NHS terms and conditions of service
This guide includes information about pay scales, sick pay, pay on appointment, pay progression, annual leave, overtime and annual leave, maternity entitlements and reckonable service.
NHS pay scales in England for 2018/2019 are available on the NHS Employers website. These include annual salary, hourly pay and adjustments for inner/outer London.
NHS pay scales in England for previous years are available in Annexes 2 and 3 of the handbook.Back to contents
Your starting pay will depend upon your circumstances – these are described below. For further information read the handbook (section 6, as applicable to the country in which you work) and your employer’s local pay policy.
We recommend that your starting salary is agreed in writing before you start a new role.
|Promotion within the NHS||Pay on promotion should be set either at the minimum of the new pay band or - if this would result in no pay increase - the first pay point in the band which would give you an increase in pay. See section 6 of the handbook, as applicable to the country in which you work.|
|Appointment to a post in a lower pay band through choice||The handbook does not state how your starting salary should be calculated if you start on a lower pay band through choice.
We believe that you should enter the new band at the point you would have reached if all your NHS service in equivalent, or higher, pay bands had been worked in the lower band.
|Moving to another AfC NHS employer||The handbook does not state how your starting pay is calculated should you have previous NHS service.
We believe that if appointed to a new post in the same pay band you should usually enter the band at the same point you were on with your previous employer (if there is no break in service).
When this happens, it is common practice for staff to be paid on the minimum of the band until confirmation of previous salary (such as a copy of the last payslip or and contract) has been received from the former NHS employer. Once this has been received, any necessary adjustment should be backdated to your start date with the new employer
|Staff with a break in NHS employment||The handbook does not state how you should have your starting pay calculated if you have had a break in NHS employment.
Under local policy, management and human resources are likely to have the discretion to take into account previous NHS service. Generally, there would be no obligation to pay new starters with previous NHS service higher than the bottom of the pay band, unless the employer's policy explicitly states this must be taken into account.
|Staff without previous NHS employment||Staff without previous NHS employment would normally be appointed to receive the minimum of the pay band. However NHS employers do have the discretion to take into consideration previous experience that may be relevant to NHS employment.|
|Temporary movement into a higher band (acting-up)||
Staff may be moved into a higher pay band on a temporary basis when a vacancy is unfilled (but being advertised), or the post is being held open for someone who is due to return - for example from maternity leave or long term sick leave.
Your pay should be set either at the minimum of the new pay band or, if this would result in no pay increase, at the first pay point in the band which would deliver an increase in pay. In circumstances where you are not required to carry out the full responsibilities of the post, pay will be determined by job evaluation. See section 6 of the handbook, as applicable to the country in which you work.
If you are being asked to work in a higher banded post for any period, you should only do so where your rate of pay is agreed in advance. If you are currently working in a higher banded post and are not being paid accordingly, you should discuss this with your manager and contact us if you need further help.
Sections 1 and 6 of the handbook set out in more detail how pay and career progression within the NHS Knowledge and Skills Framework (KSF) performance systems work. Annex 23 sets out the principles and guidance which will underpin local pay progression policies in England and Wales.
Annex 23 states that incremental pay progression will be conditional upon you demonstrating that you have the requisite knowledge and skills/competencies for the role and that you have met the required level of performance .
Frequency and timing of annual appraisals is important. KSF guidance states that employers should hold appraisals no later than three months prior to your incremental date. This would link performance and incremental pay progression and allow you time to prepare for the appraisal. You should also check your employer's written polices for specific detail of the process to be followed at your workplace.
You should be formally told the reasons for any deferral of your increment. Pay progression cannot be deferred unless there has been prior discussion, reasons have been clearly identified and documented, and the standards or levels yet to be achieved have been clarified.
An action plan with clear objectives and review dates should be agreed by you and your line manager. You should then be given the opportunity to achieve the necessary development before a final decision is made. Pay progression can be withheld if 'significant weaknesses in performance' have not been resolved despite opportunities for development. Employers can also (where appropriate) manage performance issues under local capability and/or disciplinary policies.
For more information on managing performance please see our advice on capability.
While you need to demonstrate the application of knowledge, skills and competence in your role, your employer is also required to have an agreed and fair appraisal system in place.
Employers’ appraisal, development and review systems should be transparent, and applied consistently and objectively to avoid any unfair treatment of staff protected under the Equality Act 2010. Appraisals should be evidence based and not based on bias, personalities or subjective views. Employers should also consider any 'reasonable adjustments' for those protected under the Equality Act 2010 and decisions made on a case by case basis.
In all cases, check your employers local policy for more information about local arrangements.Back to contents
Below is a summary of the NHS sick pay entitlements. For full information, please see section 14 of the handbook. Please note that there are three sections - one covering England, one covering Wales, and the other covering Scotland and Northern Ireland.
You are entitled to the following sick pay:
|During the first year of service||One month’s full pay and two months half pay|
|During the second year of service||Two months full pay and two months half pay|
|During the third year of service||Four months full pay and four months half pay|
|During the fourth and fifth years of service||Five month's full pay and five months half pay|
|After completing five years of service||Six months full pay and six months’ half pay|
Your employer will take into account all periods of paid sickness absence during the 12 months immediately preceding the first day of a new episode of sickness. This will be deducted from your entitlement when calculating sick pay.
