Annex U Pay Explained for Biomedical Scientists UK 2026
Reviewed by Desmond O., HCPC-registered Biomedical Scientist, and the PathologyLabTraining editorial team. Published , last updated
Pay figures use NHS Agenda for Change 2026/27 rates for England, effective 1 April 2026. The rules below are quoted from the NHS Terms and Conditions of Service Handbook (NHS Employers, amendment 62, June 2026): Annex 21 for trainee pay, Section 2 for unsocial hours, Section 3 for overtime and Annex 29 for on-call.
Three parts of the NHS Agenda for Change handbook decide how much a biomedical scientist is actually paid beyond the pay band: Annex 21 (trainee pay, still widely called "Annex U"), Section 2 (unsocial hours) and Annex 29 (on-call). They are often mixed up, and a lot of what circulates about them is wrong. The most common errors are that trainees get "70% for three years", that nights pay "time plus 50%" for Band 5 and above, and that on-call pays a fixed national percentage. This guide sets out what the handbook actually says, with worked 2026/27 figures.
What is Annex U (Annex 21)?
Annex U was the original name for the Agenda for Change arrangements for trainees. In the current handbook the same arrangements are Annex 21: Arrangements for pay and banding of trainees. Job adverts and trusts still use both names.
Annex 21 applies when you are employed in a trainee role, working towards the qualification needed for the band of the fully qualified post. For biomedical science that is usually a trainee biomedical scientist completing the IBMS Registration Training Portfolio before HCPC registration.
How Annex 21 trainee pay is calculated
Annex 21 has no separate trainee pay scale. For training that lasts between one and four years, your pay is a percentage of the maximum of the band you are training for. The percentage depends on how long is left before you finish training. The handbook sets:
| Time left before completing training | Pay |
|---|---|
| Up to 12 months | 75% of the band maximum |
| More than one but less than two years | 70% of the band maximum |
| More than two but less than three years | 65% of the band maximum |
| More than three years | 60% of the band maximum |
Three further rules matter:
- Minimum wage floor: Annex 21 pay can never fall below the National Minimum Wage, so the 60% rate is uplifted to the minimum wage equivalent (about £24,853 a year full time from April 2026).
- On qualifying: you enter the band "on the first pay point of the appropriate pay band or the next pay point above [your] training salary".
- Based on the maximum, not the minimum: the percentage is always taken from the top of the band.
Scotland has its own version of Annex 21, so check your contract if you work there.
Annex 21 salaries for 2026/27
Trainee in a Band 5 biomedical scientist post (Band 5 maximum £39,043):
| Time left before completing training | Percentage | Annual salary |
|---|---|---|
| Up to 12 months | 75% | £29,282 |
| One to two years | 70% | £27,330 |
| Two to three years | 65% | £25,378 |
| More than three years | 60% | £23,426, uplifted to the minimum wage equivalent (about £24,853 full time) |
| On qualifying (Band 5 first pay point) | £32,073 |
A typical two-year Annex 21 trainee post pays £27,330 in the first year (more than one year left) and £29,282 in the final year. You then move to £32,073 at Band 5 once registered.
Trainee in a Band 6 post (Band 6 maximum £48,117), for example a trust-designed development role that is formally set up under Annex 21: 70% is £33,682 and 75% is £36,088.
Annex 21 vs a Band 4 trainee post
Not every trainee biomedical scientist post uses Annex 21. Many trusts advertise trainee posts at a fixed band instead, commonly Band 4 (£28,392 to £31,157 in 2026/27). Read the advert: it will say "Annex 21", "Annex U" or name the band.
Two-year comparison (2026/27 basic pay):
- Annex 21: £27,330 + £29,282 = £56,612
- Band 4 trainee, first pay point both years: £28,392 × 2 = £56,784
- Band 5 from day one, if a trust offers it: £32,073 × 2 = £64,146
The difference between an Annex 21 post and a fully qualified Band 5 salary over two years is about £7,534. The trade-off is that a trainee post gives you a supervised route to HCPC registration.
Who Annex 21 covers
Usually covered, when the post is set up as an Annex 21 trainee post:
- Trainee biomedical scientists working towards HCPC registration
- Other trainee roles where the employer and local partnership have agreed that Annex 21 applies
Not covered:
- HCPC-registered biomedical scientists in substantive posts, including when they study for the IBMS Specialist Portfolio in their existing role
- Posts advertised at a fixed band (for example Band 4 trainee posts)
Annex 21 has to be agreed and monitored in partnership locally, so whether a particular post uses it is a trust decision.
