NHS Sick Pay Entitlement Calculator 2026/27: Full, Half & When It Stops

NHS sick pay under Agenda for Change gives you full pay for up to six months and half pay for a further six months, depending on your length of service — but it runs on a 12-month rolling window, so any absences in the past year already count against your current entitlement. In your first year of NHS service you only get one month full pay and one month half pay; this rises incrementally until you hit the maximum at four years continuous service.

When your occupational sick pay runs out, Statutory Sick Pay of £116.75 per week kicks in as the floor — and once that expires after 28 weeks, you receive nothing unless you qualify for ill-health retirement or Universal Credit. The 12-month rolling rule is what most staff misunderstand: your entitlement resets gradually as old absences fall outside the rolling window, not on your anniversary date.

Use the NHS Sick Pay Calculator

Enter your pay band, annual salary, whole-time equivalent (WTE), start date, and sick days taken in the last 12 months. The calculator shows your full pay period, half pay period, SSP phase, and estimated net take-home at each stage.

What Is NHS Occupational Sick Pay and How Does It Differ from SSP?

NHS occupational sick pay is a contractual entitlement under Agenda for Change. Unlike basic Statutory Sick Pay, it provides substantially higher payments based on your continuous service length.

It is not discretionary. The rules are set out in the NHS Terms and Conditions of Service Handbook and apply uniformly across all AfC posts — unless a local agreement expressly modifies them.

The key differences from SSP are:

• Full pay from day one of employment — no waiting period for occupational sick pay
• Enhancements included — unsocial hours payments and HCAS are part of your reference-period earnings
• No 3-day waiting period for occupational pay — though the SSP waiting day rule changed from April 2026 (see below)
• Pay band does not affect entitlement. Band 2 and Band 9 staff with identical service receive the same sick pay periods.

What Is SSP in 2026/27?

From 6 April 2026, SSP is £123.25 per week or 80% of normal weekly earnings — whichever is lower. The three unpaid waiting days have been abolished, making SSP a day-one entitlement for the first time.

The Lower Earnings Limit has also been removed, meaning all employees qualify for SSP regardless of income level.

For most AfC staff, SSP is absorbed into — not added on top of — your occupational sick pay. After contractual sick pay ends, SSP may apply for up to 28 weeks if you are still eligible.

NHS Sick Pay Entitlement Table 2026/27

Your entitlement ranges from one month’s full pay plus two months’ half pay for new starters, up to six months’ full pay plus six months’ half pay for staff with five or more years of service.

Half pay is never paid below the SSP floor. If 50% of your salary falls below £123.25 per week (from April 2026), your employer tops it up to the SSP rate automatically.

How Continuous NHS Service Is Counted

Continuous previous service with any NHS employer counts as reckonable service for sick pay purposes. This includes service across different NHS trusts and organisations.

Breaks of up to one week are permitted, and some breaks of up to 12 months may still count in limited circumstances — such as childcare, study, or reserved armed forces duties.

Always confirm your continuous service date in writing when you join a new trust. Errors in your start date directly reduce your sick pay entitlement.

What “Full Pay” Actually Means Under AfC Section 14

Full pay is not simply your basic salary. The goal is to ensure you receive exactly what you would have received had you been at work. This means:

• Basic salary
• Contracted unsocial hours enhancements (nights, weekends, bank holidays)
• Higher Cost Area Supplements (HCAS) where applicable
• Any other regular contractual payments included in your reference period

Overtime, one-off bonuses, and expenses are excluded.

How to Use the NHS Sick Pay Calculator: Step-by-Step

1. Select your pay band (Band 2 to Band 9) — this pulls in the 2026/27 AfC salary for your band automatically.
2. Enter your annual salary — use your full-time equivalent salary even if you are part-time.
3. Enter your WTE (whole-time equivalent) — for example, 0.6 for 22.5 hours on a 37.5-hour contract.
4. Enter your NHS start date — the calculator calculates your reckonable service and assigns the correct sick pay band from the table above.
5. Enter sick days taken in the last 12 months — this is essential. Days already used reduce your remaining entitlement under the rolling look-back rule.
6. Read your result — you will see the exact date your full pay ends, the date your half pay ends, the SSP phase, and estimated net pay at each stage after tax and pension deductions.

The calculator does not replace ESR or payroll. Always verify the output with your trust’s HR or payroll team before making financial decisions.

The Rolling 12-Month Rule for NHS Sick Pay Explained

This is the rule most staff misunderstand — and the one that most commonly leads to lower pay than expected.

Your employer takes into account all periods of paid sickness absence during the 12 months immediately preceding the first day of a new episode of sickness. This is deducted from your entitlement when calculating sick pay.

The look-back window is always the 365 days before your new absence starts — not the leave year.

How the Rolling Rule Works in Practice

Example 1 — Short-term absence: You have 5 years of service (entitlement: 6 months full + 6 months half). You were off for 6 weeks in January 2026. You go off sick again in September 2026. Those 6 weeks are still inside the rolling 12-month window and are deducted from your current entitlement.

