health care professionals
- Leads clinical audits; may undertake research
Midwifery 7i
Job evaluation score 481–511
- Provides specialist midwifery care for a specific group of clients or defined area of activity e.g. drug dependent, socially excluded, special needs, bereavement, diabetes, screening
- Advises other midwives in related matters
- Shares specialist knowledge with other groups/agencies
Occupational Therapist Advanced (Community)
Job evaluation score 481–514
- Provides specialist advice to social services, housing departments, clients, carers, other professionals on disability, housing, relevant legal and funding issues
- Provides occupational therapy service to the community; manages an OT caseload
- Identifies and assesses needs of clients; assists in meeting these needs through consultation with relevant authorities e.g. housing
Station/Operations Team Manager
Job evaluation score 483–507
- Manages operations across the service area, including resourcing, external relationships and line management.
- Accountable for performance and patient outcome targets
- Investigates and deals with complaints.
Nursing: 7i
Job evaluation score 484–538
- Assesses patients/clients, plans, implements care in a variety of settings, provides highly specialist advice
- Deliver specialist nursing care to a defined caseload/within a defined area of nursing
- Provides highly specialist advice and support to nurses/multi- disciplinary team
- Provides specialist education and training to other staff, students and/or patients/clients
- Leads clinical audits in own specialist area
Paramedic Specialist
Job evaluation score 518–537
- Provides specialist paramedic clinical interventions and advice, including a broad range of drug therapies and procedures; may work as sole practitioner; administers medication within broader PGD (Patient Group Directive) guidelines.
- Provides specialist clinical advice and support to other emergency care professionals.
Quoted from National profiles for physiotherapy — NHS Staff Council Job Evaluation Group national job profiles; National profiles for diagnostic and therapeutic radiographers — NHS Staff Council Job Evaluation Group national job profiles; National profiles for occupational therapy — NHS Staff Council Job Evaluation Group national job profiles; National profiles for ambulance service — NHS Staff Council Job Evaluation Group national job profiles; National profiles for midwifery — NHS Staff Council Job Evaluation Group national job profiles; National profiles for nursing — NHS Staff Council Job Evaluation Group national job profiles.
The same jobs at every band they reach, on one page each: ambulance service pay, midwifery pay, nursing pay, physiotherapy pay and radiography pay.
What changes between band 6 and band 7
A physiotherapist’s post moves up when the job evaluation score does, not when enough time has passed. In the physiotherapy family the highest band 6 profile (Physiotherapy Specialist) tops out at 465, and the lowest here (Physiotherapy Team Manager) starts at 466 — the two bands meet exactly there, with no gap between them. Crossing it means the work described at band 6 has changed.
A radiographer’s post moves up when the job evaluation score does, not when enough time has passed. In the radiography family the highest band 6 profile (Radiographer Specialist (Diagnostic, Therapeutic)) tops out at 456, and the lowest here (Radiographer Advanced) starts at 467 — the band boundary sits in that gap. Crossing it means the work described at band 6 has changed.
A occupational therapist’s post moves up when the job evaluation score does, not when enough time has passed. In the occupational therapy family the highest band 6 profile (Occupational Therapist Specialist) tops out at 465, and the lowest here (Occupational Therapist Team Manager) starts at 470 — the band boundary sits in that gap. Crossing it means the work described at band 6 has changed.
A ambulance service worker’s post moves up when the job evaluation score does, not when enough time has passed. In the ambulance service family the highest band 6 profile (Duty Manager) tops out at 449, and the lowest here (Paramedic Team Leader) starts at 473 — the band boundary sits in that gap. Crossing it means the work described at band 6 has changed.
A midwife’s post moves up when the job evaluation score does, not when enough time has passed. In the midwifery family the highest band 6 profile (Midwifery 6) tops out at 454, and the lowest here (Midwifery 7ii) starts at 473 — the band boundary sits in that gap. Crossing it means the work described at band 6 has changed.
A nurse’s post moves up when the job evaluation score does, not when enough time has passed. In the nursing family the highest band 6 profile (Nursing: 6i) tops out at 461, and the lowest here (Nursing: 7ii) starts at 474 — the band boundary sits in that gap. Crossing it means the work described at band 6 has changed.
Nights, weekends and bank holidays
Bands 4 to 9 share one unsocial hours rate, so this is the same for band 7 as for any band above 3. All four nations’ rates, and the rules for which hours qualify. Work out the take-home on this band.
| When | Enhancement | Hourly at the entry step | At the top |
|---|---|---|---|
| Saturday, and weekdays 8pm–6am | +30% | £32.84 | £37.57 |
| Sundays and public holidays | +60% | £40.42 | £46.24 |
Which hours qualify, and the rules that decide it — including what is excluded and how the other nations differ.
