Post by Deborah Udy Okusaga Akanne (@deborah_udy_okusaga)

An NHS HR department set a Band 5 entry offer for a nurse with nine years of ICU experience. She accepted it.

Twelve months later she discovered three of her colleagues with comparable experience had started higher — because they asked a question she did not know to ask.

The question is this: "Can my post-registration clinical experience from outside the UK be recognised in determining my starting pay step under Agenda for Change?"

Pay progression under NHS Agenda for Change changed in 2018 from spine points to years of experience at each band. Trusts have discretion in how they apply this to candidates whose experience was gained outside the NHS — but the framework for recognising equivalent experience exists and can be invoked.

What makes this conversation possible — and what makes it land rather than get dismissed — is evidence. Not a verbal statement of how many years you have worked.

A structured, written summary of your clinical experience that maps it to UK-equivalent competency levels — the complexity of patients managed, the governance frameworks applied, the seniority of decisions made independently.

This is what I build with my clients before offer stage. Not a complaint about pay. A professional evidence submission that gives the Trust's HR team the documentation they need to justify a higher starting point — because without the evidence, even a sympathetic HR manager cannot move the number.

The nurses who start at a higher step are not the ones who asked loudest. They are the ones who asked with evidence.

💬 Want the Experience Recognition Evidence Template — the document I use to make this case for my clients?

DM SENIORITY and I will send it to you.

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#NHSSalary #CareerEquity #NHSPayScale #InternationalNurses #AgendaForChange #UKNursing2026 #sovereignstrategy

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