The 2026/27 NHS pay rise was confirmed on 12 February 2026 and is effective from 1 April 2026. Most trusts implemented the uplift in June or July 2026 payroll, with back pay to April included. Here's the full timeline.
Key Dates for 2026/27
| Event | Date |
|---|---|
| NHSPRB report submitted | December 2025 |
| Government accepts recommendation | 12 February 2026 |
| Effective date of new rates | 1 April 2026 |
| NHS Employers issues guidance | March 2026 |
| ESR system updated | April–May 2026 |
| Most trusts implement in payroll | June 2026 |
| Back pay (April–implementation month) | With first uplifted payslip |
Why There's Always a Delay
Even when the award is confirmed before 1 April, trusts cannot implement it immediately. The Electronic Staff Record (ESR) system must be updated centrally, payroll teams must run parallel calculations, and each trust's finance department must sign off. In most years this takes 8–12 weeks from the effective date.
The 2026/27 award was confirmed unusually early (February vs. the June–November confirmations of 2022–2024), which allowed a faster implementation. Many trusts paid the uplifted rate from June 2026 payroll.
How Back Pay Is Calculated
If your trust implements the new rate in June 2026 payroll, you'll receive two months of back pay (April + May) as a lump sum alongside your June salary. This lump sum covers the difference between your old and new monthly rate for each month of delay.
Back pay is taxed in the month it's received — which can push you into a higher marginal tax rate that month. HMRC's cumulative tax system should equalise this over the tax year, but some staff may need to wait until their March 2027 payslip to see the correction.
If you leave the NHS before back pay is processed, your former trust is still obligated to pay it. Contact their payroll department.
Back Pay Example — Band 5 Entry
| Month | Old Gross | New Gross | Difference |
|---|---|---|---|
| April 2026 | £2,587 | £2,673 | +£85 |
| May 2026 | £2,587 | £2,673 | +£85 |
| Total Back Pay (2 months) | ~£171 gross | ||
| Net after deductions (~35%) | ~£111 net |
ℹ️Check Your Payslip — Your payslip should show a separate line for "arrears" or "back pay" alongside your uplifted base pay. If the arrears are missing, raise it with your line manager or payroll team immediately.
Historical Implementation Timelines
| Award Year | Confirmed | Effective | Most Trusts Paid | Months of Back Pay |
|---|---|---|---|---|
| 2024/25 | June 2024 | 1 April 2024 | August 2024 | 4 months |
| 2025/26 | April 2025 | 1 April 2025 | June 2025 | 2 months |
| 2026/27 | February 2026 | 1 April 2026 | June 2026 | 2 months |
Earlier government confirmations mean shorter back pay delays.
Tax Impact of Receiving a Lump-Sum
Receiving multiple months of back pay in one lump sum means your gross pay for that month is artificially inflated. This can cause:
• Higher-rate tax on the entire lump sum if it pushes that month's income over the threshold
• Temporary increase in pension contributions if they're calculated monthly
• Student loan deductions being higher for that one month
HMRC's cumulative PAYE system should correct most over-taxation by year-end. If not, you may be entitled to a refund via Self Assessment.