A complete year-by-year record of every Agenda for Change pay award from the landmark 2018 three-year deal through to the 2026/27 settlement. Track how NHS salaries have changed and compare them against inflation.
The 2018 Three-Year Deal
In June 2018, the government accepted a three-year pay deal covering 2018/19 to 2020/21. This was a landmark agreement — the first multi-year NHS pay deal in over a decade. It delivered cumulative increases of 6.5% across three years for most bands, restructured the pay spine by removing overlapping pay points, and introduced new entry-level rates.
Crucially, the deal was not a flat percentage each year. Lower bands received proportionally larger increases, and the old system of nine pay points per band was compressed to just two or three points per band.
Band 5 Entry Salary — Year by Year
| Year | Band 5 Entry | Annual Change | % Change |
|---|---|---|---|
| 2017/18 (pre-deal) | £22,128 | — | — |
| 2018/19 | £24,214 | +£2,086 | +9.4% |
| 2019/20 | £24,907 | +£693 | +2.9% |
| 2020/21 | £25,655 | +£748 | +3.0% |
| 2021/22 | £25,655 | £0 | +3.0% top-up |
| 2022/23 | £27,055 | +£1,400 | +5.5% |
| 2023/24 | £28,407 | +£1,352 | +5.0% |
| 2024/25 | £29,970 | +£1,563 | +5.5% |
| 2025/26 | £31,049 | +£1,079 | +3.6% |
| 2026/27 | £32,073 | +£1,024 | +3.3% |
2021/22: A 3% award was applied as a one-off "top-up" payment (non-consolidated for most staff) rather than a permanent pay scale increase. The consolidated base remained at £25,655.
Band 2 Entry Salary — Year by Year
| Year | Band 2 Entry | Annual Change | % Change |
|---|---|---|---|
| 2018/19 | £17,652 | — | — |
| 2019/20 | £18,005 | +£353 | +2.0% |
| 2020/21 | £18,546 | +£541 | +3.0% |
| 2021/22 | £18,546 | £0 | +3.0% top-up |
| 2022/23 | £20,270 | +£1,724 | +9.3% |
| 2023/24 | £22,383 | +£2,113 | +10.4% |
| 2024/25 | £23,615 | +£1,232 | +5.5% |
| 2025/26 | £24,465 | +£850 | +3.6% |
| 2026/27 | £25,272 | +£807 | +3.3% |
2022/23 and 2023/24 saw the largest increases for lower bands due to a flat-rate £1,400 component and the incorporation of the £1,035 supplement.
Cumulative Growth 2018–2027
| Band | 2018/19 Entry | 2026/27 Entry | Cash Growth | % Growth |
|---|---|---|---|---|
| Band 2 | £17,652 | £25,272 | +£7,620 | +43.2% |
| Band 3 | £18,813 | £25,760 | +£6,947 | +36.9% |
| Band 5 | £24,214 | £32,073 | +£7,859 | +32.4% |
| Band 6 | £29,177 | £39,959 | +£10,782 | +37.0% |
| Band 7 | £36,644 | £49,387 | +£12,743 | +34.8% |
| Band 8a | £42,414 | £57,528 | +£15,114 | +35.6% |
Awards vs. Inflation (CPI)
Between 2018/19 and 2026/27, cumulative CPI inflation was approximately 28–30%. Band 5 salaries grew by 32.4% over the same period — meaning NHS Band 5 nurses have seen real-terms pay restoration of approximately 2–4% over the full period.
However, this masks the significant real-terms erosion of 2021–2023, when inflation surged to 10%+ while awards were 3–5%. The 2024/25 and 2025/26 awards began restoring lost ground, and 2026/27 continues that trend.
| Year | Pay Award | CPI Inflation | Real-Terms |
|---|---|---|---|
| 2018/19 | +9.4% (B5) | 2.4% | +7.0% |
| 2019/20 | +2.9% | 1.7% | +1.2% |
| 2020/21 | +3.0% | 0.7% | +2.3% |
| 2021/22 | +3.0%* | 5.4% | -2.4% |
| 2022/23 | +5.5% | 10.7% | -5.2% |
| 2023/24 | +5.0% | 6.7% | -1.7% |
| 2024/25 | +5.5% | 3.2% | +2.3% |
| 2025/26 | +3.6% | 2.6% | +1.0% |
| 2026/27 | +3.3% | 1.7% | +1.6% |
*2021/22 was largely non-consolidated for most staff.
ℹ️Understanding "Non-Consolidated" — A non-consolidated payment is a one-off lump sum that doesn't permanently raise the pay scales. It helps in the short term but doesn't compound into future years' pay. The 2021/22 3% "award" was largely non-consolidated — which is why the 2022/23 base rate showed a much larger jump.
The Pattern of NHS Pay Negotiations
NHS pay awards follow a well-established cycle:
1. NHS Pay Review Body (NHSPRB) calls for evidence (autumn)
2. Unions, NHS Employers, and DHSC submit written evidence (winter)
3. NHSPRB deliberates and produces recommendations (spring)
4. Government decides whether to accept (varies: sometimes immediate, sometimes months later)
5. Implementation via ESR and trust payroll systems
The speed of step 4 determines how much back pay staff receive. In 2022/23, the government delayed acceptance until November — causing 7 months of back pay. The 2026/27 award was accepted in February 2026, the earliest in recent memory.
What Next for NHS Pay?
Current union positions suggest demand for awards at or above inflation for 2027/28 and beyond, with calls for "pay restoration" to recover losses from the 2010–2023 period. The NHS Long Term Workforce Plan also acknowledges that competitive pay is essential for recruitment and retention targets.
The NHSPRB has signalled that workforce supply concerns — particularly in nursing, mental health, and community care — will continue to feature prominently in future recommendations.