Example 2 — Reset: That same January 2026 absence drops off the rolling calculation in January 2027. From that point, your full 6 + 6 months entitlement is restored, assuming no new absences have occurred.

After returning from sick leave, a staff member’s entitlement gradually goes up again until it returns to the maximum level for their years of service.

What Does Not Count Towards the Rolling 12 Months

No account is taken of injuries, diseases, or other health conditions sustained or contracted in the discharge of employment duties, as defined in Section 22 of the handbook.

Additional exclusions:

• Pregnancy-related sickness absence (fully excluded from the rolling count)
• Absence caused by a work-related assault or accident
• Sickness during an approved phased return to work, in some circumstances — check your trust’s local policy

NHS Sick Pay by Pay Band 2026/27: Real Examples

Your entitlement period is identical regardless of band, but the cash amount differs because salaries differ. The 2026/27 AfC pay scales took effect from 1 April 2026.

Band 2 Health Care Assistant — 3 years’ service

• Full-time salary (2026/27): approximately £24,071
• Full pay entitlement: 4 months — approximately £8,024
• Half pay entitlement: 4 months — approximately £4,012
• SSP floor check: 50% of weekly salary exceeds £123.25, so no top-up needed

Band 5 Registered Nurse — 5+ years’ service

• Full-time salary (2026/27): approximately £29,970 (entry point)
• Full pay: 6 months — approximately £14,985
• Half pay: 6 months — approximately £7,493 (includes unsocial hours in reference period)
• SSP runs alongside during half pay and is absorbed — not added

Band 7 Ward Manager — 5+ years’ service

• Full-time salary (2026/27): approximately £46,148 (entry point)
• Full pay: 6 months — approximately £23,074
• Half pay: 6 months — approximately £11,537
• London weighting (HCAS) included in full and half pay calculations

Part-time Band 5 Nurse, 0.6 WTE — 5+ years’ service

• Pro-rata salary: approximately £17,982
• Full pay: 6 months — approximately £8,991
• Half pay: 6 months — approximately £4,496

All figures are gross. The calculator shows estimated net figures after income tax, National Insurance, and NHS pension contributions at each phase.

Full Pay vs Half Pay in the NHS: What’s Included and What’s Not

During full pay: You receive 100% of your normal reference-period earnings. This includes basic salary and contracted enhancements. Your NHS pension contributions continue at your normal tier rate.

During half pay: You receive 50% of salary — never below the SSP rate. SSP runs alongside and is absorbed into your half pay, not paid on top of it. Your pension contributions continue. Tax and NI are applied to actual pay received.

When SSP takes over: If your occupational sick pay entitlement is exhausted, SSP applies for up to 28 weeks from the start of your sickness absence, subject to eligibility.

Important: SSP is calculated from the first day of your absence (from April 2026). The 28-week clock starts from your first day off — it does not restart when occupational pay ends.

What Happens When NHS Sick Pay Runs Out?

If you exhaust both the full pay and half pay periods, you enter an unpaid phase unless SSP is still running.

The timeline for a staff member with 5+ years’ service is:

1. Months 1–6: Full occupational pay (100% of normal earnings)
2. Months 7–12: Half occupational pay (50%, never below SSP)
3. Up to 28 weeks total: SSP at £123.25/week or 80% of weekly earnings (from April 2026), if still within the 28-week SSP window
4. After SSP exhausted: No pay from the NHS

At the no-pay stage, your options include:

• Employment and Support Allowance (ESA) — claim via DWP once SSP ends or if you are not SSP-eligible
• Universal Credit — if your household income drops below the threshold
• Occupational Health referral — your trust should refer you before pay ends; an OH assessment may lead to reasonable adjustments, redeployment, or ill-health retirement
• Section 22 Injury Allowance — if your absence is caused by a work-related injury or condition, you may receive up to 85% of your pay for up to 12 months (see below)
• NHS Pension ill-health retirement — if you are unlikely to return to work, your pension may be accessible early through the ill-health tier process

Your employer may, at their discretion, extend your sick pay on a half-pay basis beyond the standard entitlement. This depends on your trust’s sickness absence policy and may apply where a return to work is likely in the near term.

Annual leave continues to accrue throughout your sick leave. Staff who are sick on bank holidays are not entitled to a replacement public holiday. However, if you have pre-booked annual leave and become sick, you can generally cancel the leave and receive sick pay instead.

Part-Time NHS Staff Sick Pay: Pro-Rata Rules Explained

Part-time staff receive the same entitlement periods (months of full and half pay) as full-time colleagues. What changes is the cash amount, which is calculated on your actual pro-rata salary.

Pro-rata salary formula:

Full-time salary × WTE = your pro-rata annual salary

Example — 22.5 hours per week (0.6 WTE), Band 5, 5+ years:

• Pro-rata salary: £29,970 × 0.6 = £17,982
• Monthly full pay: approximately £1,499
• Monthly half pay: approximately £749

Your WTE also affects any enhancements. If you regularly work nights or weekends, those contracted enhancements are included in your reference-period earnings and appear in both full and half pay calculations.

