NHS Sick Pay Calculator 2026/27
Calculate your NHS sick pay entitlement under Agenda for Change. See your full pay, half pay, and nil pay periods.
Your Details
AfC Sick Pay Entitlement
| Service | Full Pay | Half Pay |
|---|---|---|
| Less than 1 year | 1 mo (4 wks) | 2 mo (9 wks) |
| 1-2 years | 2 mo (9 wks) | 2 mo (9 wks) |
| 2-3 years | 4 mo (17 wks) | 4 mo (17 wks) |
| 3-5 years | 5 mo (22 wks) | 5 mo (22 wks) |
| 5+ years | 6 mo (26 wks) | 6 mo (26 wks) |
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Enter your details to see your sick pay breakdown.
How NHS Sick Pay Works
NHS staff employed under Agenda for Change (AfC) benefit from an occupational sick pay scheme that is significantly more generous than the statutory minimum. The scheme is set out in Section 14 of the AfC handbook and applies to all directly employed NHS staff in England, Wales, Scotland, and Northern Ireland.
Under the AfC framework, eligible employees receive a combination of full pay and half pay during periods of sickness absence, with the duration depending on their length of continuous NHS service. This is known as Occupational Sick Pay (OSP) and is far more generous than Statutory Sick Pay (SSP), which in 2026/27 is just £116.75 per week.
The key principle is that NHS occupational sick pay includes SSP within it — it is not paid on top. So when you receive full pay during sickness, that amount already encompasses any SSP entitlement. Only when your occupational sick pay entitlement is exhausted, or if you are not eligible for OSP, would you fall back to SSP alone.
To qualify for NHS sick pay, you must follow your employer's sickness absence reporting procedures, which typically include notifying your line manager on the first day of absence and providing a fit note from your GP for absences lasting more than seven calendar days.
NHS Sick Pay Entitlement by Service Length
Your NHS sick pay entitlement is determined solely by your length of continuous NHS service — not your pay band or role. The longer you have worked for the NHS, the more sick pay you are entitled to. The entitlement tiers are set out in Section 14 of the AfC handbook.
| Length of Service | Full Pay | Half Pay | Total Paid Sickness |
|---|---|---|---|
| During first year | 1 month | 2 months | 3 months |
| During second year | 2 months | 2 months | 4 months |
| During third year | 4 months | 4 months | 8 months |
| During fourth year | 5 months | 5 months | 10 months |
| Five years or more | 6 months | 6 months | 12 months |
Important: During your first year of NHS service, there is a probationary entitlement of 1 month full pay and 2 months half pay. Entitlements increase progressively with each completed year of service, reaching the maximum of 6 months full pay and 6 months half pay after 5 years of continuous service.
Continuous service includes time spent across different NHS employers, provided there is no break of more than 12 months between posts. Service with some non-NHS bodies (e.g. local authorities, civil service) may also count under the NHS continuity of service framework.
The Rolling 12-Month Rule
One of the most important — and frequently misunderstood — aspects of NHS sick pay is the rolling 12-month calculation. Your sick pay entitlement is not based on a calendar year (April to March) or a leave year. Instead, it is calculated by looking back over the previous 12 months from the first day of your current sickness absence.
Any sickness absence you have already taken during that rolling 12-month window is deducted from your current entitlement. This means that if you have had previous episodes of sickness in the last 12 months, your available full pay and half pay periods will be reduced accordingly.
📌 Example Scenario
Sarah is a Band 5 nurse with 6 years of NHS service, giving her a maximum entitlement of 6 months full pay and 6 months half pay. In June 2025, she was off sick for 8 weeks (2 months) on full pay.
In February 2026, Sarah goes off sick again. Because her June 2025 absence falls within the rolling 12-month lookback, she now has only 4 months of full pay remaining (6 months minus 2 months already taken), followed by her full 6 months of half pay.
Once June 2026 passes, the earlier absence drops out of the 12-month window, and her full entitlement is restored — provided she has returned to work.
