Key points at a glance

NHS Terms and Conditions of Service - 2018

This page shows the key points at a glance from the framework agreement:

At a glance

  • Three year deal covering 2018/19, 2019/20, and 2020/21.
  • Covers all NHS employers in England (covered in Annex A of the Terms and Conditions of Service Handbook).


  • Starting salaries increased across all pay bands.
  • New pay structure with fewer pay points – overlapping pay points removed initially followed by further pay points.
  • New system of pay progression.
  • Top of pay bands to be increased by 6.5 per cent over the three years (apart from band 8d and 9 which will be capped at the increase of Band 8c).
  • Minimum rate of pay in the NHS to be set at £17,460 from 1 April 2018 – ahead of the Living Wage Foundation Living Wage rates.

Structural changes

  • Band 1 to be closed to new starters from 01 December 2018. The NHS Staff Council to agree a process for this including upskilling Band 1 jobs to Band 2 roles during the 3 years of the pay deal.
  • Bands 2 to 4 and 8 to 9 will only have two pay points in the new structure. Bands 5 to 7 will have three.
  • Staff below band 8 will have the opportunity to reach the top of their pay band more quickly than under the current pay system.
  • The time it takes for bands 8 to 9 to reach the top remains unchanged.
  • Re-earnable pay remains for those staff that have reached the top of their pay band in bands 8c to 9

Other changes

  • Terms and conditions amendments to:
    - include enhanced shared parental leave
    - child bereavement leave
    - a national framework on buying and selling leave.
  • Unsocial hours payments while off sick to be paid only to existing staff earning at or below £18,160.
  • Unsocial hours percentage rates for Band 1 – 3 to be adjusted in line with increases to basic pay.

Ambulance sector

  • New entrant ambulance staff, and those changing jobs or moving roles internally or moving to a new employer, to be paid unsocial hours under Section 2 rather than Annex 5.
  • Voluntary move to Section 2 terms will be offered to all existing ambulance staff.

Future NHS Staff Council work programme

  • Programme of work to improve health and wellbeing to support better attendance levels and reduce sickness absence.
  • To explore the alignment between Agenda for Change and other senior NHS pay arrangements.
  • NHS Staff Council to negotiate provisions for apprenticeship pay as a matter of urgency.
  • NHS Staff Council to undertake work on exploring the scope for a collective framework agreement on bank and agency working.
  • Monitoring the impact of any deal.

NHS Pay Review Body

  • NHS Pay Review Body retains its standing remit and will look at the progress of implementation and its impact.
  • This monitoring role will also consider the future use and values of RRPs and High Cost Area Supplement (HCAS) payment.

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