Common pitfall: Some payroll teams incorrectly apply a full-time sick pay calculation and then halve it at the wrong stage. If your payslip looks lower than the above formula, query it with your payroll department directly and reference AfC Section 14.

Fit Notes, Self-Certification and Reporting Sickness Absence

Getting your reporting right protects your sick pay entitlement from day one.

Days 1–7 (calendar days): Staff can self-certify for up to seven calendar days. You do not need a GP appointment or fit note. Follow your trust’s absence reporting line or ESR self-service process on the first day.

Day 8 onwards: After seven days, you will usually need a fit note from a GP or other authorised healthcare professional. A fit note can say you “may be fit for work” with adjustments — this does not end your sick pay entitlement. Discuss any adjustments with your line manager and Occupational Health.

Return to work interview: Staff are normally asked to attend a return to work interview with their manager — even after a single day of absence. This is a supportive process, not disciplinary. It records the absence on ESR and ensures your sick pay entitlement is protected.

Important: Missing the first-day reporting requirement does not automatically stop your sick pay, but your trust may treat unreported absence differently. Always follow your trust’s local sickness policy.

Special Cases: Pregnancy, Work Injury Allowance and Bank Staff

Pregnancy-Related Sickness

Any absence that is wholly or mainly related to your pregnancy is excluded from the rolling 12-month sick pay calculation. It does not reduce your entitlement for any future, non-pregnancy-related absence. This protection applies under AfC Section 14 as confirmed in the NHS Terms and Conditions Handbook.

Your trust must record pregnancy-related absences separately in ESR to ensure the exclusion is applied correctly. If you believe this has not been done, raise it with your HR team.

Section 22 Injury Allowance (Work-Related Conditions)

If your sickness absence is caused by an injury, disease, or health condition wholly or mainly attributable to your NHS employment, you may be entitled to the Section 22 Injury Allowance.

Staff on sickness absence due to a work-related injury, disease, or health condition may be entitled to an injury allowance as defined in Section 22 of the handbook.

Key features of Section 22:

• Pays up to 85% of your normal pay for up to 12 months
• Applies where occupational sick pay alone would take you below 85%
• Does not reset the rolling 12-month sick pay clock in the same way as standard absence
• Requires Occupational Health assessment and usually a formal HR process

If you believe your condition is work-related, raise it with your manager, Occupational Health, and your union representative at the earliest opportunity.

Bank Staff Sick Pay

Where bank workers hold a substantive or hybrid contract recognised under Agenda for Change, they may gain access to NHS occupational sick pay. Employers must check the specific contractual position before confirming eligibility.

There are key differences between bank and substantive contracts in the NHS. Working under a bank contract affects entitlements to NHS pay uplifts, pension, sick leave, and other contractual benefits.

Most bank-only staff receive SSP only — £123.25/week or 80% of average weekly earnings, whichever is lower, from day one of absence (from April 2026). If you hold both a substantive and a bank contract with the same employer, each contract is treated separately.

How Tax and Pension Work During Sick Leave

Your income tax and National Insurance are calculated on actual pay received. During full pay, your deductions are the same as when you are working. During half pay, your gross income falls and your tax band may change — resulting in less tax deducted.

NHS Pension: Contributions continue during sick leave. Sickness is recorded on the Electronic Staff Record (ESR), the NHS payroll and HR database used across all NHS Trusts in England and Wales. Pension contributions are taken from actual pay received — so during half pay, you pay contributions on the reduced amount. Your pensionable service continues to build throughout, which matters significantly for your final benefit under the 2015 NHS Pension Scheme.

Annual pay progression: A period of sick leave does not automatically stop your pay progression under AfC. However, extended absence may be considered by some trusts as part of their local progression policies. Check with your HR team.

Conclusion

The NHS Sick Pay Calculator removes the guesswork from one of the most important financial calculations an NHS employee can make. Your entitlement under Agenda for Change Section 14 is significantly more generous than SSP alone — but it depends entirely on accurate service data, correct pro-rata figures, and a clear understanding of the rolling 12-month rule.

Use the calculator at the top of this page to get your exact figures for 2026/27. Bookmark this page — figures update each April when new AfC pay scales take effect.

If you are currently unwell or managing a long-term condition, speak to your Occupational Health team and your union representative early. Protecting your entitlement starts with knowing it.

Disclaimer: This guide is based on the NHS Agenda for Change Terms and Conditions Handbook, Section 14, and current HMRC and DWP guidance. Figures are correct as of April 2026. Always verify your entitlement with your trust’s HR or payroll team and your ESR record. Does not cover Medical and Dental staff, Very Senior Managers, or GP practice staff on non-AfC contracts.

NHS Sick Pay FAQs 2026/27

Daniel Carter

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.