UK Care Worker Pay 2026/27: NHS HCA & Social Care Take-Home
UK care worker pay 2026/27 - NHS Healthcare Assistant Bands 2 to 4, the National Living Wage floor, ONS pay data, sleep-ins, pensions and take-home.
Overview: two sectors, one workforce
"Care worker" in the United Kingdom is a single labour-market label covering two structurally different sectors with very different pay-setting mechanisms. The first is the National Health Service: Healthcare Assistants (HCAs) and Assistant Practitioners working in NHS Trusts are paid on the centrally negotiated Agenda for Change (AfC) pay spine alongside nurses, allied health professionals and clinical support staff. Their pay is set nationally on Bands 2, 3 and 4; the 2026/27 award was 3.3% from 1 April 2026. The second is adult social care: care assistants, senior carers, team leaders and registered managers working for private providers, local authority adult social care services and the voluntary sector. Social care has no national pay scale: pay is set by each employer, with the National Living Wage as the legal floor for workers aged 21 and over.
Skills for Care estimates 1.60 million filled posts in adult social care in England in 2024/25, across an estimated 19,000 organisations. The vacancy rate was 7.0% (111,000 vacant posts), down from a peak of 10.5% in 2021/22, and turnover among directly employed staff was 23.1% (Skills for Care, October 2025). Overseas recruitment has narrowed: gov.uk now lists care workers and home carers (code 6135) and senior care workers (code 6136) for the Health and Care Worker visa only for people extending, updating or switching from inside the UK.
Pay progression looks different in each sector. In the NHS each band has published pay points, and staff move up them after a set number of years subject to meeting the progression requirements. In social care, progression usually runs from care assistant through senior care assistant (often medication-trained, with a Level 3 diploma) to team leader, deputy manager and registered manager, with the pay at each step set by the employer. Crossing between sectors is common in both directions.
NHS Healthcare Assistant pay (Bands 2 to 4)
NHS Healthcare Assistants and Assistant Practitioners are paid on AfC Bands 2, 3 and 4. Band 2 has a single pay point. Band 3 (senior HCA, nursing assistant) and Band 4 (Assistant Practitioner, advanced HCA, Nursing Associate) have an entry and a top point. All figures below are annual gross before HCAS, from the NHS Employers Agenda for Change pay scales for England 2026/27 (3.3% award, effective 1 April 2026).
Band 2 - Healthcare Assistant (entry)
Single pay point. Entry-grade HCA performing personal care, observations, manual handling and assistance with activities of daily living under registered nurse supervision.
| Pay point | Annual salary |
|---|---|
| Single pay point | £25,272 |
Band 3 - Senior HCA / Nursing Assistant
Care Certificate plus clinical skills (for example venepuncture, ECG, wound care). Often performs delegated tasks under the supervision of a registered nurse.
| Pay point | Annual salary |
|---|---|
| Entry (first 2 years) | £25,760 |
| Top (after 2 years) | £27,476 |
Band 4 - Assistant Practitioner / Nursing Associate
Typically a Foundation Degree or Higher Apprenticeship in health and social care, or a trainee Nursing Associate role. Greater clinical autonomy under a registered nurse delegated framework.
| Pay point | Annual salary |
|---|---|
| Entry (first 3 years) | £28,392 |
| Top (after 3 years) | £31,157 |
HCAS (London weighting)
HCAs based at NHS premises in a designated London zone receive the High Cost Area Supplement: a percentage of basic pay, but never less than the zone minimum or more than the maximum. At Bands 2 to 4 the percentage often falls below the minimum, so the minimum is paid; the columns on the right show the supplement actually payable.
| Zone | Uplift on base pay | Minimum | Maximum | Payable at Band 2 | Payable at Band 3 top | Payable at Band 4 top |
|---|---|---|---|---|---|---|
| Inner London | 20% | £5,794 | £8,746 | £5,794 | £5,794 | £6,232 |
| Outer London | 15% | £4,870 | £6,137 | £4,870 | £4,870 | £4,870 |
| Fringe | 5% | £1,346 | £2,270 | £1,346 | £1,374 | £1,558 |
Source: NHS Employers Agenda for Change pay scales 2026/27. Retrieved 2026-09-30.
