A newly qualified nurse on the NHS Band 5 pay scale earns £32,073 to £39,043 a year in 2026/27, depending on experience, before London weighting. Most registered nurses sit on Band 5 or Band 6, with senior and specialist roles reaching Band 7 and above. If you’re an international nurse working toward UK registration, your pay looks different again before and after you pass OSCE and that gap is usually the part people struggle to find a straight answer on.
This guide covers both. First, the official 2026/27 NHS pay bands and what actually affects your take-home pay. Then, specifically for internationally trained nurses, what you can expect to earn while you’re still completing CBT and OSCE, and how that changes once you’re on the NMC register.
How much do nurses earn in the UK?
Nurses in the NHS are paid under the Agenda for Change pay system, which sets nine numbered bands. Nearly all registered nurses start on Band 5, with pay rising through fixed steps as they gain experience, and through promotion as they take on more senior or specialist roles.
Here are the confirmed 2026/27 rates, effective from 1 April 2026:
| Band | Typical role | Entry | Top of band |
|---|---|---|---|
| Band 5 | Newly qualified staff nurse | £32,073 | £39,043 |
| Band 6 | Senior staff nurse, specialist nurse | £39,959 | £48,117 |
| Band 7 | Ward sister/charge nurse, advanced practice | £49,387 | £56,515 |
| Band 8a | Modern matron, nurse consultant (mental health) | £57,528 | £64,750 |
| Band 8b–9 | Senior clinical/strategic leadership | £66,582 | £129,783 |
Source: NHS Employers, Agenda for Change pay scales, effective 1 April 2026.
Band 5 is where the overwhelming majority of nurses UK-trained and internationally registered alike begin their NHS career. Within Band 5, pay isn’t flat: you move from the entry point to an intermediate point after two years, and reach the top of the band after four years, subject to a satisfactory appraisal each year.
What determines where you sit on the scale
Band, not job title, sets your pay. “Nurse” covers a huge range of roles, and your band reflects your responsibilities and experience rather than your specific job title. A Band 5 adult nursing role and a Band 5 mental health nursing role are paid on the same scale.
Specialisation moves you up faster. ICU, critical care, mental health and midwifery specialisms, along with advanced practice roles, are where nurses typically reach Band 6 and 7 soonest through additional training and demonstrated competency, not simply time served.
Shift patterns add real money. Nurses working nights, weekends and bank holidays receive unsocial hours enhancements on top of basic pay, on top of the banded salary above. The exact enhancement depends on your trust’s local agreement.
Location changes your take-home significantly see the London weighting section below.
London weighting and other allowances
If you work in or around London, you receive a High Cost Area Supplement (HCAS) on top of your banded salary, for 2026/27:
| Area | Supplement | Minimum payment | Maximum payment |
|---|---|---|---|
| Inner London | 20% of basic salary | £5,794 | £8,746 |
| Outer London | 15% of basic salary | £4,870 | £6,137 |
| Fringe (edge of London) | 5% of basic salary | £1,346 | £2,270 |
Source: NHS Employers, Pay scales for 2026/27.
A Band 5 nurse at the entry point in Inner London, for example, receives their £32,073 basic salary plus the Inner London supplement — a meaningful uplift, though living costs in London are correspondingly higher.
Hourly and monthly pay
Nurses are usually contracted for a 37.5-hour working week. As a rough guide at Band 5 for 2026/27:
- Entry point (£32,073): roughly £16.44 per hour, or around £2,673 gross per month
- Top of band (£39,043): roughly £20.02 per hour, or around £3,254 gross per month
These are gross figures before tax, National Insurance and pension deductions, and before any unsocial hours or London weighting is added.
What actually lands in your bank account
Three things come off your gross pay before you see it: income tax, National Insurance, and your NHS Pension Scheme contribution.
The pension contribution is worth understanding because it’s tiered you pay a higher percentage of your pensionable pay as you earn more, from roughly 5% at the lowest tier up to over 12% at the highest, reviewed each April. In return, your employer contributes 23.7% of your pensionable pay on your behalf, which is a substantial part of your overall NHS reward package even though you never see it on your payslip.
