How Much NHS Sick Pay Can You Get?
For staff covered by the NHS Agenda for Change (AfC) terms and conditions in England, occupational sick pay increases with reckonable NHS service.
| NHS reckonable service | Full pay | Half pay |
| During the first year | 1 month | 2 months |
| During the second year | 2 months | 2 months |
| During the third year | 4 months | 4 months |
| During the fourth and fifth years | 5 months | 5 months |
| After completing 5 years | 6 months | 6 months |
This means someone with five or more years of qualifying service can have up to six months’ full pay followed by six months’ half pay, subject to the NHS sickness absence rules and any sick leave already taken into account.
However, NHS sick pay is not simply a fixed allowance that starts again every calendar year. Previous sickness absence and your reckonable service can affect what you have available.
What Is NHS Sick Pay?
NHS sick pay is the occupational sick pay provided under NHS employment terms. It is separate from Statutory Sick Pay (SSP), although the two can interact.
For staff covered by Agenda for Change, NHS occupational sick pay is designed to provide additional support during periods of illness. The amount available depends largely on reckonable NHS service.
The NHS Terms and Conditions of Service Handbook currently sets out the following sick pay scale:
- First year: 1 month full pay + 2 months half pay
- Second year: 2 months full pay + 2 months half pay
- Third year: 4 months full pay + 4 months half pay
- Fourth and fifth years: 5 months full pay + 5 months half pay
- After five years: 6 months full pay + 6 months half pay
These figures are particularly useful if you are trying to understand what could happen to your income during a longer period of sickness.
NHS Sick Pay by Length of Service
Less than one year of NHS service:
During your first year, the standard AfC entitlement is:
1 month full pay + 2 months half pay: So, if you have a prolonged period of sickness during your first year, your occupational sick pay can move from full pay to half pay before the maximum entitlement has been reached.
One to two years of service
During your second year:
2 months full pay + 2 months half pay: Your entitlement therefore increases as your reckonable service builds.
Two to three years of service
During your third year:
4 months full pay + 4 months half pay: This represents a significant increase compared with the first two years.
Three to five years of service
During the fourth and fifth years:
5 months full pay + 5 months half pay
Five years or more
Once you have completed five years of reckonable service, the standard entitlement reaches:
6 months full pay + 6 months half pay: This is the maximum level shown in the standard AfC sick pay scale.
Does NHS Sick Pay Reset Every Year?
Not necessarily.
This is one of the most important points to understand.
Your NHS sick pay entitlement takes account of sickness absence within the relevant 12-month period, rather than simply giving you a completely fresh allowance at the start of every calendar year.
NHSBSA guidance identifies a 12-month Continuous Service Date for sickness absence pay, and the NHS Terms and Conditions provide the underlying sick-pay framework.
For example, if you have already had a period of sickness during the previous 12 months, that absence may affect the amount of occupational sick pay available when you become ill again. This is why two NHS employees with the same length of service can potentially have different remaining sick pay entitlements.
Related guide: When Does NHS Sick Pay Reset? Understanding the 12-Month Rolling Period
Does Length of Service Affect NHS Sick Pay?
Yes.
For staff covered by Agenda for Change, reckonable service is central to determining the standard sick pay entitlement.
The longer your qualifying NHS service, the greater your occupational sick pay entitlement becomes, reaching six months’ full pay and six months’ half pay after five years.
However, you should not assume that every period worked for the NHS automatically produces exactly the same outcome. NHSBSA guidance explains how continuous and reckonable service dates are used for different employment benefits, including sickness absence pay.
If you have moved between NHS employers, taken a career break or had a gap in employment, it is worth checking how your service is recorded.
What Happens During Half Pay?
Moving from full pay to half pay does not necessarily mean that your only income becomes 50% of your normal earnings.
Occupational sick pay and Statutory Sick Pay (SSP) can interact, depending on your circumstances.
From 6 April 2026, SSP rules changed. Eligible employees can receive SSP from the first full day of sickness, and the rate for 2026/27 is £123.25 a week or 80% of average weekly earnings, whichever is lower. SSP can be paid for up to 28 weeks.
Your actual pay during sickness will depend on your circumstances, employment terms, payroll treatment and any applicable NHS arrangements. For this reason, it is better not to assume that “half pay” simply means receiving exactly half of your usual payslip.
Does NHS Sick Pay Include Your Normal Pay?
The calculation of occupational sick pay can depend on the terms applying to your employment and the payments you normally receive.
NHS Employers explains that the purpose of the sick pay arrangements is to provide support broadly reflecting what an employee would receive while working, with certain additional payments potentially continuing during sickness. Exact treatment can vary, including between UK administrations and local arrangements.
If your earnings include regular enhancements or other payments, check how your employer calculates sick pay rather than assuming it will simply be your basic salary.
