NHS Staff Rights in England and Wales

Who this guide is for

People employed by an NHS organisation in England or Wales, such as an NHS trust or a Welsh health board. Most of it is about staff on Agenda for Change (AfC) terms: nurses, healthcare assistants, allied health professionals, admin, estates and other non-medical staff. There is a short outline for doctors and dentists.

What this guide does not cover

• NHS staff in Scotland: see NHS Scotland Staff Rights. Health and Social Care (HSC) staff in Northern Ireland: see Health and Social Care (HSC) Staff Rights in Northern Ireland.
• Staff of GP practices, care homes and private providers who are not employed by an NHS organisation. Your contract sets your terms: use the employee rights checker (Your Rights as an Employee in England, Wales and Scotland).
• Agency and bank work: use Agency Workers in England, Wales and Scotland.
• Statutory sick pay, statutory holiday and dismissal rights: use Your Rights as an Employee in England, Wales and Scotland.
• Doctors' and dentists' contracts in detail. Ask NHS Employers or your union.
• Complaints about NHS care as a patient: see How Do I Complain About NHS Care in England? or How Do I Complain About NHS Care in Wales?.
• Professional regulation (for example the NMC, GMC or HCPC fitness to practise process). Ask your regulator or union.

What the rules depend on

1. Who employs you? An NHS organisation, or a GP practice, contractor or agency. Only NHS organisations must use the handbook in full.
2. Are you on Agenda for Change, or a medical or dental contract, or a very senior manager contract?
3. England or Wales? Pay is the same headline figure. Speaking up routes are different.
4. How long is your NHS service? It decides your annual leave and sick pay.
5. Is it a contract issue or a legal right? Contract terms: your employer's policies and your union. Legal rights: Acas and the employment tribunal.

"What will I be paid?"

For 2026/27 the government accepted the NHS Pay Review Body's recommendation of a 3.3% consolidated rise for AfC staff, paid in April 2026 salaries. The Welsh Government accepted the same 3.3% for all AfC pay points from 1 April 2026. It also pays the real living wage, so the lowest paid staff in Wales get rises of 3.8% to 5.9%.

NHS Employers' pay scales from 1 April 2026 start at £25,272 a year for band 2 and £32,073 for band 5. Band 1 is closed to new entrants.

"How much annual leave and sick pay do I get?"

Annual leave (handbook section 13), including 8 general public holidays:

• When you start: 27 days + 8 days
• After 5 years' service: 29 days + 8 days
• After 10 years' service: 33 days + 8 days

If you must work or be on call on a public holiday, you get equivalent time off at plain time rates, as well as the payment for the work.

Sick pay (handbook section 14, England and Wales):

• First year of service: 1 month's full pay and 2 months' half pay
• Second year: 2 months' full pay and 2 months' half pay
• Third year: 4 months' full pay and 4 months' half pay
• Fourth and fifth years: 5 months' full pay and 5 months' half pay
• After 5 years: 6 months' full pay and 6 months' half pay

NHS sick pay and statutory sick pay together cannot be more than your full pay. On full sick pay, your statutory sick pay is included. On half pay, statutory sick pay can be added but the total must not be more than full pay. For statutory sick pay, see Your Rights as an Employee in England, Wales and Scotland.

"What about my pension?"

NHSBSA runs the NHS Pension Scheme in England and Wales. How much you pay depends on your actual annual pensionable pay. From 1 April 2026:

• Up to £13,259: 5.2%
• £13,260 to £28,854: 6.5%
• £28,855 to £35,155: 8.3%
• £35,156 to £52,778: 9.8%
• £52,779 to £67,668: 10.7%
• £67,669 and above: 12.5%

For questions about your own pension, contact NHSBSA (NHS Pensions). For your general pension rights, see Workplace Pensions & Auto-Enrolment: Your Rights in 2026.

"How do I speak up?"

England: Freedom to Speak Up guardians help build safe speaking-up cultures in NHS organisations. All organisations will be required to list their guardian or guardians, and how to contact them, on their website. The National Guardian's Office closed on 30 June 2026. From 1 July 2026 NHS England took on some of the National Guardian's Office's activities, and national escalation goes through NHS England's Freedom to Speak Up policy and the Care Quality Commission (CQC).

Wales: the Speaking up Safely Framework for NHS Wales (20 September 2023) sets out the responsibilities of NHS Wales organisations, managers and staff for raising concerns.

Whistleblowing law protects you whichever route you use, if your disclosure qualifies. Prescribed bodies include the CQC (health and social care), Healthcare Inspectorate Wales (health care in Wales), and the NMC, GMC and HCPC for fitness to practise. See Whistleblowing at Work in England, Wales and Scotland.

"What about doctors?"

Doctors and dentists are not on Agenda for Change. Their pay is set after recommendations from the Doctors' and Dentists' Review Body. For 2026/27 the government accepted a 3.5% rise from 1 April 2026 in England for resident doctors and dentists, SAS doctors and dentists, consultants and salaried GPs. The Welsh Government accepted 3.5% from 1 April 2026 for consultants, SAS, resident and locally employed doctors and dentists. For your contract terms, ask NHS Employers, NHS Wales Employers or your union.

"Can we go on strike?"

Industrial action must follow a properly run union ballot. Since 18 February 2026 (Great Britain):

• The 40% support threshold for public sector ballots has gone. Ballots need more votes for action than against.
• The union must give your employer 10 days' notice, instead of 14.
• A mandate lasts 12 months, instead of 6.
• Dismissal for taking part in protected industrial action is automatically unfair, with no 12-week limit, if you started taking part on or after 18 February 2026.

Minimum service levels were repealed on 18 December 2025. See Trade Union Rights: What You Can and Can't Do at Work in 2026.

Deadlines you must meet

• Most employment tribunal claims: 3 months less 1 day from the act you are complaining about, or 6 months less 1 day where that act (or the last act in a series) happened on or after 1 October 2026.
• Notify Acas within your time limit. Early conciliation pauses the clock.
• Your exact date depends on your facts. See our tribunal deadline guide.

Money figures

• AfC pay rise 2026/27: 3.3% from 1 April 2026 (England and Wales).
• Band 2 starts at £25,272 and band 5 at £32,073 a year from 1 April 2026 (NHS Employers pay scales).
• Most doctors and dentists: 3.5% from 1 April 2026 (England and Wales). Salaried community dentists: 3.75%.
• NHS Pension Scheme contribution rates: see "What about my pension?".

Traps

• Agenda for Change does not cover doctors, dentists or very senior managers.
• NHS sick pay and leave count your NHS service. Check your start date on your contract.
• The National Guardian's Office has closed. Speak to your organisation's guardian, NHS England or the CQC.
• A grievance does not stop the tribunal clock. Notifying Acas within the time limit pauses it.
• Do not use the 6-month limit for an act that happened before 1 October 2026.