Pay education hub

This hub helps employers understand the journey, history, evolution and key developments of NHS pay.
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Your guide to understanding NHS pay

NHS pay is complex and continually evolving. This hub brings together resources to help employers understand how NHS pay has developed over time, how it is structured today, and the key processes, policies and partnerships that shape it.

The hub covers the history and evolution of NHS pay, including Agenda for Change and medical and dental pay arrangements, how pay is set, the role of pay review bodies and partnership working, and the importance of job evaluation and equal pay. It also explores how NHS pay has changed over time and provides information and resources to support a greater understanding of NHS terms and conditions of service.

Developing knowledge and understanding of NHS pay can help employers have more informed conversations with staff about pay, reward and the wider employment package. As part of one of the most comprehensive employment offers available, it is important that staff understand not only their pay, but also the wider benefits, opportunities and support available throughout their NHS career. Whether you are new to NHS pay or looking to strengthen your knowledge, this hub will help employers and managers have informed conversations with staff about their pay, terms and conditions, and the wider NHS employment offer. 

The history:

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History of pay

Background into the history of pay including the establishment of the General Whitley Council, Agenda for Change and the medical and dental contracts.

The journey of NHS pay over the last decade

Details of pay over the last decade including workforce trends and how pay has changed during this time.

Governance and structures:

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Guidance

The NHS annual pay award process

Learn how NHS Employers participates in the NHS annual pay award process.

30 October 2025
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Agenda for Change

Introduction of Agenda for Change (AfC), the importance of equal pay and key changes to AfC terms and conditions since 2004.

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How pay is set in the NHS

Details on the NHS Pay Review Bodies, NHS Staff Council, partnership working and key changes to NHS pay policy since 2004.

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Medical and dental pay structure

Details on how medical and dental pay is agreed, annual pay awards over the last ten years and the recently negotiated pay deals.

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Medical and dental staff groups

Information about the different medical and dental staff groups.

Support for employers:

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Article

Job evaluation and equal pay

The importance of equal pay and why effective job evaluation practice is still so important today.

10 April 2025
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Promoting the total NHS employment offer

This page details the importance of promoting the total NHS employer offer along with the actions employers can take to do this.

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Audio/Video

NHS total reward personas

Resources to support employers with understanding, promoting and communicating the value of the total employment package.

26 August 2025
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Guidance

Explaining the total reward offer across the employment journey

Our guide gives an overview of the NHS total reward package and supports line managers to promote the offer at various stages of an employee's career.

20 December 2024