Unsocial hours payments (Section 2)
Unsocial hours payments are set nationally in Section 2 of the handbook, not in Annex 29. In England the rates since 1 April 2020 are:
| Pay band | Saturday (all day) and weekdays 8pm to 6am | Sundays and public holidays (all day) |
|---|---|---|
| Band 1 | Time plus 47% | Time plus 94% |
| Band 2 | Time plus 41% | Time plus 83% |
| Band 3 | Time plus 35% | Time plus 69% |
| Bands 4 to 9 | Time plus 30% | Time plus 60% |
Rules that change the arithmetic:
- There is no separate "night rate". Weekday nights and Saturdays attract the same enhancement.
- If more than half of a weekday evening or night shift falls between 8pm and 6am, the enhancement applies to the whole shift.
- You receive only one rate of enhancement for each hour.
- Enhancements are calculated on basic pay. They do not include high cost area supplements.
- You cannot be paid unsocial hours and on-call payments for the same hours.
Worked shift examples (Band 6 top point, 2026/27)
A Band 6 BMS at the top point earns £48,117, which is about £24.61 an hour (£48,117 ÷ 52.143 weeks ÷ 37.5 hours).
Early shift, Monday 7am to 3pm (8 paid hours):
- No enhancement
- 8 × £24.61 = £196.88
Late shift, Tuesday 2pm to 10pm:
- 2pm to 8pm at plain time: 6 × £24.61 = £147.66
- 8pm to 10pm at time plus 30%: 2 × £24.61 × 1.30 = £63.99
- Total £211.65
Weekday night shift, 8 paid hours mostly between 8pm and 6am:
- More than half the shift is in the 8pm to 6am window, so the whole shift is enhanced
- 8 × £24.61 × 1.30 = £255.94 (£59.06 more than a day shift)
Sunday day shift, 8 paid hours:
- 8 × £24.61 × 1.60 = £315.01 (£118.13 more than a weekday day shift)
What unsocial hours add over a year
Take a Band 6 BMS at the top point on a rotating pattern that includes 12 weekday nights, 12 Saturdays, 12 Sundays and 2 public holidays a year (8 paid hours each):
| Shifts | Extra per shift | Extra per year |
|---|---|---|
| 12 weekday nights | £59.06 | £708.77 |
| 12 Saturdays | £59.06 | £708.77 |
| 12 Sundays | £118.13 | £1,417.54 |
| 2 public holidays | £118.13 | £236.26 |
| Total | about £3,070 |
That is roughly 6% of basic pay. On a pattern with more nights and weekends the figure rises in proportion. Staff who work or are on-call on a public holiday also get equivalent time off in lieu at plain time rates, in addition to the payment.
On-call payments (Annex 29)
This is where most published figures go wrong. In England there is no national on-call availability rate. Since 1 July 2018, paragraph 2.27 of Section 2 says that on-call payments are agreed locally, and must be consistent with the principles in Annex 29: Principles for harmonised on-call arrangements.
A member of staff is on-call when, as part of an established arrangement with their employer, they are available outside their normal working hours, at the workplace, at home or elsewhere, to work as and when required.
What Annex 29 requires local schemes to include
- An availability payment for being on-call. Local partnerships choose between a flat rate for all staff, a flat rate by band, or a percentage of salary, and the payment must reflect how often you are on-call. Weekend and public holiday commitment has to be taken into account.
- Equal pay: staff at the same pay band on the same on-call frequency should receive consistent payments.
- Payment for work done, including work done at home, at the appropriate hourly rate under the handbook. Local partnerships may agree a minimum payment period.
- Time off in lieu as an option instead of payment for work done.
- Compensatory rest after work done.
- Travel time paid at the rate agreed for on-call work done.
- Public holidays: covering a public holiday attracts a day in lieu, whether or not you are called in.
The "interim regime" percentages
Annex 29 reproduces the old Agenda for Change "interim regime", which it says "may provide a useful model" for dividing up the week. It set availability payments as a percentage of basic pay by frequency:
| Frequency of on-call (of nine weekly periods) | Enhancement |
|---|---|
| 1 in 3 or more frequent | 9.5% |
| 1 in 6 or more, but less than 1 in 3 | 4.5% |
| 1 in 9 or more, but less than 1 in 6 | 3% |
| 1 in 12 or more, but less than 1 in 9 | 2% |
These are not a national entitlement today. Your trust's local agreement sets your actual rate. Ask for the on-call policy before you accept a post.
Illustration only: if a trust's scheme matched the interim regime, a Band 6 BMS at £48,117 on a 1 in 4 rota would receive 4.5%, which is £2,165 a year for availability, plus payment for any work done.
Payment for work done during on-call
Hours worked above 37.5 in a week are overtime under Section 3:
- Bands 1 to 7: time and a half, or double time on general public holidays
- Bands 8 and 9: no overtime payments
- Time off in lieu instead of overtime is at plain time
Example: a Band 6 BMS at £24.61 an hour is called in for 2 hours on a weekday night and the work counts as overtime: 2 × £24.61 × 1.5 = £73.83. Whether a minimum payment period applies (for example "minimum 1 hour" or "minimum 2 hours") depends on your trust's local agreement.