Social care pay: the legal floor and the ONS distribution
Social care has no national pay scale, so there is no published hourly rate for a senior carer, team leader or manager that applies across employers. What is published is the legal floor and the survey distribution. From 1 April 2026 the National Living Wage is £12.71 an hour for workers aged 21 and over, £10.85 for 18 to 20 year olds, £8.00 for under-18s, and £8.00 for apprentices aged under 19 or in the first year of their apprenticeship. At 35 hours a week the adult rate comes to £23,132 a year.
| Measure (care workers and home carers, SOC 6135) | Annual gross, full-time |
|---|---|
| National Living Wage, 35 hr/wk (2026/27) | £23,132 |
| ASHE 10th percentile | £17,938 |
| ASHE 25th percentile | £22,798 |
| ASHE median | £27,468 |
| ASHE 75th percentile | £32,493 |
| ASHE 90th percentile | £38,265 |
ASHE measures pay in April 2025, before the 2026 uplift, and counts actual annual pay for full-time jobs including overtime and shift premia, so its percentiles are not hourly rates and the lower ones can sit below the current NLW-at-35-hours figure. The 21-and-over age threshold for the NLW was lowered from 23 in April 2024.
Sources: gov.uk National Minimum Wage and National Living Wage rates; ONS ASHE 2025 provisional, Table 14.7a Annual pay - Gross, Full-Time. Retrieved 2026-09-30.
Sleep-in shifts and live-in care
Two shift patterns are paid differently from the standard hourly model: sleep-in shifts (overnight cover where the carer may sleep but must be available if needed) and live-in care (continuous in-home placement). Following the Supreme Court ruling in Royal Mencap Society v Tomlinson-Blake (2021), a worker who is permitted to sleep and is only available to be woken is entitled to the minimum wage for the time they are awake for the purpose of working, not for the whole night. Employers usually pay a sleep-in allowance on top; its amount is set by each employer and is not regulated, so this page does not quote one.
Any sleep-in allowance is employment income taxed through PAYE. Live-in carers are engaged either as employees (of an agency or directly of the family) or as self-employed. A self-employed live-in carer pays Income Tax and Class 4 National Insurance through Self Assessment on profits and must register with HMRC by 5 October after the end of the first tax year of self-employment (gov.uk). Class 2 no longer has to be paid: above the Small Profits Threshold it is treated as paid (gov.uk).
Take-home matrix: five scenarios
Figures below apply the 2026/27 England tax bands to five care worker pay levels: the NLW at 35 hours, the ONS ASHE median and upper quartile for social care, and two NHS HCA Agenda for Change positions. NHS scenarios include the tiered NHS Pension 2015 contribution (net pay arrangement, Income Tax relief at the marginal rate, National Insurance still due on the contribution); social care scenarios use a 0% pension baseline for comparability. Computed from our HMRC-verified salary engine.
| Scenario | Gross | Income Tax | NI | Pension | Annual take-home | Monthly |
|---|---|---|---|---|---|---|
| Social care: NLW care assistant National Living Wage (£12.71) at 35 hr/wk x 52 weeks. Pension 0% baseline. | £23,132 | £2,112 | £845 | £0 (0.0%) | £20,175 | £1,681 |
| Social care: ASHE median (SOC 6135) ONS ASHE 2025 provisional full-time median, care workers and home carers. Pension 0% baseline. | £27,468 | £2,980 | £1,192 | £0 (0.0%) | £23,297 | £1,941 |
| Social care: ASHE upper quartile (SOC 6135) ONS ASHE 2025 provisional full-time 75th percentile. Pension 0% baseline. | £32,493 | £3,985 | £1,594 | £0 (0.0%) | £26,915 | £2,243 |
| NHS HCA Band 2 Single AfC pay point. NHS Pension tier applied. | £25,272 | £2,212 | £885 | £1,643 (6.5%) | £20,533 | £1,711 |
| NHS HCA Band 4 (top) Assistant Practitioner / advanced HCA. NHS Pension tier applied. | £31,157 | £3,200 | £1,280 | £2,586 (8.3%) | £24,091 | £2,008 |
The NLW care assistant on £23,132 keeps £20,175 after Income Tax and Class 1 National Insurance. The NHS HCA at Band 2 on £25,272 is £2,140 higher in gross and, after a 6.5% NHS Pension contribution, takes home £358 more a year, while also building a defined benefit pension funded by a 23.7% employer contribution that does not appear on the payslip.
