How do increments work in the NHS?

Pay progression through increments in the National Health Service (NHS) in England is based on a system known as Agenda for Change (AfC). This is a national pay and grading system that covers most NHS staff, excluding doctors and some other clinical roles.

The AfC system is designed to provide a fair and transparent way to determine pay and progression for NHS staff, based on their qualifications, experience, and performance. It is made up of nine pay bands, which are based on the level of skills and responsibility required for a particular role. Staff members typically start at the bottom of the pay band for their role, and can progress to the top of the pay band through a combination of experience and performance.

For example, a nurse who is just starting out in their career would typically start at the bottom of pay band 5, which is the pay band for qualified nurses. As they gain experience and develop their skills, they would be able to progress through the pay band, moving up to an intermediate increment (with higher salary) after two years. This process would continue until they reached the top of the pay band after two further years.

Increments are not implemented in the same way for all pay bands. Some AfC bands have just a bottom and top increment, whilst others have a mid-point or intermediate increment. The differences between bands are outlined below:

• Bands 2-3: staff move from bottom to top increment after two years
• Band 4: staff move from bottom to top increment after three years
• Band 5: staff move from bottom to middle increment after two years, and to the top increment after two further years
• Bands 6-7: staff move from bottom to middle increment after two years, and to the top increment after three further years
• Bands 8-9: staff move from bottom to top increment after five years

Generally, there is no automatic progression for staff who have reached the top of their pay band. Staff in this situation must consider whether to apply for more senior roles, which may require moving departments or locations.