What If You Have Worked for the NHS for More Than Five Years?
After completing five years of reckonable service, the standard AfC entitlement is:
6 months full pay + 6 months half pay.
However, this does not necessarily mean that you can take 12 months of paid sickness absence every time you are ill.
Previous sickness absence within the relevant period can affect your remaining entitlement.
This distinction is important and is one reason why looking only at your total years of NHS service may not give you the complete picture.
What If You Change NHS Employers?
Changing NHS employers does not automatically mean that your NHS service is treated as starting again.
NHSBSA guidance sets out how reckonable service and continuous service dates are determined. For sickness absence pay, the relevant service date is based on reckonable NHS service, with specific rules applying to breaks in service.
If you have changed Trusts or other NHS employers, check your recorded service dates rather than assuming that your sick pay entitlement has restarted.
NHS Sick Pay: What Should You Check?
If you are trying to understand your own entitlement, consider checking:
1. Your reckonable NHS service
Find out which service date your employer is using for sickness absence purposes.
2. Your previous sickness absence
Previous periods of sickness can affect your remaining entitlement.
3. Your employment terms
The standard AfC arrangements do not apply to every NHS worker. The NHS Terms and Conditions Handbook specifically covers staff on Agenda for Change contracts, while doctors and dentists have separate national terms and conditions.
4. Your employer’s policy
There can be differences in how particular elements of sick pay are administered, particularly across the UK’s devolved NHS systems.
5. Your financial position
If you are concerned about a longer period away from work, it may be sensible to consider how your household finances would cope if your income reduced from full pay to half pay and eventually beyond occupational sick pay.
Why NHS Sick Pay Matters for Your Financial Planning
NHS sick pay is more than an employment benefit. For many NHS employees, their salary is the main source of household income.
A prolonged illness could therefore affect:
- Mortgage payments
- Household bills
- Savings
- Pension contributions
- Family finances
- Other financial commitments
Understanding your sick pay entitlement can help you identify how much income you could have available if you were unable to work for an extended period.
This can also help you consider whether additional financial protection may be appropriate for your circumstances.
NHS Sick Pay and Income Protection
For some NHS employees, income protection may be considered alongside their employer’s sick pay.
The purpose is different: NHS sick pay provides contractual support during sickness, while an income protection policy may provide an agreed benefit if you are unable to work because of illness or disability, subject to the policy terms.
The right type and level of cover depends on factors such as your income, employment arrangements, existing benefits and financial commitments.
Related guide:NHS Sick Pay vs Income Protection: What Happens When Your NHS Sick Pay Ends?
Frequently Asked Questions
How much sick pay do NHS employees get?
For staff covered by Agenda for Change, sick pay depends on reckonable NHS service. It ranges from one month full pay plus two months half pay during the first year to six months full pay plus six months half pay after five years.
Does NHS sick pay increase with length of service?
Yes. Under the standard Agenda for Change arrangements, the entitlement increases as reckonable service increases, reaching six months’ full pay and six months’ half pay after five years.
Does NHS sick pay reset every 12 months?
The calculation takes previous sickness absence into account over the relevant 12-month period. It is therefore not simply a fresh allowance at the beginning of each calendar year.
What happens after NHS sick pay runs out?
Once contractual or occupational sick pay entitlement is exhausted, your circumstances may need to be reviewed in relation to statutory payments and any other support available. SSP can be paid for up to 28 weeks if you remain eligible.
Does this sick pay table apply to every NHS employee?
No. The table above relates to staff covered by Agenda for Change terms and conditions. Doctors and dentists have separate national terms, and arrangements can differ across the UK’s devolved administrations.
How Wealth Genius Can Help
At Wealth Genius, we help NHS professionals understand the wider financial implications of their employment benefits, including NHS sick pay and financial protection.
Understanding what could happen to your income during a prolonged illness can be an important part of broader financial planning.
Explore ourNHS Sick Pay & Benefits guidance!
Key Takeaway
For NHS staff covered by Agenda for Change, sick pay generally increases with reckonable service, from one month of full pay and two months of half pay during the first year to six months of full pay and six months of half pay after five years.
However, your actual remaining entitlement can also depend on previous sickness absence, reckonable service, your employment terms and the rules applicable to your NHS employer.
If you are concerned about your income during a prolonged illness, checking your contractual sick pay entitlement and understanding your wider financial position can help you plan ahead.
Important Information
This article is provided for educational and informational purposes only and does not constitute financial advice or a personal recommendation.
The information is based on current publicly available NHS and Government guidance and is intended as a general guide. NHS employment terms can vary depending on your role, contract, UK nation and employer.
Always check your employment contract, local NHS policy and the latest NHS Employers or NHSBSA guidance for your individual circumstances.
Tax and benefit rules are subject to change. Approver: Quilter Financial Services Limited – Sep 2026
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