If you work in or near London
A percentage of basic salary, but with a floor and a ceiling — so what band 7 actually gets is not simply the percentage.
| Zone | Rate | At the entry step | At the top |
|---|---|---|---|
| Inner London | 20% | £8,746.00 (the maximum) | £8,746.00 (the maximum) |
| Outer London | 15% | £6,137.00 (the maximum) | £6,137.00 (the maximum) |
| Fringe London | 5% | £2,270.00 (the maximum) | £2,270.00 (the maximum) |
At band 7 the straight 20% would exceed the maximum, so inner London pay is capped at £8,746.00 — worth proportionally less here than lower down the scale.
What band 7 actually pays after deductions
The gross figure is not what reaches your bank. Run through income tax, National Insurance and the pension contribution for an England member in the scheme, each step of band 7 comes out at:
| Step | Gross | Hourly | Pension tier | Take-home | A month |
|---|---|---|---|---|---|
| Entry | £49,387 | £25.26 | 9.8% | £35,206.74 | £2,933.90 |
| Intermediate | £51,932 | £26.56 | 9.8% | £36,939.53 | £3,078.29 |
| Top | £56,515 | £28.90 | 10.7% | £39,708.45 | £3,309.04 |
England, in the pension scheme, standard tax code, no student loan and no salary sacrifice. Unsocial hours and overtime are paid on top of these figures and are not in them. An estimate from published rates, not a payslip and not financial advice — check it against your own before acting on it. Change any assumption, or pick another nation.
Moving up a step crosses a pension tier
Going from intermediate to top raises gross pay by £4,583 — but it also moves you from the 9.8% pension tier to the 10.7% one. The scheme charges that rate on your whole pensionable pay, not just the part above the threshold, so your contribution rises by £957.77 and you keep £2,768.92 of the £4,583 rise.
That is a real feature of the scheme rather than a rounding artefact, and it is why the calculator shows the tier it used.
Band 7 in the other nations
The four nations set their own Agenda for Change rates, and this year they set four different ones. One of them has not made an award yet, so its figures are the previous year’s — the table says which.
| Nation | Entry | Top | Steps | Week | Hourly at entry |
|---|---|---|---|---|---|
| England | £49,387 | £56,515 | 3 | 37.5h | £25.26 |
| Scotland | £52,845 | £61,466 | 3 | 36h | £28.15 |
| Wales | £50,129 | £57,365 | 3 | 37.5h | £25.64 |
| Northern Ireland 2025/26 — no newer award | £47,810 | £54,710 | 3 | 37.5h | £24.45 |
Hourly rates are not comparable across the row without reading the week column: Scotland works 36 hours where the others work 37.5, so the same salary buys a higher hourly rate there.
If you work part time
What you keep does not scale with your hours. The pension tier is set by your actual pensionable pay too, so some part-time hours fall into a lower tier and pay a lower percentage as well as a smaller amount.
| Hours a week | Gross | Pension tier | Take-home | A month | Kept |
|---|---|---|---|---|---|
| 18.8a lower pension tier | £24,693.50 | 6.5% | £20,015.38 | £1,667.95 | 81.1% |
| 22.5a lower pension tier | £29,632.20 | 6.5% | £23,314.37 | £1,942.86 | 78.7% |
| 30 | £39,509.60 | 9.8% | £28,869.41 | £2,405.78 | 73.1% |
| 37.5 — full time | £49,387 | 9.8% | £35,206.74 | £2,933.90 | 71.3% |
Entry step, England, in the pension scheme. Enter your own hours.
The step before and after
Below this sits band 6. The next band up is band 8a, which most people reach by applying for a different post rather than by progression — the steps within a band are time-served, but moving between bands is not.
Other bands
Sources for the band 7 figures 2 documents · last checked Verified
- NHS Terms and Conditions 2025 (Agenda for Change) — pay bands and pay points from 1 April 2025, England NHS Employers ·2025-26 · Effective · checked · independently checked Verified
- NHS Terms and Conditions 2026 (Agenda for Change) — pay bands and pay points from 1 April 2026, England NHS Employers ·2026-27 · Effective · checked · independently checked Also relied on: NHS Terms and Conditions of Service Handbook, version 21 — Section 2 (England), Table 2: unsocial hours payments Pay scales for 2026/27 — High Cost Area Supplement rates, NHS Employers Pay scales for 2026/27 — NHS Employers' HTML publication of the same pay table, used as the corroborating second document Verified