NHS Annual Leave, TOIL and Carry-Over: Financial Guide
NHS annual leave entitlements range from 27 days at entry to 33 days after ten years, plus eight bank holidays — worth £3,325 to £7,755 per year depending on band. TOIL is financially inferior to paid overtime for unsocial hours work. Unused leave that cannot be carried over is permanently lost with no cash value. This guide covers leave entitlements, financial value at each band, TOIL mechanics, carry-over rules, maternity and sick leave interactions, and the most commonly missed financial protections for NHS staff in 2026/27.
NHS Annual Leave Entitlement 2026/27
NHS annual leave in 2026/27 is worth £3,325 to £7,755 per year depending on band and service length. TOIL costs approximately £73 per Saturday shift versus paid overtime at Band 6 — over a year of regular weekend working, this compounds into hundreds of pounds in foregone earnings. Carry-over is limited to five days in most trusts without written approval; untaken leave beyond this is permanently lost.
Annual leave accrues in full during sick leave and maternity leave — these are statutory rights. Sickness before or during annual leave allows reinstatement of those days. Untaken leave is paid out on leaving the NHS at your daily rate. Part-time leave is calculated in hours. The 2026/27 pay award increases the financial value of every leave day proportionally.
AfC annual leave is determined by continuous NHS service — not band, role or grade.
| NHS Service | Annual Leave | Bank Holidays | Total |
|---|---|---|---|
| Under 5 years | 27 days | 8 days | 35 days |
| 5 — 10 years | 29 days | 8 days | 37 days |
| Over 10 years | 33 days | 8 days | 41 days |
Continuous service counts from your NHS start date across all NHS employers. Career breaks and certain types of leave may affect continuity — verify with your trust HR if you have had a break in service.
Financial Value of Annual Leave by Band
Every day of annual leave has a calculable monetary value. Understanding this prevents you from undervaluing what you hold.
Daily Rate Formula: Annual salary ÷ 260 working days
Leave Value — England 2026/27 Mid-Point Salaries
| Band | Mid-Point Salary | Daily Rate | 35 Days (under 5 yrs) | 41 Days (over 10 yrs) |
|---|---|---|---|---|
| Band 3 | £24,702 | £95.01 | £3,325 | £3,895 |
| Band 4 | £27,767 | £106.80 | £3,738 | £4,379 |
| Band 5 | £33,344 | £128.25 | £4,489 | £5,258 |
| Band 6 | £40,545 | £155.94 | £5,458 | £6,394 |
| Band 7 | £49,178 | £189.15 | £6,620 | £7,755 |
A Band 6 nurse with over ten years’ service holds £6,394 of annual leave value per year. Allowing that to lapse unclaimed is a direct financial loss. Use the NHS annual leave calculator at nhspaycalculatorss.co.uk to calculate your exact entitlement and daily rate.
Bank Holiday Pay — How It Works Financially
Bank holiday treatment depends on whether you work them or not.
If you work bank holidays: AfC pays time plus 94% on all bank holiday shifts. At Band 6 mid-point (£20.79 basic hourly), a bank holiday shift pays approximately £40.33 per hour. Over an eight-hour shift, that is approximately £322 gross — versus £166 at basic rate.
If you do not work bank holidays: You receive the day off with full pay. If your rota pattern means you would not have worked that day, you receive a day in lieu added to your leave balance.
Part-time staff: Bank holidays are pro-rated by WTE. A 0.6 WTE employee receives 4.8 bank holiday days rather than eight. Where patterns cause consistent bank holiday inequity between full-time and part-time staff, most trusts resolve this through a calculated leave adjustment rather than rota changes. See how part-time hours affect your overall pay picture at the NHS part-time pay calculator.
TOIL — Time Off in Lieu: The Financial Reality
TOIL accrues when you work additional hours beyond your contracted hours and take equivalent time back rather than pay. It sounds neutral — but for unsocial hours work, TOIL is always financially inferior to paid overtime.
TOIL vs Paid Overtime — Band 6 Saturday Shift (7.5 hours)
| Option | Calculation | Gross Value |
|---|---|---|
| Paid Saturday overtime | £20.79 × 1.47 × 7.5 | £229.22 |
| TOIL at plain time | £20.79 × 7.5 | £155.93 |
| Financial gap | £73.29 per shift |
For every Saturday shift taken as TOIL rather than paid overtime, a Band 6 nurse loses approximately £73 gross. Over twelve Saturday shifts per year, that is approximately £879 in foregone earnings. Where your trust offers a choice, paid overtime for unsocial hours work is almost always more financially advantageous. Check your NHS overtime hours calculator to see the exact value of paid overtime versus TOIL at your band.
