Classification: Official
Publication reference: PRN02382

To:

• NHS trust and foundation trust:
  • chief executive officers
  • chief nurses
  • chief people officers
  • chief finance officers
  • chief operating officers
  • chairs

cc.

• NHS trust and foundation trust:
  • communication leads
• NHS England regional:
  • directors
  • directors of workforce, training and education
  • chief nurses
  • finance directors
  • heads of communication

Dear colleagues

Actions to deliver Agenda for Change uplift and a fairer deal for nurses

Thank you for the progress you have made to implement existing Agenda for Change (AfC) non-pay deal recommendations. Strengthening job evaluation practice, improving job documentation and board-level ownership have required sustained effort and remain central to the effective operation of AfC.

This letter updates you on and asks for your support in implementing the Government’s announcements this week on supporting nurses and the acceptance of Pay Review Body recommendations for AfC staff in 2026/27.

A fairer deal for nurses

After constructive engagement with the Royal College of Nursing (RCN) and NHS Staff Council, the Government has announced a series of measures to recognise the significant value of the nursing profession and make sure nurses receive the pay and support they deserve.

These commitments are:  

• making sure every nurse is in the right band, and reviewing all band 5 nurse job descriptions, with additional funding available to support this review process
• making graduate pay a priority as part of ongoing reforms to Agenda for Change staff pay structure
• launching a national nursing preceptorship to ensure every nurse has the best start to their career, wherever they work
• reviewing the evidence from the review of band 5 nursing roles to determine whether any further action is required

The focus of this work with the RCN is on band 5 nursing roles as they represent the largest proportion of the nursing workforce and are at a critical point in nurses’ career progression pathways. Any pay outcomes will continue to be determined through the fair and proper application of the Job Evaluation Scheme.

This focus on band 5 nursing roles is in the context of the wider nursing commitments agreed as part of previous non-pay deals, including action on career progression, role clarity and the consistent application of job evaluation.

Please ensure local plans are in place to complete this work at pace, with board-level oversight and engagement with staff side partners. This builds on existing requirements and accelerates expectations already set for employers.

For all NHS band 5 nurses, please undertake a proper assessment of the duties they are being asked to undertake and whether these are consistent with the job description. Additional recurrent funding is available to support implementation of the evaluation outcomes.

NHS England regions will maintain oversight of progress, supporting consistency and identifying risks early.

National funding will be issued on a fair shares basis in the usual way using the existing allocations mechanisms. This is new funding over and above what has already been set aside for headline pay uplifts and investment in pay structure reform.

We do not underestimate the scale of the work required to ensure every band 5 nursing role is reviewed and thank you in advance for your leadership in taking this forward.

Further detail on delivery, timescales and assurance arrangements will follow shortly – in the meantime, you can find frequently asked questions on our website: NHS England » Actions to deliver Agenda for Change uplift and a fairer deal for nurses – frequently asked questions

Pay Review Body recommendations for Agenda for Change staff

The Agenda for Change Pay Review Body (PRB) has recommended a 3.3% rise for AfC staff in 2026/27. The Government has accepted this recommendation today and has asked NHS Business Services Authority to ensure staff receive this pay uplift in their April pay packets for staff paid through ESR. The government has also committed to work with NHS Staff Council to invest in reforming the Agenda for Change pay structure.

This is the earliest PRB recommendations have been accepted by the Government and implemented by the NHS in six years, which we know colleagues will welcome. It is a further example of the commitment to reward NHS staff fairly and to constructively work with trade unions.

Additional funding will be provided to reflect the final pay award by increasing integrated care board (ICB) allocations and NHS Payment Scheme prices. Full guidance will be available in due course, but given the tight timescales, we will issue interim guidance to ICBs and trusts shortly. This will provide clarity on the cash flow and reporting requirements to support staff to be paid from this April onwards. Please take all necessary steps to support readiness for this uplift from April.

Announcements about other Pay Review Body recommendations will follow.

Thank you for your continued leadership and commitment. We will continue to support you wherever we can and provide the guidance you need – please let us know how else we can help. By working together – nationally, regionally and locally – we can make the NHS better for our patients, communities and our staff.

Yours sincerely

Jo Lenaghan, Director General, People, NHS England and DHSC (Interim)
Duncan Burton, Chief Nursing Officer for England