This rolling calculation means it is critical to understand how previous absences affect your current entitlement. Your HR or workforce team can provide a summary of your sickness record and remaining entitlement at any time.
What Counts as Full Pay?
When the AfC handbook refers to "full pay" during sickness, it means more than just your basic salary. Full sick pay is intended to replicate what you would normally earn if you were at work, and it includes several components:
- Basic salary — Your normal AfC pay band salary
- Regular enhancements — If you have a regular working pattern that includes unsocial hours, your full pay may include an average of these enhancements based on what you would normally have earned
- High Cost Area Supplement (HCAS) — If you work in an area that attracts HCAS (inner London, outer London, or fringe), this is included in full pay
- Recruitment and retention premia — Where applicable, these are also included
SSP is included within NHS pay — a common point of confusion. When you receive full pay during sickness, SSP is not added on top. Your employer pays your full salary, which already encompasses any SSP entitlement. SSP only becomes separately relevant when your occupational sick pay entitlement runs out.
Half pay is calculated as 50% of your normal pay. However, there is a floor: if half pay plus any SSP you are entitled to would be less than your full SSP rate, you will receive the SSP rate instead. This ensures you never receive less than the statutory minimum during your half pay period.
Once both full pay and half pay periods are exhausted, you move to nil pay. During nil pay, you may still be entitled to SSP (up to 28 weeks total) and should discuss options with your employer, including potential referral to occupational health and access to the NHS pension ill-health retirement provisions.
Statutory Sick Pay (SSP) in 2026/27
Statutory Sick Pay is the legal minimum sick pay that all eligible employees are entitled to. For the 2026/27 tax year, the key SSP figures are:
| SSP Detail | 2026/27 Rate |
|---|---|
| Weekly SSP rate | £116.75 |
| Lower earnings limit | £125 per week |
| Maximum SSP duration | 28 weeks |
| Waiting days | 3 qualifying days |
Waiting days: SSP is not payable for the first 3 qualifying days of sickness. These are known as "waiting days." However, under NHS occupational sick pay, you receive full pay from day one, so waiting days are only relevant if you have no occupational sick pay entitlement remaining.
Lower earnings limit: To qualify for SSP, you must earn at least £125 per week on average. Most NHS staff will comfortably exceed this threshold, but it can be relevant for some part-time or bank workers.
When SSP ends: After 28 weeks of SSP, your employer will issue an SSP1 form, which you can use to apply for Employment and Support Allowance (ESA) or the health element of Universal Credit. It is important to start this application process before your SSP runs out to avoid gaps in income.
Remember: for most NHS staff with occupational sick pay entitlement, SSP acts as an underlying safety net rather than a primary source of income during sickness. The NHS occupational scheme provides substantially higher payments during both full and half pay periods.
Special Circumstances
Certain situations attract special provisions under the AfC sick pay framework. Understanding these exceptions is important for affected staff.
Pregnancy-Related Sickness
Sickness absence that is directly related to pregnancy is recorded separately from general sickness and does not count towards your sick pay entitlement. This means pregnancy-related illness will not reduce your available full pay or half pay periods. This protection applies from the start of pregnancy until the end of maternity leave. If you are off sick with a pregnancy-related condition in the last 4 weeks before your due date, your maternity leave may be triggered automatically.
Injury at Work — Section 22 (Injury Allowance)
Under Section 22 of the AfC handbook, staff who sustain an injury or illness that is wholly or mainly attributable to their NHS employment may be eligible for Injury Allowance. This provides a top-up payment of up to 85% of pay (less any benefits received) for a temporary period, and can extend beyond normal sick pay entitlements. This is particularly relevant for staff who suffer workplace injuries, needlestick incidents, or occupational diseases. Claims must be made through your employer and supported by evidence.
Retire and Return Staff
Staff who have retired from the NHS and subsequently returned to employment will typically have their continuous service recalculated from their return date. This means sick pay entitlements restart based on the new period of service, not their total historical NHS career. However, some employers may exercise discretion on this point, so it is worth checking your local policy.
