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Nursing staff at work

NHS conditions of employment

Standard working hours, overtime, annual leave and on-call working arrangements

The standard full-time working week for NHS staff is 37.5 hours. Overtime and annual leave entitlements are also standardised across the NHS. 

Find out more about these conditions and entitlements here, along with information on high cost area supplements and on-call working arrangements.

NHS annual leave, including public holidays

The number of days of annual leave you are entitled to depends on how long you've worked in the NHS. Any previous periods of continuous service in the NHS are also taken into account.


days a year for first 5 years


days a year after 5 years' service 


days a year after 10 years' service

NHS overtime payments 

All NHS staff in pay bands 1–7 are eligible for overtime payments if they work more than 37.5 hours a week. Senior staff in pay bands 8 and 9 are not entitled to overtime payments. 
1.5x  your standard hourly rate for every hour of overtime worked

your standard hourly rate for working on bank holidays

You can request time off in lieu instead of overtime.

On-call work

If you are on an NHS Agenda for Change contract and you work on-call, you are entitled to receive an on-call payment. These payments are negotiated locally but have to comply with national principles to ensure a consistent approach and to meet equal pay requirements.

High cost area supplements

If you work in Greater London or the counties immediately surrounding London (the fringe zone), you'll receive extra pay on top of your basic salary as follows:

+ 20% if you work in inner London (subject to a minimum payment of £4,608 & a maximum payment of £7,097)
+ 15%
if you work in outer London
(subject to a minimum payment of £3,898 & a maximum payment of £4,967)
+ 5% if you work in the fringe zone (subject to a minimum payment of £1,066 & a maximum payment of £1,845)

Your pay and conditions

You can find more in-depth information on all the topics covered on this page in the NHS terms and conditions of service handbook.

Annual pay increments

Each Agenda for Change pay band has a number of points. If you have not reached the maximum point in your pay band, you will progress to the next point each year if your performance is satisfactory and you demonstrate the expected knowledge and skills. Your employer must have a fair appraisal system in place to assess your performance.

The competencies for each band are determined by the Agenda for Change Knowledge and Skills Framework (KSF), which sets out the knowledge and skills required for each job role.

You can find more about pay progression on the NHS Employers website.

What is Agenda for Change?

Agenda for Change is the system of standardised pay, terms and conditions for NHS workers

When implemented in the NHS across the UK in 2004, Agenda for Change was the biggest overhaul of NHS-wide pay, terms and conditions in more than 50 years.

We're here for you

If you're an RCN member and need advice on your pay and conditions of employment, you can contact the RCN seven days a week, 365 days a year.