Source: NHS Business Services Authority (NHSBSA), NHS Pension Scheme member contributions.
What international nurses actually earn before and after OSCE
If you’re training or registered outside the UK, your pay follows a different path in the early stages, and this is the part most salary guides skip entirely.
Once you have a UK job offer and a Certificate of Sponsorship, you’re typically employed as a pre-registration candidate while you complete the practical part of NMC registration the OSCE. NHS Employers guidance sets out that most international nurses have up to 12 weeks from their sponsorship start date to sit their first OSCE attempt, and can be legally employed in this pre-registration period.
Pay during this window is set at the appropriate band for the work you’re doing commonly below Band 5 rather than full registered-nurse pay, because you aren’t yet on the NMC register.
Once you pass OSCE and receive your NMC PIN, you move onto the full Band 5 pay scale on the same terms as any UK-trained nurse starting at £32,073 for 2026/27, with the same progression through the band from there.
This is exactly why the time it takes to pass CBT and OSCE matters financially, not just professionally. Every month spent retaking an exam or waiting for a resit slot is a month at pre-registration pay rather than full Band 5. If you’re preparing specifically for the practical exam, structured OSCE preparation for adult nursing is built around practising the actual station formats under timed conditions, which is where most first-attempt failures come from.
Source: NHS Employers, Recruitment of overseas nurses and midwives.
The full route from CBT to full Band 5 pay
For nurses trained outside the UK, registration runs through the NMC’s Test of Competence: an English language requirement, a Computer-Based Test (CBT) taken before you travel, and the OSCE taken in person at a UK test centre. You can see the complete NMC registration pathway for the full sequence and requirements, and the NMC’s own overseas registration information for the current official process.
If you’re earlier in the process and want the full picture from CBT through to starting work in the UK, the nursing journey pathway guide walks through each stage in order. For CBT specifically, a structured CBT training programme covers the theory content the exam draws from, so it isn’t the exam itself catching people out it’s usually the OSCE.
Getting to full pay faster
The single biggest lever you have over your own timeline is how well-prepared you are for OSCE on the first attempt. Candidates who fail commonly cite the same issues: not enough structured practice under real exam timing, and underestimating how procedural and specific the NMC’s marking criteria are.
Practical steps that make a measurable difference:
- Practise full OSCE stations under timed conditions, not just individual skills in isolation
- Get feedback against the actual NMC marking criteria rather than general clinical competence
- Understand your specific route (adult, mental health, midwifery, paediatric, nursing associate) the practical tips for passing OSCE first time breaks this down station by station
Frequently asked questions
What is the starting nurse salary in the UK for 2026/27?
Newly qualified Band 5 nurses start at £32,073 a year in England, rising to £39,043 at the top of the band, before any London weighting.
Do international nurses earn less than UK-trained nurses?
Only during the pre-registration period before OSCE, when pay is set at the relevant supporting band rather than full Band 5. Once you pass OSCE and receive your NMC PIN, you’re paid on the same Band 5 scale as any other nurse.
How long can I work in the UK before I have to sit OSCE?
NHS Employers guidance allows most sponsored international nurses up to 12 weeks from their start date to sit their first OSCE attempt, working in a pre-registration role during that time.
How much extra is London weighting worth?
For 2026/27, Inner London adds 20% of basic salary (minimum £5,794), Outer London adds 15% (minimum £4,870), and the fringe area adds 5% (minimum £1,346).
Which nurses earn the most?
Advanced practitioners, nurse consultants and senior specialists on Band 8a and above, where 2026/27 pay starts at £57,528 and rises well past £100,000 at the most senior levels.
Do I pay into a pension automatically?
Yes, NHS Pension Scheme membership is automatic for eligible staff, with tiered employee contributions and a 23.7% employer contribution on top.
Where to go from here
The band you land on tells you what a UK nursing role pays. For an international nurse, the more urgent question is usually how quickly you can get there and that comes down to CBT and OSCE preparation, not the pay scale itself. Explore Medax’s OSCE and CBT courses if you’re ready to start preparing, or book a free consultation if you’d rather talk through which route fits your situation first.
