Understanding Band 8d NHS Salary
Band 8d NHS salary represents C-suite executive leadership within the NHS, including Deputy Chief Executives, Executive Directors, and senior Board members with ultimate organizational accountability. The Band 8d pay scale recognizes 15-20+ years of executive leadership experience, doctoral qualifications, and the ability to provide strategic direction at the highest organizational levels, manage entire portfolios with budgets exceeding £100M+, and serve as voting Board members with fiduciary duty. Band 8d salary reflects the substantial expertise required to deputize for Chief Executives, lead major transformations, and shape NHS strategy at system and national levels.
Band 8d Pay Scale 2025/26
Current Band 8d NHS salary rates across all UK regions
| Years | Type | England | Wales | Scotland | Northern Ireland |
|---|---|---|---|---|---|
| 0–2 | per year | £91,342 | £92,712 | £103,764 | £88,168 |
| 0–2 | per hour | £46.79 | £47.45 | £53.78 | £45.13 |
| 2–5 | per year | £96,941 | £98,395 | £108,206 | £93,572 |
| 2–5 | per hour | £49.72 | £50.50 | £56.09 | £47.98 |
| 5+ | per year | £104,295 | £105,847 | £115,649 | £100,664 |
| 5+ | per hour | £53.46 | £54.22 | £59.92 | £51.54 |
* These Band 8d pay rates are effective from April 2025, based on a standard 37.5 hour working week.
Typical Roles in NHS Band 8d
Band 8d NHS salary and Band 8d pay positions are for C-suite executives with ultimate organizational accountability, extensive executive leadership at the highest levels, and Board-level governance responsibilities. These roles require exceptional strategic management capabilities, advanced qualifications, and proven success in leading major NHS services. They represent the highest level of NHS executive leadership below Chief Executive:
Career Progression from Band 8d
Band 8d pay positions represent the pinnacle of NHS executive careers before Chief Executive, with clear pathways to CEO and system leadership roles:
Excel as Deputy CEO/Executive Director (2-5 years at Band 8d)
Demonstrate organizational transformation, system leadership, and Board-level strategic impact while earning competitive Band 8d salary with annual increments to £104,295.
Progress to Chief Executive (Band 9: £115,000-£180,000+)
Move to Chief Executive or Managing Director roles in smaller NHS trusts with ultimate accountability for organizational performance, Board Chair relationships, and system leadership.
Advance to Large Trust CEO (£150,000-£300,000+)
Become CEO of major acute trusts, teaching hospitals, or Integrated Care Systems with budgets exceeding £500M+ and ultimate accountability for thousands of staff and regional healthcare delivery.
National Leadership / Regulatory Roles
Progress to NHS England leadership, regulatory body CEOs (CQC, NHSE), academic professorships, or national health policy roles earning £200,000-£400,000+, shaping NHS direction at the highest levels.
NHS Band 8d Benefits & Perks
NHS Pension Scheme
13.5% employee contribution with exceptional employer contributions
C-Suite Leave Package
30-33 days annual leave plus 8 bank holidays plus discretionary leave
Voting Board Member Status
Full Board voting rights, ultimate fiduciary duty, governance authority
Executive Car & Benefits
Premium executive car allowance or fully-expensed lease car
CEO Development Programs
Funded CEO development, executive DBA/PhD, national leadership programs
Significant Performance Bonuses
Substantial performance-related pay and organizational achievement bonuses
Compare with Other NHS Pay Bands
What is Agenda for Change?
Agenda for Change (AfC) is the NHS's comprehensive pay system that determines the Band 8d NHS salary and compensation structure for over one million NHS staff. Introduced in 2004, it provides transparent frameworks for C-suite executive career progression, with Band 8d pay representing Deputy Chief Executive and Executive Director level leadership—the highest level of NHS executive compensation before Chief Executive roles.
The system covers all NHS staff from entry-level support workers to executive directors, with Band 8d positioned as the second-highest grade within the nine-band structure (Bands 1-9). The Band 8d salary recognizes 15-20+ years executive leadership experience, doctoral qualifications, and the ability to serve as voting Board members with ultimate accountability for organizational performance, fiduciary duty, and strategic direction at the highest NHS levels.
The Knowledge and Skills Framework (KSF) underpins Agenda for Change, ensuring that Band 8d pay earners demonstrate advanced competencies in C-suite leadership, organizational governance at scale, and system-wide transformation. Annual pay progression within Band 8d occurs through successful Board performance reviews, rewarding strategic impact, organizational excellence, and C-suite executive leadership at the highest NHS levels.
Band 8d NHS salary levels reflect the substantial experience, executive qualifications (DBA, PhD, MD), and ultimate Board-level responsibilities required at this grade. The pay scale provides exceptional C-suite compensation while offering direct pathways to Band 9 Chief Executive positions and system leadership roles, making Band 8d salary the pinnacle of NHS executive careers for Deputy CEOs and Executive Directors leading major NHS organizations.
NHS Pay Rise 2025/26
3.6% Pay Increase for 2025/26 | Backdated to April 1, 2025
In May 2025, the UK government announced a 3.6% pay increase for all Agenda for Change staff for the 2025/26 financial year, backdated to April 1, 2025. This has positively impacted Band 8d NHS salary rates, with the starting point rising to £91,342 and the top point reaching £104,295 in England. These above-inflation awards recognize the C-suite leadership, ultimate organizational accountability, and Board-level governance of Deputy Chief Executives and Executive Directors earning Band 8d salary compensation.
The Band 8d NHS salary improvements reflect consecutive years of above-inflation awards (3.6% in 2025/26 following 5.5% in 2024/25), ensuring that C-suite executives receive fair compensation for their ultimate strategic accountability and organizational leadership. This represents a cumulative increase of over £15,000 for Band 8d positions since 2022/23, significantly enhancing Band 8d pay competitiveness for experienced Deputy CEOs and Executive Directors.
Recent NHS Pay Awards Timeline:
These pay increases apply uniformly across all Agenda for Change bands, ensuring that Band 8d pay earners receive the same percentage uplift as colleagues in other bands. The government continues to work with NHS Employers and trade unions to negotiate settlements that reward C-suite professionals appropriately, maintaining the attractiveness of the Band 8d salary structure for Deputy Chief Executives, Executive Directors, and senior Board-level leaders across the NHS.