TOIL Accrual Limits and Expiry Rules
NHS trusts apply their own TOIL caps. Standard limits are:
- Maximum accrual of 37.5 hours (one working week) at any point
- TOIL must typically be taken within three months of accrual
- Expired TOIL is lost — it cannot be converted to cash retrospectively
- TOIL balances are not paid out on leaving the NHS, unlike untaken annual leave
Allowing TOIL to expire is a direct loss of worked time with no compensation. Track your TOIL balance actively and request leave dates before the expiry window closes.
Annual Leave Carry-Over Rules 2026/27
AfC does not set a universal carry-over limit — individual trust policies govern this within AfC parameters.
Typical Carry-Over Arrangements
| Policy Type | Carry-Over Allowance |
|---|---|
| Standard | 5 days maximum |
| Flexible (with approval) | Up to 10 days |
| Exceptional (COVID legacy) | Up to 75% of entitlement |
| Nil carry-over | All leave must be taken in year |
Carry-over above the standard allowance requires line manager and HR approval in writing. Carried-over leave must usually be taken in the first quarter of the new leave year — by end of June in most trusts running April to March leave years.
Verbal agreements to carry over leave are not enforceable. Get written confirmation before your leave year closes.
What Happens to Untaken Leave — The Real Financial Cost
Untaken leave that cannot be carried over is permanently lost with no cash value for substantive NHS employees at year end.
Exceptions where untaken leave generates payment:
On leaving NHS employment — any untaken leave from the current leave year is paid at your daily rate in your final salary payment.
| Band | Daily Rate | 10 Days Untaken | 15 Days Untaken |
|---|---|---|---|
| Band 5 | £128.25 | £1,283 | £1,924 |
| Band 6 | £155.94 | £1,559 | £2,339 |
| Band 7 | £189.15 | £1,892 | £2,837 |
If you are leaving the NHS, calculate your untaken leave carefully before your final day. The NHS back pay calculator can help verify your final payment entitlement.
Sickness During Annual Leave — Your Financial Rights
Two specific rules protect your leave balance when sickness and annual leave overlap.
Rule 1 — Sickness before annual leave starts: If you are signed off sick before a leave period begins, the annual leave is reinstated to your balance. You receive sick pay for the certified sick period.
Rule 2 — Sickness during annual leave: If you become ill during annual leave, you can convert those days to sick leave — provided you follow your trust’s notification procedure and obtain medical certification. The annual leave days are returned to your balance.
Both rules are established in AfC terms and confirmed by case law incorporated into UK employment law. Trusts cannot override them through local policy. For how sick pay interacts with your income, see the NHS sick pay calculator.
Annual Leave Accrual During Sick Leave
Annual leave accrues at the full contractual rate throughout all sick leave regardless of duration. This is a statutory right under the Working Time Regulations 1998 — it cannot be removed by trust policy.
Leave Accrued During Sick Leave — Band 6 Example
| Sick Leave Duration | Leave Accrued | Financial Value |
|---|---|---|
| 3 months | 6.75 — 8.25 days | £1,053 — £1,286 |
| 6 months | 13.5 — 16.5 days | £2,105 — £2,573 |
| 12 months | 27 — 33 days | £4,210 — £5,146 |
This accrued leave must be taken on return or paid out on termination. Employers cannot cancel it. For staff on long-term sick leave, this represents significant value that should be factored into any return-to-work planning.
Annual Leave During Maternity Leave
Annual leave accrues at the full contractual rate throughout all maternity leave — both Ordinary and Additional Maternity Leave — regardless of whether pay has reduced to SMP or zero.
Key rules that protect financial value:
- Take outstanding annual leave before maternity leave starts — it is paid at full contractual pay, not SMP rate
- Annual leave accrued during maternity leave cannot be taken during maternity leave itself
- Carry-over of maternity-period accrual must be agreed with your employer before leave starts — get this in writing
- A Band 6 nurse returning from 12 months maternity leave holds up to 33 days accrued leave worth approximately £5,146 that must be honoured
Use the NHS maternity pay calculator to plan the financial sequencing of leave before and after maternity.
Part-Time Leave — Calculated in Hours, Not Days
Annual leave for less-than-full-time staff is calculated in hours to ensure fairness across different working patterns and shift lengths.