Bank Staff
NHS bank workers are typically not entitled to occupational sick pay under the AfC scheme, as they are usually employed on a casual or zero-hours basis. Bank staff may still be entitled to SSP provided they meet the earnings threshold and other qualifying conditions. Some NHS Trusts have introduced enhanced terms for regular bank workers, so check your specific bank agreement for details.
NHS Sick Pay — Frequently Asked Questions
Do I need a fit note for sick leave?
For absences of 7 calendar days or less, you can self-certify your sickness. For absences longer than 7 days, you will need a fit note (previously called a sick note) from your GP or hospital doctor. Your employer may require you to notify your line manager on the first day of absence and maintain regular contact throughout.
What are "waiting days" for SSP?
Waiting days are the first 3 qualifying days of a period of sickness during which SSP is not paid. Under NHS occupational sick pay, you receive full pay from day one, so waiting days do not affect your pay unless you have exhausted your occupational entitlement. If you only qualify for SSP, you will not receive payment for the first 3 days.
How do linked periods of incapacity for work (PIWs) work?
For SSP purposes, if you have two or more periods of sickness separated by 8 weeks or fewer, they are "linked" and treated as a single period. This means the 3 waiting days only apply once (at the start of the first period), and the 28-week SSP clock continues from where it left off rather than restarting. For NHS occupational sick pay, all absences within the rolling 12-month window count towards your entitlement regardless of linking.
Can I get NHS sick pay if I retire and return?
If you retire from the NHS and return to a new post, your sick pay entitlement is generally based on your new period of continuous service from the date you rejoined. Your previous service before retirement does not typically count. This means you would start with the first-year entitlement (1 month full pay, 2 months half pay) and build up again over time.
What is the NHS Injury Allowance?
The NHS Injury Allowance (covered under AfC Section 22) provides financial support to staff who lose earnings as a result of an injury or illness caused by their NHS work. It can top up your income to up to 85% of your pay for a temporary period and may continue beyond normal sick pay entitlement. It is not automatic — you must apply through your employer and provide evidence that the injury or illness is attributable to your work.
Do bank staff get NHS sick pay?
Bank staff are generally not entitled to NHS occupational sick pay as they are not on permanent AfC contracts. However, bank workers may qualify for Statutory Sick Pay (£116.75/week in 2026/27) if they meet the lower earnings limit of £125 per week averaged over 8 weeks. Some Trusts have begun offering enhanced sick pay to regular bank workers — check your bank terms and conditions.
What happens if I'm still sick after my entitlement runs out?
Once your NHS occupational sick pay (full and half pay) is exhausted, you move to "nil pay." You may still receive SSP for up to 28 weeks in total. After SSP ends, your employer issues an SSP1 form so you can claim Employment and Support Allowance (ESA) or Universal Credit. Your employer should also refer you to occupational health to discuss rehabilitation, reasonable adjustments, redeployment, or ill-health retirement through the NHS Pension Scheme.
Key Takeaways
- NHS occupational sick pay (AfC Section 14) is far more generous than Statutory Sick Pay — up to 6 months full pay + 6 months half pay for staff with 5+ years of service.
- Your entitlement depends on length of continuous NHS service, not your pay band or role.
- Sick pay is calculated on a rolling 12-month basis — previous absences in the last year reduce your remaining entitlement.
- Full pay includes basic salary, regular enhancements, and HCAS. SSP is included within occupational sick pay, not paid on top.
- SSP is £116.75/week in 2026/27, payable for up to 28 weeks after 3 waiting days.
- Pregnancy-related sickness is recorded separately and does not affect your sick pay entitlement.
- Staff injured at work may qualify for Injury Allowance (up to 85% pay) under AfC Section 22.
- Bank staff typically qualify for SSP only — not NHS occupational sick pay.
- After all sick pay is exhausted, apply for ESA or Universal Credit using the SSP1 form from your employer.