Deciding to leave your NHS role is a big step, whether you’re moving to a new opportunity, taking a career break, or retiring. Making sure you handle the process correctly ensures a smooth transition and protects your entitlements, like your final pay and pension. This guide walks you through the key things you need to know, from handing in your notice to understanding what happens next.
Handing in your notice
The first formal step is to resign from your post. It’s important to do this professionally to maintain good relationships, especially as you may need a reference in the future.
Your notice period is the minimum amount of time you must continue working after you’ve told your employer you’re leaving. This is a contractual requirement, so the first place to look is your contract of employment or your trust’s local policies.
For staff on Agenda for Change (AfC) contracts, notice periods are often linked to your pay band and length of service, but are typically:
- Bands 1 to 4: 4 weeks
- Bands 5 and above: Often 4 weeks initially, but can rise to 8 or 12 weeks for more senior roles or after a certain length of service.
Always check your specific contract, as local agreements can vary. For medical staff, notice periods are usually longer, often three months.
To resign, you should submit a formal letter or email to your line manager. It’s also good practice to have a conversation with them first. Your letter should be clear and concise, stating your intention to resign and your expected last day of employment, based on your notice period.
Sorting out your final pay and annual leave
Your final salary payment should include your normal pay for your last working month, plus any outstanding payments for things like overtime, unsocial hours, or on-call allowances. Most importantly, it will be adjusted to account for your annual leave.
Under AfC, your annual leave entitlement depends on your length of NHS service:
- On joining: 27 days + 8 bank holidays
- After 5 years’ service: 29 days + 8 bank holidays
- After 10 years’ service: 33 days + 8 bank holidays
This is significantly more generous than the UK statutory minimum of 5.6 weeks (which is capped at 28 days and can include bank holidays). When you leave part-way through a leave year (which usually runs from 1st April to 31st March), your entitlement is calculated on a pro-rata basis.
If you have taken less leave than you’ve accrued by your leaving date, the value of that untaken leave will be paid to you in your final payslip. Conversely, if you’ve taken more leave than you were entitled to, the value of the excess days will be deducted. It’s always best to clarify your final leave balance with your manager or HR department well before your last day. You can use our NHS annual leave calculator to get a good estimate.
A quick example
Aisha is a Band 6 Physiotherapist with six years of NHS service, working full-time. Her annual leave entitlement is 29 days plus 8 bank holidays. She decides to leave the NHS, and her last day of service is 30th June. The leave year started on 1st April.
She has worked for 3 months of the 12-month leave year (April, May, June). Her pro-rata leave entitlement is therefore 3/12ths of her annual total.
Calculation: (29 days / 12) * 3 months = 7.25 days of annual leave accrued. She would also be entitled to any bank holidays that fell within that three-month period. If she has only taken 5 days of leave, she is owed payment for the remaining 2.25 days.
Understanding your NHS Pension when you leave
One of the most valuable benefits of working in the NHS is the pension scheme. A common worry is that you’ll “lose” your pension if you leave, but this is not the case. As long as you have been a member of the scheme for at least two years, your pension benefits are protected for you until you retire.
When you leave, your pension becomes a ‘deferred’ or ‘preserved’ pension. This means your accumulated benefits are held securely for you. They will continue to increase in value each year to protect them against inflation, and you can claim them when you reach your scheme’s pension age.
Which scheme are you in?
Most current NHS employees are in the 2015 NHS Pension Scheme. This is a Career Average Revalued Earnings (CARE) scheme. For each year you are a member, you build up a pension equal to 1/54th of your pensionable pay for that year. This amount is then revalued each year until you retire to keep its value in line with inflation (specifically, it's increased by the Consumer Prices Index + 1.5% while you remain an active member, and by CPI when you leave).
Some longer-serving staff may also have benefits in the older 1995 or 2008 Sections. Thanks to the McCloud remedy, if you were in service on or before 31st March 2012 and were still in service on or after 1st April 2015, you will get to choose at retirement whether your benefits for the period between 2015 and 2022 are calculated based on your old scheme rules or the 2015 scheme rules.
The value of your pension
It’s easy to underestimate the value of your NHS pension. As well as your own contributions, the NHS as your employer makes a significant contribution of 23.7% of your salary. This is a huge benefit you don’t receive in most non-public sector roles.
Your own contribution rate depends on your pensionable earnings. The rates are due to change slightly from April 2025:
| Pensionable Earnings (from 1 April 2025) | Member Contribution Rate |
|---|---|
| Up to £13,259 | 5.2% |
| £13,260 to £27,288 | 6.5% |
| £27,289 to £33,247 | 8.3% |
| £33,248 to £49,913 | 9.8% |
| £49,914 to £63,994 | 10.7% |
| £63,995 and over | 12.5% |
If you leave with less than two years' membership, you generally have the option to take a refund of your own contributions (less tax). However, this means you forfeit the valuable employer contributions and give up your entitlement to a pension. If you think you might return to the NHS, it can be better to leave the benefits where they are.
Losing and preserving continuous service
‘Continuous service’ is a key concept in the NHS. It’s essentially a measure of how long you’ve worked in the NHS without a significant break. This date is important because it determines your entitlement to things like:
- Annual leave (as shown above)
- Occupational sick pay
- Maternity, paternity and adoption leave and pay
- Redundancy pay
If you leave the NHS and have a break of more than three months before starting a new NHS job, your continuous service may be reset to zero for some of these entitlements. For redundancy pay calculations, the rules are stricter and even a break of over a week can sometimes be enough to break service.
If you are planning to return to the NHS after a break, it's worth being mindful of this. Taking on bank work can sometimes preserve your continuous service, but policies vary between trusts, so you must check with your local HR or staff bank team.
Practical steps before you go
As your leaving date approaches, there are a few final things to tick off your list.
Exit Interview: Most trusts will invite you to an exit interview. This is a confidential conversation, usually with someone from HR, about your reasons for leaving. It’s a valuable opportunity to provide honest, constructive feedback about your role and the organisation.
References: Your future employer will need a reference. Your line manager is usually the best person to provide this. It’s courteous to ask them before you list them as a referee. When you're preparing for your next move, make sure your CV is up to date. You can use tools like our professional CV builder to help create a standout application.
Final Payslip and P45: When you receive your final payslip, check it very carefully. Make sure your final hours, enhancements, and holiday pay are all correct. You will also be issued with a P45 form after you leave. Keep this safe, as you will need to give it to your next employer so you are taxed correctly.
Return of Property: Make sure you return all NHS property before you leave. This includes your ID badge, any laptops, phones, uniforms, and keys.
Key takeaways
- Check your contract of employment to confirm your exact notice period before you resign.
- Your final pay will be adjusted for any annual leave you’ve accrued but not taken.
- If you have over two years of service, your NHS pension is deferred for you until retirement. You do not lose it.
- A break in service of more than three months can reset your ‘continuous service’ date, affecting future entitlements if you return to the NHS.
- Keep your final payslip and your P45 form safe for your own records and for your next employer.
- Always aim to leave on good terms – the NHS is a smaller world than you think and you may need a reference or wish to return one day.