Leave in Hours — Band 6 at Different WTE
| WTE | Hours/Week | Leave (under 5 yrs) | Leave (over 10 yrs) |
|---|---|---|---|
| 1.0 | 37.5 | 202.5 hours | 247.5 hours |
| 0.8 | 30.0 | 162.0 hours | 198.0 hours |
| 0.6 | 22.5 | 121.5 hours | 148.5 hours |
| 0.5 | 18.75 | 101.25 hours | 123.75 hours |
Converting to hours prevents part-time staff being disadvantaged when their working days are longer or shorter than the standard 7.5-hour NHS day. For the full financial picture of part-time working across pay and pension, see the NHS flexible working and job sharing guide.
Buying and Selling Annual Leave
Some NHS trusts offer voluntary leave purchase or encashment schemes within defined limits.
Buying additional leave: Cost is deducted via salary sacrifice — reducing pensionable pay and generating small tax and NI savings. A Band 6 nurse buying five additional days pays approximately £779 via salary sacrifice but saves approximately £97 in tax and NI — net cost approximately £682. This also reduces your pensionable pay for pension accrual purposes. Review the pension impact using the NHS pension calculator before purchasing additional leave.
Selling leave back: Where trusts allow encashment above the statutory minimum, payment is at your daily rate added to salary and taxed as normal earnings. A Band 6 nurse selling five days receives approximately £779 gross — approximately £468 net at 20% tax after pension contribution. Use the NHS tax calculator to calculate your net encashment value.
Not all trusts offer these schemes — check your trust’s annual leave policy.
Managing Your Leave Year — Avoiding Financial Loss
Most NHS trusts run an April to March leave year. End-of-year leave loss is avoidable with simple planning.
Leave Management Timeline
| Period | Action |
|---|---|
| April — June | Book key annual leave dates; plan the year |
| July — September | Check balance; ensure at least 40% taken |
| October — December | Book remaining leave; flag any carry-over need |
| January — March | Final drawdown; confirm carry-over in writing |
Managers cannot refuse all leave requests — they must ensure you can take the statutory minimum of 28 days (including bank holidays) within the leave year. A blanket refusal that results in statutory entitlement being forfeited is unlawful.
The NHS Pay Rise Effect on Leave Value
The 2026/27 AfC pay award increases both your salary and the financial value of every day of annual leave — because leave value is calculated from your current salary. A Band 5 nurse who received a pay increase from £31,534 to £33,344 sees their daily leave rate rise from £121.29 to £128.25 — adding approximately £243 to the total annual value of a 35-day entitlement.
Check the current pay award impact on your specific band at the NHS pay rise 2026/27 guide.
Frequently Asked Questions
How many days annual leave do NHS staff get in 2026/27?
AfC entitlement is 27 days plus eight bank holidays for staff with under five years’ NHS service, rising to 33 days plus eight bank holidays after ten years. Entitlement is based on continuous NHS service, not band or role.
Can NHS annual leave be carried over to the next year?
Most trusts allow five days carry-over by default. Above that, written manager and HR approval is required. Carried-over leave must usually be taken in the first quarter of the new leave year. Leave that cannot be carried over and is not taken is permanently lost with no cash value.
Is TOIL better than overtime pay for NHS staff?
No — for unsocial hours work, paid overtime is financially superior. TOIL returns one hour per hour worked at plain time. Paid overtime returns the AfC enhancement rate — 47% extra on Saturdays, 94% on Sundays — making paid overtime worth significantly more per hour than TOIL for the same shift.
What happens to unused annual leave when leaving the NHS?
Untaken leave from the current leave year is paid out at your daily rate in your final salary. A Band 6 nurse with ten days untaken receives approximately £1,559. TOIL balances are generally not paid out on leaving.
Does annual leave accrue during NHS sick leave?
Yes. Annual leave accrues at full contractual rate throughout all sick leave regardless of length. This is a statutory right under the Working Time Regulations 1998 that trust policy cannot remove.
Can I reclaim annual leave if I was sick during it?
Yes. Illness during annual leave can be converted to sick leave with medical certification and prompt notification to your employer. The annual leave days are reinstated to your balance. Trusts cannot override this entitlement.
How does annual leave work during NHS maternity leave?
Annual leave accrues throughout all maternity leave at the full contractual rate. Taking outstanding leave before maternity starts maximises pay — it is paid at full salary rather than SMP. Accrued leave during maternity must be carried over by agreement and cannot be taken during the maternity period itself.
All figures reflect 2026/27 AfC pay rates for England. Daily rate calculations use 260 working days. Trust carry-over and TOIL policies vary — verify against your trust’s current annual leave policy and AfC Section 13.
Daniel Carter is a senior NHS Payroll Accountant with over 10 years of experience in Agenda for Change pay structures, tax, and pensions. He created the NHS Pay Calculators platform to help NHS staff easily understand their take-home pay, sick pay, maternity pay, and pension entitlements through simple, accurate online tools.
