Practice nurses earn thousands of pounds less than hospital colleagues, finds report

Nurses working in general practice are earning thousands of pounds less than those in secondary care on Agenda for Change (AfC) terms, a new and exclusive report by Nursing in Practice has revealed.

Nursing in Practice’s General practice nurse pay: A salary survey of the profession 2026 has been published today – with key findings discussed and shared with nurses at our Nursing in Practice London event at the Business Design Centre this morning.

The report focuses on general practice nurse (GPN) basic pay and salaries, annual pay uplifts, pensions, employment benefits, the additional roles reimbursement scheme and more.

Based on a survey of almost 900 general practice nursing staff and informed by expert advice, including from the Royal College of Nursing (RCN), the findings point to a widening gap between the contribution of GPNs and how they are recognised and rewarded.

A key focus of the report is that the exclusion of GPNs from AfC means their pay levels are falling way behind their NHS secondary care colleagues who benefit from AfC terms.

For example, our data suggests AfC NHS nurses at the top end of Band 5 are earning over £1,000 more than practice nurses working at Band 6.

Furthermore, the report shows that AfC nurses at the top of Band 6 are earning almost £5,700 more than practice nurses working at Band 7.  (see table below).

Being on AfC also means that NHS nurses are guaranteed an annual pay rise, while those in general practice can often miss out – as evidenced in the report’s data. It also has implications for employment benefits, which again are further explored in the report.

Our analysis gathered data for different nursing roles within primary care, including GPNs, advanced nurse practitioners, nurse specialists, nurse team leads, enhanced level practice nurse, and nursing associates.

And according to the survey, the average salary of a full-time (or full-time equivalent) GPN in the UK is £35,884.

Significantly, this comes in lower than the government’s National Career Service salary estimates – calculated at £40,000 for a new starter GPN and rising up to £57,000 for an experienced GPN.

But even for advanced nurse practitioners (ANPs) respondents to our survey, the full-time average salary came out at £49,321.

Data also showed that:

• Those with a GPN job title at Band 5 earn an average salary of £29,976,
• GPNs at Band 6 earn an average salary of £36,443
• GPNs at Band 7 are being paid an average salary of £40,892.

Not only are these salaries again lower than the government’s National Career Service expectations, but they are also much lower than the AfC pay levels.

Average pay for GPNs not on AfC versus pay band ranges for nurses on AfC:

Source: Nursing in Practice survey and data from NHS Employers

Many nurses responding to our survey raised concerns that their pay does not reflect the work they do, including one GPN who said: ‘Practice nurses don’t get the recognition we deserve. We are highly skilled nurses who work autonomously but are an integral part of the wider team. We deserve the same pay scale as nurses working in secondary care, to reflect our hard work and expertise in general practice. We are the “forgotten nurses”.’

The issue of not having AfC terms and its impact on  recruitment was discussed by several respondents, including one nurse who said : ‘Nurses don’t want to leave Agenda for Change for less pay. This was reflected in our recent advertising – it took 18 months to recruit.’

Another added: ‘Our pay would be better if we were on Agenda for Change conditions. It makes recruiting GPNs difficult as there are huge implications when accepting a job.’

As highlighted in the report, the RCN has called in the past for GPNs to be aligned to AfC, as well as for ringfenced funding to support general practice nursing and for a nursing seat on government negotiations.

Nursing in Practice has echoed these calls, backed by the evidence set out in the report, and has made three key recommendations.

Our key recommendations are:

1. The government must introduce ringfenced funding for general practice nursing – to ensure practices have adequate funds to provide their nurses with fair pay, terms and conditions that reflect their highly skilled, complex, and vital roles.

1. Nursing staff in general practice must have their pay, terms and conditions set at least in line with those on Agenda for Change, to help stamp out pay inequity within the profession and ensure GPNs have access to timely, annual pay uplifts and above statutory employment benefits, such as maternity and occupational sick pay.
2. The nursing voice must be represented in national negotiations in relation to primary care and general practice, including the GP contract. The RCN has stressed it stands ready to be that voice and to ensure nurses are heard at every level.

Our full report also features commentary from a GP from the grassroots organisation Doctors Association UK (DAUK) about the funding constraints faced by GP partners when it comes to paying their nurses, as well as expert advice for nurses on managing their pensions and how to negotiate a pay rise.

Further details, including on pay rises, bonuses, employment benefits and pensions will be provided in further coverage in the coming weeks.

To view the General practice nurse pay: A salary survey of the profession 2026 report click here.