NHS Pension 2015 (HCAs)
NHS Healthcare Assistants are enrolled in the NHS Pension Scheme 2015, a Career Average Revalued Earnings (CARE) defined benefit scheme. Member contributions are tiered by pensionable pay; the table shows which HCA pay points land in each tier for 2026/27. The contribution is deducted under the net pay arrangement, giving Income Tax relief at the marginal rate. The employer contribution rate is 23.7% of pensionable pay (NHS Employers).
| Pensionable pay band | Member rate | HCA pay points in this tier |
|---|---|---|
| Up to £13,259 | 5.2% | Part-time HCAs on pro-rata pay in this range. |
| £13,260 to £28,854 | 6.5% | Band 2, Band 3 entry, Band 3 top, Band 4 entry |
| £28,855 to £35,155 | 8.3% | Band 4 top |
| £35,156 to £52,778 | 9.8% | Band 4 top with Inner London HCAS |
The 2015 scheme builds up 1/54 of pensionable earnings each year, revalued during active membership. Normal Pension Age is the member's State Pension age. As an illustration, 45 years at an average pensionable pay of £25,000 would build a pension of about £20,833 a year in today's money (45 x £25,000 / 54), before any HCAS or Band 4 progression, on top of the State Pension.
Sources: NHS Employers - NHS Pension Scheme member contributions; NHS Business Services Authority - Cost of being a scheme member. Retrieved 2026-09-30.
Social care pension (auto-enrolment)
Most social care workers in the private and voluntary sectors are auto-enrolled into a workplace pension under the Pensions Act 2008. The statutory minimum is 8% of qualifying earnings (the slice between £6,240 and £50,270): at least 3% from the employer, with the employee paying the rest including tax relief (gov.uk). Some employers pay more than the minimum.
Council-employed care workers in England and Wales can join the Local Government Pension Scheme (LGPS), a CARE defined benefit scheme in which members pay between 5.5% and 12.5% of pensionable pay depending on earnings (LGPS member site). Employer rates are set fund by fund.
A care worker on £23,132 gross (the NLW at 35 hours) paying 5% of qualifying earnings contributes about £845 a year (5% of £23,132 minus £6,240), including basic-rate tax relief, and the employer adds at least £507.
Health and Care worker visa context
The Health and Care Worker visa is part of the Skilled Worker route for eligible health and adult social care jobs, and holders do not pay the Immigration Health Surcharge. You will usually need to be paid at least £25,000 a year, or the going rate for the occupation if that is higher; the general Skilled Worker threshold is £41,700 or the going rate. Care workers and home carers (code 6135) and senior care workers (code 6136) are listed only for people extending, updating or switching to the visa from inside the UK, and for work in England the sponsor must be registered with the Care Quality Commission.
Sources: gov.uk Health and Care Worker visa: your job; gov.uk Skilled Worker visa: your job. Retrieved 2026-09-30.
