NHS salary if you drop a grade?

If you drop from Band 7 back to Band 6, you don’t automatically go to the bottom of the Band 6 scale, but you also don’t always land on the exact “mid-point” either. In the NHS Agenda for Change system, when someone moves down a band, your starting point in the new band is usually based on your previous experience, skills, and the closest matching pay step, but it is ultimately decided by HR based on “pay protection” rules and internal policy.
In many cases, someone with 4 years’ Band 7 experience would likely be placed at a higher Band 6 point (not entry level), especially if your skills are still relevant to the Band 6 role. However, this is not guaranteed as automatic progression—some trusts may still place you at a lower point but above the bottom, depending on matching criteria and local policy.
Also worth remembering: dropping a band can affect not just basic salary, but also pension contributions, overtime rates, and overall monthly take-home pay. So it’s always a good idea to calculate what the actual difference will look like before making the decision.
If you want to clearly compare your exact take-home pay between Band 7 and different Band 6 points, you can check it here:
https://nhspaycalculatorss.co.uk/

It’s negotiable. I went for a band 5 job (which I am massively overqualified for but omg I love it and my life is so much easier) as a top end band 6 (having just changed my mind about the band 7 job I was supposed to start). They agreed top of band 5.

This is great to hear. I did similair and the balance is great

I left the NHS now but I was on a different point to what I should have been.
I would insist on being a band 6 top point. They will always say you can't do this but if they want you they can.

@Iwillhavealargeone
brilliant news and glad they put you at top band 6.
I’m a year on from you, having gone back to a 6 from a 7 and have zero regrets. In fact I’m loving the better work/life balance and rarely think of work unless I am physically on duty.

Glad to hear it OP, congratulations!

Great news OP, well done!

I'm sorry to hear you aren't enjoying your band 7 job. I'm finding it reassuring to read it isn't just me though. I did it for 13 years including through COVID, and then... I'm now working agency, in charge of my own shifts/time and loving the patient care, less responsibility, and earning slightly more (but pension has taken a hit). Overall worth it in terms of family life.

I did this after going on maternity after being in a B7 secondment. I dropped back to a B6 for a short time after mat leave before getting a different B7 role and was put at the top of B6. There arent any overlaps anymore

@onepieceoflollipop

You sound like you have made the right move

There is a definite shift of b7 responsibilities now. So much operational responsibility!

@JessicaBrassica
i don’t think there are any overlaps any more, so the NHS screenshot I posted may be out of date - but the principle of the agreement should still be there.

Empathising with all who are struggling with a band 7. Mine was a management post but still loads of clinical responsibilities. It was literally impossible to do all I had to do, in fact just reading the several hundred emails per week was impossible.

I now work 3 long days most weeks for the same money…
I was working 5-6 long days just to get it all done. Totally unsustainable and I never switched off.

Definitely discuss with the recruiting manager. I am a band 7 and applied for a band 6 purely because I had moved house and had a 90 mile round commute. At interview I was offered a band 7 even though I had not applied for one. I always thought there was no flex with these sort of things but there definitely is. Good luck with it working for the NHS can be very stressful these days.

I think it's down to negotiation and the line manager. I have put someone at the of the band due to them moving down a grade, but I knew they were really experienced

I'd expect you to get top of B6 as you were B6 for 5 years and now B7. I would set your expectations at the point of the job offer: "I had 5 years of experience at B6 plus an additional one now at B7 so my understanding is that I'll go in at the top of the band - can you confirm for me how we can make sure this gets sorted?" Or similar.

That's interesting @onepieceoflollipop I actually didn't think there were any overlaps on banding any more, but I could be wrong.

I have a substantive b5 contract but I've been acting up b6 for a couple of years. When someone forgot to tick the box I was paid as B5 +1 increment - appropriate for b5 with 3yrs pqe. I'd assume you'd probably go back to b6 with appropriate increments unless you fight for the top of b6 which seems reasonable given your additional skills and experience.

@Iwillhavealargeone

I will try and do this- not sure if I can off the app!

Band 7 is shit, you get all the pressure from above and have to manage everyone below! I hope they give you too band 6 if that’s what you were on.

It’s my dream to drop back to top band 6, I miss my old job so much😥 I’m bottom band 7, 1 year in and I go through phases but definitely hate it more than like it.

I dropped back to band 6 from band 7 last year and am on top increment of band 6. There was no discussion with manager/HR it just happened automatically. (I'm earning much more now from nights/weekends than I did as a band 7 which is mad and am a million times happier!!!!)

OP would you mind sharing more details of why you are returning to a band 6?

I am wondering whether to do the same. Not sure if B7 is for me either

I thought that Foundation Trusts were able to set their own pay and conditions so we're able to move away from AfC. Although less favourable than AfC would mean they'll lose staff.

@Iwillhavealargeone
good luck with it all. I’m now back established as a 6 and no regrets.
I could do the band 7 but it wasn’t for me.
sorry you are unhappy, I’m sure it will all work out but obviously working notice and getting through the pre employment stuff etc takes time.

You’d be surprised the number of times AfC is used as a guide rather than a standard