NHS Band pay 2026 for internationally recruited nurses — what to expect on your payslip

Agenda for Change pay rises took effect April 2026. Band 5 (Newly Qualified Nurse) entry point is £29,970, rising to £36,483 at top of band. Band 6 (Senior Staff Nurse / Specialist) sits at £37,338–£44,962. Add High Cost Area Supplement: Inner London 20% (min £5,414, max £8,172), Outer London 15%, Fringe 5%.

Your first payslip will show PAYE income tax on a 1257L W1/M1 emergency code if you started mid-month. NI is 8% above £12,570 annualised. The IHS you paid with your visa is NOT deducted from payroll — it's a one-off paid at visa application.

Pension auto-enrolment kicks in at month two for most trusts. NHS Pension Scheme member contribution is 6.1% on Band 5 entry, 9.8% at Band 6 top. It's salary-sacrifice for tax efficiency. You can opt out and re-join later, but you'll lose the death-in-service and ill-health protection.

Many internationally recruited nurses qualify for a relocation tax exemption (up to £8,000 of relocation costs paid by the employer can be tax-free under s.287 ITEPA 2003). Ask your HR if they've structured the offer correctly — most trusts have a template.

If your code is still 1257L W1/M1 by month three, ring HMRC on 0300 200 3300. A 10-minute call usually fixes it and triggers a refund of any overpayment in your next payslip.