Career progression: where the pay distribution sits
Because social care has no national pay scale, the rows below are not job titles with assigned salaries: they are points on the ONS ASHE 2025 provisional full-time distribution for care workers and home carers (SOC 6135), starting from the NLW at 35 hours. Senior carers, team leaders and managers are coded to different SOC groups and are not in this table. The NHS route (Band 2 to Band 4, then Nursing Associate and Registered Nurse at Band 5) is on the published AfC scale above. Take-home figures use England 2026/27 rates with 0% pension.
| Point on the distribution | Gross | Income Tax | NI | Annual take-home | Monthly |
|---|---|---|---|---|---|
| NLW full-time (35 hr/wk at £12.71) | £23,132 | £2,112 | £845 | £20,175 | £1,681 |
| Social care, ASHE lower quartile (SOC 6135) | £22,798 | £2,046 | £818 | £19,934 | £1,661 |
| Social care, ASHE median (SOC 6135) | £27,468 | £2,980 | £1,192 | £23,297 | £1,941 |
| Social care, ASHE upper quartile (SOC 6135) | £32,493 | £3,985 | £1,594 | £26,915 | £2,243 |
| Social care, ASHE 90th percentile (SOC 6135) | £38,265 | £5,139 | £2,056 | £31,070 | £2,589 |
Moving from the ASHE median to the upper quartile adds £5,025 gross and £3,618 take-home a year. Source: ONS ASHE 2025 provisional.
Comparison vs similar roles
Cross-sector comparison at the care worker pay level. NHS rows include the tiered NHS Pension 2015 contribution; other rows use 0% pension for comparability.
| Role | Gross | Take-home | Monthly | Notes |
|---|---|---|---|---|
| Care worker (NLW, 36 hr/wk) | £23,793 | £20,651 | £1,721 | NLW £12.71/hr at 36 hr/wk x 52 weeks. |
| Care worker, ASHE median (SOC 6135) | £27,468 | £23,297 | £1,941 | ONS ASHE 2025 provisional, full-time. |
| Nursing auxiliaries and assistants, ASHE median | £29,084 | £24,460 | £2,038 | ONS ASHE 2025 provisional, full-time. The SOC group NHS HCAs code to. |
| NHS HCA Band 2 (this page) | £25,272 | £20,533 | £1,711 | AfC 2026/27 single pay point, NHS Pension 2015. |
| NHS HCA Band 4 top (this page) | £31,157 | £24,091 | £2,008 | Assistant Practitioner, AfC 2026/27 Band 4 top, NHS Pension 2015. |
| NHS Nurse Band 5 (entry) | £32,073 | £24,695 | £2,058 | Newly qualified registered nurse, AfC 2026/27. |
The largest difference between NHS and social care at the same gross is the employer pension. At Band 4 top (£31,157) the NHS employer contribution of 23.7% is worth £7,384 a year. On the same salary, the 3% auto-enrolment statutory minimum on qualifying earnings above £6,240 is £748.
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Frequently asked questions
How much does a UK care worker earn in 2026/27?
The legal floor for a care worker aged 21 or over is the National Living Wage of £12.71 an hour from 1 April 2026, which is £23,132 a year at 35 hours a week. ONS ASHE 2025 provisional puts the full-time median for care workers and home carers (SOC 6135) at £27,468. NHS Healthcare Assistants on Agenda for Change 2026/27 earn £25,272 at Band 2, £25,760 to £27,476 at Band 3 and £28,392 to £31,157 at Band 4.
NHS Healthcare Assistant vs social care - what is the difference?
NHS Healthcare Assistants (HCAs) work in NHS Trusts (hospitals, community trusts, mental health trusts) and are paid on the national Agenda for Change pay spine. Social care workers work for private and local authority providers in care homes, supported living and home care, and are paid an hourly rate set by the provider, typically at or close to the National Living Wage. NHS HCAs get NHS Pension 2015 access (currently a 23.7% employer contribution), occupational sick pay, and unsocial-hours premium under Section 2 of the AfC handbook. Social care employers must offer at least an auto-enrolment pension, and many pay Statutory Sick Pay only: Skills for Care found 38% of responding employers paid care workers more than SSP in 2024/25.
