NHS Salary · Agenda for Change

NHS Band 5 Take-Home Pay 2026/27

A 2026/27 Band 5 Agenda for Change salary runs from £32,073 at entry to £39,043 at the top of the band. This calculator applies the correct NHS pension tier, adds any London weighting (HCAS) with its floor and ceiling, and shows your true take-home pay after Income Tax and National Insurance — the parts generic salary calculators get wrong.

5 min read· Updated 19 August 2026· 🇬🇧 UK

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Key takeaways

Key takeaways · Band 5 · 2026/27

Band 5 runs from £32,073 (entry) to £39,043 (top) for 2026/27.
At entry, the NHS pension is charged at the 8.3% tier on all pensionable pay.
Take-home at entry is about £24,483 a year (£2,040 a month), national rate.
HCAS is pensionable: Inner London adds £6,415 here and can raise your pension tier.

How it works

What does an NHS Band 5 salary take home in 2026/27?

Band 5 on the Agenda for Change (AfC) pay spine runs from £32,073 at entry to £39,043 at the top of the band. Typical roles include Newly qualified nurses, midwives, physiotherapists, occupational therapists, paramedics. Your take-home depends on three NHS-specific things generic calculators miss: the tiered NHS pension, any High Cost Area Supplement (HCAS) for London, and the fact that the pension is a net-pay arrangement (it cuts Income Tax but not National Insurance).

Worked example: Band 5 entry, England (national)

A Band 5 starter on £32,073 (2026/27 entry step) has all pay pensionable. The NHS pension is charged at the 8.3% tier — that is £2,662 a year, taken before Income Tax. Income Tax works out at £3,368, employee National Insurance at £1,560 (NI is charged on the full salary, as the NHS pension is a net-pay arrangement, not salary sacrifice). That leaves take-home pay of about £24,483 a year, or £2,040 a month.

Move to the top of Band 5 (£39,043) and take-home rises to about £28,570 a year — but note the NHS pension tier can step up on the way, so part of the gross rise is offset by a higher contribution rate.

Add Inner London weighting and the same entry-step nurse gains £6,415 of pensionable HCAS, lifting gross to £38,488 and take-home to about £28,213 a year. HCAS is pensionable, so it can also nudge you into a higher pension tier.

What Band 5 pay means in practice

Band 5 is where most clinical NHS careers begin — it is the standard entry band for newly qualified nurses, midwives, paramedics and allied health professionals straight out of training. If you have just moved from a student bursary or a Band 4 support role, this is usually your first taste of full Agenda for Change pay, pension deductions and National Insurance all landing on the same payslip, which is why the take-home figure often surprises people who only budgeted around the gross.

The detail that catches Band 5 starters out is the first increment. Band 5 has three pay points, and progression from entry to the next step can nudge your pensionable pay towards the next contribution tier. Because NHS pension tiers are non-marginal, that can mean a modest gross rise brings home slightly less than expected for a period. It is worth modelling the entry, mid and top points before assuming each step is a clean pay rise.

Band 5 is also the band where the decision between substantive and agency or bank work comes up most. Agency day rates can look higher, but they usually come without the employer pension contribution, sick pay and incremental progression that make a substantive Band 5 post more valuable than the headline hourly rate suggests.

Why the NHS pension tier matters so much

The NHS Pension Scheme charges contributions in non-marginal tiers — your whole pensionable pay is charged at the single rate its total falls into, not band by band. A Band 5 entry salary sits in the 8.3% tier. Cross a tier boundary — through a pay step, a promotion, or London weighting — and the higher rate applies to all your pensionable pay, so a small rise can briefly cut your net pay. The calculator flags when you are within £300 of a boundary.

London weighting on Band 5

If your trust is in the London zones, HCAS is added to basic pay before pension, tax and NI. It is pensionable, so it can push you into a higher pension tier. Inner London is 20% (capped between £5,794 and £8,746), Outer 15% (£4,870–£6,137) and Fringe 5% (£1,346–£2,270). Select a zone in the calculator, or see the dedicated NHS London weighting calculator for the full floor/ceiling logic.

Working nights, weekends or bank holidays? Add Section 2 enhancements with the NHS unsocial hours calculator. To compare against a non-NHS salary, use the main take-home pay calculator.

Sources: NHS Employers — 2026/27 pay scales and the NHS Pension Scheme 2026/27 tier table. Figures are estimates; confirm with your trust's payroll.

NHS pay

Your first Band 5 year: payslips, Plan 5 loans and the first night shifts

By CalculatorDashboard Editorial Team·Updated 3 October 2026·Reviewed 3 October 2026·3 min read

Most people reach Band 5 straight from a degree, and the first year brings several changes at once: a full salary for the first time, a pension deduction, a student loan that starts collecting, and often a rota that includes nights. The calculator above shows take-home pay at each step of the band. This guide walks through the first year as it actually unfolds, so the payslips hold fewer surprises.