In aggregating periods of absence due to illness no account will be taken of:
Staff who are on sickness absence due to a work related injury, disease or other health condition may also be entitled to payment of an injury allowance as defined in Section 22 of the handbook. To accompany section 22, the NHS Staff Council has published Injury Allowance – a guide for staff.
If sickness absence is because of an injury or disease wholly or mainly attributable to your employment, you may be entitled to claim additional benefits. For further information see accidents at work and personal injury.
Section 14 explains how sick pay for NHS staff is to be calculated. Please see the section that applies to the country in which you work.
The way in which your 'usual' sick pay is calculated will depend on what band you work in and whether the absence is due to work-related injury or disease.
Under section 13, table six of the handbook, you are entitled to the following annual leave:
|On appointment||27 days annual leave + eight days general public holiday|
|After five years’ service||29 days annual leave + eight days general public holiday|
|After ten years’ service||33 days annual leave + eight days general public holiday|
If you work standard shifts, other than seven and a half hours excluding meal breaks, your annual leave and general public holiday entitlements should be calculated on an hourly basis, to prevent you receiving greater or less leave than colleagues on standard shifts (section 13.5).
Part-time workers will be entitled to paid public holidays no less than pro-rata to the number of public holidays for a full-time worker, rounded up to the nearest half day (section 13.6). As a part-time worker, your public holiday entitlement shall be added to your annual leave entitlement, and you should take the public holidays you would normally work as annual leave (section 13.7).
Pay during annual leave will include regularly paid supplements, including any recruitment and retention premia, payments for work outside normal hours and high cost area supplements. Pay is calculated on the basis of what you would have received had you been at work. This would be based on the previous three months at work or any other reference period that may be locally agreed (section 13.9). If you believe you have been underpaid, please call us.Back to contents
Please check section 15 of the Agenda for Change handbook (note there are different provisions for England and Scotland, Wales and Northern Ireland) and your employer's policy for more detail.
Contractual payments in the handbook are as follows:
Whether you work full-time or part-time you will be entitled to paid and unpaid maternity leave under the NHS contractual maternity pay scheme if you have 12 months’ continuous service with one or more NHS employers at the beginning of the 11th week before the expected week of childbirth.
Before the end of the 15th week before the expected date of childbirth (or if this is not possible, as soon as is reasonably practicable thereafter) you must provide your employer with a MATB1 form.
You must also inform your employer in writing of:
See sections 12 and 15 of the handbook for advice on continuous service.
To claim NHS contractual maternity pay you must intend to return to work with the same or another NHS employer for a minimum period of three months after your maternity leave has ended.
You can return to work early if you give at least 28 days’ notice, although some local policies require eight weeks.
You have the right to return to your job, under your original contract with no less favourable terms and conditions.
If you want to return to work on different hours in the same job your employer must facilitate this unless they provide written, objectively justifiable reasons why this is not possible.
If you do not return to NHS employment within 15 months of the beginning of your maternity leave, then you will be liable to refund the whole of your maternity pay (except for the Statutory Maternity Pay element). In cases where your employer considers that to enforce this provision would cause undue hardship or distress, they will have the discretion to waive their rights to recovery.
If you satisfy the conditions in paragraph 15.7 but do not intend to work with the same or another NHS employer for a minimum period of three months after your maternity leave is ended, you will only will be entitled to pay that is equivalent to Statutory Maternity Pay. This is paid at 90 per cent of your average weekly earnings for the first six weeks of your maternity leave and at a flat rate sum for the following 33 weeks.
You can find out more about maternity, work and family here.Back to contents
Section 12 of the handbook states:
"12.1 An employee’s continuous previous service with any NHS employer counts as reckonable service in respect of NHS agreements on redundancy, maternity, sick pay and annual leave.
12.2 Employers have discretion to take into account any period or periods of employment with employers outside the NHS, where these are judged to be relevant to NHS employment.
12.3 When employees who have been transferred out of NHS employment to a non-NHS provider return to NHS employment, their continuous service with a new non-NHS employer providing NHS funded services, will be counted as reckonable in respect of NHS agreements on sick pay, annual leave and incremental credit.”Back to contents
Historically bank work has not been considered as employment because the normal requirements of a 'contract of employment' do not exist between the parties. In particular, the requirement that there was 'mutuality of obligation', i.e. the compulsion on an employee to attend work and the compulsion on the employer to pay them for that attendance (amongst other things). As a result, working on the NHS bank is generally not counted for the purposes of reckonable and/or continuous service.
We have tested this issue on behalf of members in the courts in the past without success. In the absence of 'continuous previous service' with the NHS, employers do have discretion under section 12.2 of the handbook to take in to account 'any period or periods of employment with employers outside the NHS where these are judged to be relevant to NHS employment'.
Whilst this is discretionary and employers may argue that staff who work solely on a bank are not employees, staff might want to argue that this approach goes against the spirit of the clause and they should be entitled to some recognition of the years of service.Back to contents
Page last updated - 29/11/2018