What is the National Living Wage in 2025 and 2026?
The National Living Wage from 1 April 2026 is £12.71 an hour for workers aged 21 and over (up from £12.21 in 2025/26). The 21-and-over age threshold was lowered from 23 in April 2024 as part of the Low Pay Commission roadmap to a single adult rate. The 2026 uplift followed the Low Pay Commission recommendation; the 18-to-20 rate rose to £10.85 the under-18 rate to £8.00 and the apprentice rate to £8.00 on the same date.
How are sleep-in shifts paid for care workers?
Following the Supreme Court ruling in Royal Mencap Society v Tomlinson-Blake (2021), sleep-in shifts are not paid the full hourly rate for the sleeping period. Where the worker is permitted to sleep and is only available to be woken, the minimum wage applies only to the time they are awake for the purpose of working. Employers usually pay an allowance for the night on top; the amount is set by each employer and is not regulated. Any allowance is taxable as employment income through PAYE.
How are live-in carers paid and taxed?
There is no published scale for live-in care: pay is set by the agency or the family. A live-in carer employed through PAYE is a worker for minimum wage purposes, and the family or agency is the employer. A self-employed live-in carer pays Income Tax and Class 4 National Insurance through Self Assessment on profits, and must register with HMRC by 5 October after the end of the first tax year of self-employment. Class 2 National Insurance no longer has to be paid: above the Small Profits Threshold it is treated as paid, and below the threshold paying is voluntary.
Can care workers use the Health and Care worker visa to work in the UK?
The Health and Care worker visa is part of the Skilled Worker route, with exemption from the Immigration Health Surcharge. The usual minimum salary is £25,000 a year, or the going rate for the occupation if that is higher. gov.uk now lists care workers and home carers (code 6135) and senior care workers (code 6136) only for people extending, updating or switching to the visa from inside the UK, and the sponsor must be registered with the Care Quality Commission for work in England. NHS clinical roles remain eligible for new applications, subject to the salary rules.
What pension do social care workers get?
Most social care workers in the private sector are auto-enrolled into a workplace pension under the Pensions Act 2008. The statutory minimum is 8% of qualifying earnings (between £6,240 and £50,270): at least 3% from the employer, with the rest from the employee including tax relief. Some employers pay more than the minimum. NHS HCAs are in the NHS Pension Scheme 2015, with tiered member contributions and a 23.7% employer contribution. Separately, council-employed care staff in England and Wales can join the Local Government Pension Scheme, where members pay between 5.5% and 12.5% of pensionable pay depending on earnings.
How does a care assistant progress to registered manager?
Social care progression usually runs care assistant, then senior care assistant (often medication-trained, with a Level 3 diploma), then team leader or shift supervisor, deputy manager and registered manager, a role registered with the Care Quality Commission in England. Social care has no national pay scale, so the pay step at each stage is set by the employer. The alternative is the NHS route: Band 2 or Band 3 Healthcare Assistant, then Band 4 Assistant Practitioner or Nursing Associate, then Registered Nurse at Band 5, each on the published Agenda for Change scale.
How big is the UK care workforce?
Skills for Care estimated 1.60 million filled posts in adult social care in England in 2024/25, across an estimated 19,000 organisations and 42,000 establishments. The vacancy rate was 7.0%, equivalent to 111,000 vacant posts, down from a peak of 10.5% in 2021/22. Turnover among directly employed staff was 23.1%. These figures are for England only and come from the October 2025 edition of its annual report.
Do care workers in Scotland and Wales earn more?
In Wales, the Welsh Government funds an uplift to the Real Living Wage for registered social care workers in care homes and domiciliary care, and for personal assistants funded through a local authority direct payment. The Real Living Wage is a voluntary rate set by the Living Wage Foundation, above the statutory National Living Wage. Scotland sets its own adult social care pay policy; check the current rate with the Scottish Government. NHS HCA pay (Agenda for Change) is set separately in each of the four nations.