NHS Gender Pay Gap 2026: What the Latest Figures Actually Show

The NHS employs more than a million people in England, and roughly three out of every four of them are women. Despite that, men in the NHS still earn more on average than women, and the gap hasn’t closed as quickly as many expected. For staff checking their own pay through an NHS pay calculator or trying to understand why their payslip looks different from a colleague’s, the gender pay gap is a fair question to ask — and a more complicated one to answer than it first appears.

This article breaks down what the gender pay gap actually means, what the current NHS figures show for 2025-26 reporting, why the gap persists even under a single national pay structure like Agenda for Change, and what individual trusts and NHS England are doing about it.

Gender pay gap vs. equal pay: they are not the same thing

This is the single most misunderstood part of the topic, and every NHS trust report says it explicitly for a reason. Equal pay is a legal requirement under the Equality Act 2010: a man and a woman doing the same job, or work of equal value, must be paid the same. The NHS, through Agenda for Change and the national medical and dental contracts, already pays men and women on identical pay scales for identical roles. A Band 5 staff nurse is paid the same whether they are male or female.

The gender pay gap is a different measure entirely. It looks at the average hourly pay of all men across an organisation compared to the average hourly pay of all women, regardless of what job each person does. If men are disproportionately concentrated in higher-paid roles — consultants, senior managers, certain surgical specialties — and women are disproportionately concentrated in lower-paid bands, the organisation will show a gender pay gap even though every individual role is paid equally.

That distinction matters because it points to where the real problem sits: not in the pay scales themselves, but in who ends up in which roles.

What the current NHS gender pay gap figures show

Since 2017, any employer in England with 250 or more staff has been legally required to publish gender pay gap data every year, based on a snapshot date of 31 March. Individual NHS trusts, integrated care boards (ICBs), and arm’s-length bodies each publish their own figures — there is no single official “NHS-wide” number, because NHS England does not consolidate a national gender pay gap report. That means the picture varies quite a bit from one organisation to the next, but some clear patterns emerge across dozens of published reports.

Mean gender pay gaps across NHS organisations for the current 2025-26 reporting cycle are commonly landing somewhere between roughly 6% and 23%, with the majority of acute and community trusts reporting a mean gap in the low-to-mid teens. To put that in concrete terms: several trusts report that for every £1 a man earns on average, a woman earns somewhere between 77p and 97p, depending on the organisation’s workforce mix.

A few examples from published 2025-26 reports illustrate the range:

• One integrated care board reported a mean gender pay gap of 22.8%, up 1.5 percentage points on the previous year, alongside a median gap of 6.7%.
• An ambulance trust reported a much smaller mean gap of 6.6%, with women earning 97p for every £1 earned by men on a median basis.
• A different ICB in the same region reported a mean gap of nearly 38%, showing just how much variation exists even between neighbouring organisations.

Nationally, NHS Employers has cited a figure of 10.2% as the average pay difference between male and female health professionals, while the overall UK gender pay gap across all sectors sat at 14.3% in the most recent Office for National Statistics data cited in NHS workforce guidance. The direction of travel over the past five years has been downward, but slowly, and 2025-26 reports from several trusts actually show a small increase rather than a continued decline.

Why the gap exists when pay scales are equal

Given that Agenda for Change and the medical pay structures apply the same rates regardless of gender, the gap comes down almost entirely to workforce composition. Several factors repeat across nearly every trust report published this year.

Consultant and senior medical roles skew male. Trust reports consistently show a higher proportion of male consultants than female consultants, even as the overall NHS workforce is majority female. One trust’s 2025 report noted that female representation among consultants actually fell slightly year on year, from 35% to 34%, while roughly 84% of its broader workforce is female. Because consultants sit at the top of the medical pay scale, and because Clinical Excellence Awards (CEAs) — the discretionary bonus payments available to consultants — have historically gone disproportionately to men, this drives a large share of both the pay gap and the separate “bonus gap” that trusts report alongside it.

Part-time working is heavily gendered. Women are far more likely than men to work part-time in the NHS, often due to childcare and caring responsibilities. Part-time roles are more common in lower-paid bands and less common in senior leadership positions, which pulls down average female hourly pay even where the hourly rate itself is identical to a full-time equivalent.

Lower pay bands are disproportionately female. Roles such as healthcare assistants, administrative and clerical staff, and lower-band nursing posts are overwhelmingly staffed by women. Estates, IT, and some senior corporate functions skew more male. Since these differences sit at opposite ends of the pay scale, the aggregate effect widens the gap even though no individual role is paid unequally.

Specialty choice within medicine. Independent research into the medical gender pay gap — including the 2020 “Mend the Gap” review by Professors Dame Jane Dacre and Carol Woodhams — found that specialty distribution alone accounts for a measurable share of the pay gap among hospital doctors, since certain specialties pay more in additional allowances and private practice opportunities than others, and men remain overrepresented in several of the higher-earning specialties.

GP partnership structures. In general practice, men make up the majority of GP partners, who typically earn more than salaried GPs, while women make up the majority of salaried GPs. Because partners’ earnings depend on practice profits rather than a fixed salary, this structural split creates a persistent gap that sits outside the standard Agenda for Change framework entirely.

What NHS organisations are doing about it

NHS England’s Equality, Diversity and Inclusion (EDI) Improvement Plan, published in 2023, set an explicit target for NHS organisations to work toward eliminating pay gaps linked to gender and ethnicity, with disability and other protected characteristics due to be incorporated into reporting from 2026 onward. In practice, most individual trust action plans repeat a similar set of measures:

• Reviewing and reforming how Clinical Excellence Awards are allocated, to remove the historical bias toward male consultants
• Structured interview processes designed to reduce unconscious bias in recruitment and promotion panels
• Publishing salary ranges in job adverts, since research from the Equality and Human Rights Commission has found women are less likely than men to negotiate pay when it isn’t disclosed upfront
• Expanding flexible working and job-share options in senior and consultant-grade roles, so part-time working doesn’t act as a ceiling on progression
• Targeted leadership and mentoring programmes aimed at increasing the proportion of women in Band 8c and above, and in consultant posts

Whether these measures move the needle in the next reporting cycle remains to be seen. Several 2025-26 reports show the gap holding roughly flat or even ticking upward slightly compared to the previous year, which suggests structural change — particularly around consultant grade and CEA distribution — is happening more slowly than the policy targets anticipated.

Common mistakes when interpreting NHS gender pay gap data

Assuming a pay gap means unequal pay for the same job. As covered above, this is legally distinct and almost never the actual cause within NHS pay structures.

Comparing mean and median figures as if they’re interchangeable. The mean can be skewed heavily by a small number of very high earners (senior consultants with large CEAs, for instance), while the median gives a more typical picture of the “middle” employee. A trust can have a mean gap of over 20% and a median gap in single figures, and both numbers are correct — they’re just measuring different things.

Treating one trust’s figure as representative of the whole NHS. Because there’s no single consolidated NHS report, a 6% gap at one ambulance trust and a 38% gap at a neighbouring ICB can both be accurate simultaneously. Workforce mix, specialty concentration, and local demographics all vary enormously.

Ignoring the bonus/CEA gap as a separate figure. Most trust reports publish bonus gap data alongside the hourly pay gap, and the two can diverge sharply, especially in acute trusts with large consultant workforces.

Frequently Asked Questions

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.