The first payslip

Your first payslip may not match the calculator. If you haven't worked under PAYE earlier in the tax year, or your P45 from a student job hasn't reached the trust, payroll may use an emergency tax code until HMRC sends the right one. Your tax will be corrected in a later month, usually with a refund, so keep your first few payslips and check that the tax code changes to 1257L or your correct code. Your first month's pay may also be part-month or paid in arrears, depending on your start date and the trust's payroll cut-off.

Plan 5 joins the deductions

Many 2026 graduates in England began their courses in or after September 2023, which puts them on the Plan 5 student loan. Plan 5 repayments begin from April 2026 at 9% of earnings above £25,000. On the Band 5 entry salary of £32,073, that's about £637 a year, or roughly £53 a month. With income tax, National Insurance and the 8.3% pension tier, a Band 5 starter on Plan 5 takes home about £23,846 a year, roughly £1,987 a month. If you started your course earlier, you're more likely to be on Plan 2, which has a higher threshold and takes less at this salary. The calculator lets you choose either.

Night shifts and what they add

If your rota includes nights, your pay will vary from month to month. Nights attract a 30% enhancement on your basic hourly rate, which is about £16.40 at the Band 5 entry point. Working around 240 enhanced night hours a year, roughly two night shifts a month, adds about £1,181 a year before deductions. A Plan 5 starter keeps about £666 of that, taking monthly take-home to around £2,043 on average. Enhancements are pensionable, so they also build a little more pension each year.

Progression through the band

Band 5 has three pay steps. You move from entry to the middle step after two years, and to the top after four, provided you meet the expected standards in your appraisals. The jump to the middle step, £34,592, is the point where many nurses' pensionable pay approaches the next contribution tier, especially with regular enhancements. That's worth knowing before you budget for the pay rise, because the higher tier applies to all your pay, not just the increase.

Building good habits early

The first year is the easiest time to set up habits that last. Keep your pension. The employer contribution of 23.7% of your pay is worth far more than the take-home you'd gain by opting out. Put aside a small emergency fund before taking on bigger commitments, because the first months can be uneven while tax codes and rotas settle. And if you're offered bank shifts, compare them on what you'll keep after tax, not the hourly rate. Your pension and other benefits on bank work may differ from your substantive post.

Next steps

Choose your step and any London weighting above to see your figures. The NHS unsocial hours calculator models your rota in detail, and the Plan 5 student loan calculator explains how the loan behaves over a career. When you're ready for the next step, the Band 6 page shows what the promotion is worth.

For a longer walk-through, see our guide NHS pay bands explained, with take-home pay at every Agenda for Change band.

Band 5 — Frequently Asked Questions

What is Band 5 take-home pay after the NHS pension in 2026/27?

A Band 5 starter on £32,073 takes home about £24,483 a year (£2,040 a month) at the national rate, after the 8.3% NHS pension tier, Income Tax of £3,368 and National Insurance of £1,560. The NHS pension is a net-pay arrangement, so it lowers your Income Tax but National Insurance is still charged on your full salary.

How much is Band 5 worth in Inner London?

Inner London weighting adds £6,415 of High Cost Area Supplement to a Band 5 entry salary, taking gross to £38,488 and take-home to roughly £28,213 a year. HCAS is pensionable and taxable, so part of it is absorbed by tax, NI and a possibly higher pension tier.

Which NHS pension tier does Band 5 fall into?

At the £32,073 entry step, a Band 5 salary sits in the 8.3% NHS pension contribution tier for 2026/27. Because the tiers are non-marginal, your whole pensionable pay is charged at that rate — and a pay rise or London weighting that crosses a tier boundary raises the rate on all of it, so watch the cliff-edge.

Is the NHS pension worth it on Band 5?

For almost everyone, yes. The NHS Pension Scheme is a defined-benefit (CARE) scheme with an employer contribution of 23.7% and guaranteed inflation-linked income in retirement — far more valuable than the headline contribution rate suggests. This calculator shows the take-home cost; the pension itself is not modelled as an investment.

Does this include unsocial hours or overtime?

This page models basic pay plus any London weighting. For nights, weekends and bank-holiday enhancements under Section 2, use the NHS unsocial hours calculator, which applies the +30% and +60% multipliers on top of your Band 5 hourly rate.

Disclaimer: Estimates based on 2026/27 Agenda for Change pay, NHS pension tiers and HMRC rates, which may change. Confirm with your trust's payroll or a qualified adviser before making decisions.