Common on-call frequencies
The frequency is the share of on-call periods you cover:
- 1 in 3: about 17 weeks a year. Heavy, usually in small departments.
- 1 in 4: about 13 weeks a year
- 1 in 5: about 10 weeks a year
- 1 in 6: about 8 to 9 weeks a year
A number of pathology departments have replaced traditional on-call with 24/7 shift working. In that case you are paid unsocial hours enhancements on rostered shifts rather than on-call availability.
Which specialties have out-of-hours work
Out-of-hours cover follows the clinical need, not a national rule, so check each department:
- Blood transfusion, haematology and biochemistry usually form part of the 24/7 blood sciences service, through shifts or on-call
- Microbiology commonly provides extended hours and some out-of-hours cover (for example urgent CSF and blood culture work), varying by trust
- Cellular pathology is mostly a weekday service, with limited out-of-hours work such as frozen sections at some sites
- Andrology is usually a weekday service
Tax and pension on extra payments
- Unsocial hours, on-call and overtime payments are taxed as earnings through PAYE.
- In England, Wales and Northern Ireland for 2026/27, income above the £50,270 higher-rate threshold is taxed at 40%. Employee National Insurance is 8% between £12,570 and £50,270 and 2% above that. Scotland has different income tax bands.
- Pension: Annex 29 says the employer decides which on-call payments are pensionable, using NHS Pensions criteria. Do not assume every extra payment counts towards your pension. Check with payroll.
Annex U (Annex 21) trainee pay: FAQs
1. "Can I be paid full Band 5 instead of Annex 21?"
Some trusts advertise trainee posts at Band 5 or at a fixed band, and some take relevant prior experience into account. It is a local decision about how the post is set up, so compare adverts. If a post is advertised under Annex 21, the percentage is set by the handbook table and is not normally open to negotiation.
2. "How long does Annex 21 pay last?"
Until you complete training. Your percentage steps up as your completion date gets closer (60%, 65%, 70%, then 75% in the final 12 months). The IBMS says the Registration Training Portfolio normally takes the equivalent of 9 to 12 months, but trainee posts are often set up over longer periods. Your contract states the planned training period.
3. "Do Annex 21 trainees go on the on-call rota?"
That is a local decision. Trainees work under supervision before HCPC registration, so they are not normally left to provide unsupervised out-of-hours cover. If you do work unsocial hours or on-call, the Section 2 and local Annex 29 arrangements apply to you as they do to other staff.
4. "What happens to my pay when I qualify?"
You move onto the band at its first pay point, or the next pay point above your training salary. For a Band 5 trainee on 75% (£29,282), that means £32,073, an increase of £2,791 a year (9.5%).
On-call: FAQs
1. "Can I refuse on-call?"
If on-call is part of your contract and job description, it is a contractual requirement. Ask about on-call expectations before accepting a post. Requests to change your working pattern for health or caring reasons go through your trust's flexible working policy. Every NHS employee has the right to request flexible working.
2. "What if I can't respond to a call?"
Contact the on-call manager straight away so they can arrange alternative cover. Trust on-call policies set response-time expectations and conditions such as being fit to work. Failing to respond without explanation can become a conduct matter under local policy.
3. "Am I paid if I'm called in?"
Yes. Work done is paid at the appropriate hourly rate. For Bands 1 to 7 that is usually overtime at time and a half (double time on public holidays), or time off in lieu at plain time if you choose it. Minimum payment periods and travel-time rules are set locally.
Key takeaways
- Annex U is now Annex 21. Trainee pay is 60%, 65%, 70% or 75% of the band maximum depending on how long is left before you complete training. For a Band 5 trainee in 2026/27 that is £23,426 to £29,282, never below the minimum wage.
- Unsocial hours are national and simple. For Bands 4 to 9 it is time plus 30% on Saturdays and weekdays 8pm to 6am, and time plus 60% on Sundays and public holidays. There is no separate night rate.
- On-call pay is local. Annex 29 sets principles, not rates. The 9.5/4.5/3/2% interim-regime figures are a historic model, not an entitlement. Ask for the trust's on-call policy.
- Overtime is time and a half for Bands 1 to 7 (double time on public holidays). Bands 8 and 9 get none.
- Check your contract. The advert and contract tell you whether a post is Annex 21, a fixed band, on-call or shift-based. Those decide most of the difference in what two BMSs at the same band take home.
Figures are NHS England Agenda for Change 2026/27 rates. Scotland, Wales and Northern Ireland publish their own pay scales and some rules differ. Rules quoted from the NHS Terms and Conditions of Service Handbook (NHS Employers). Check your individual contract and your trust's policies.
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