Cross-Channel Physios: Working in the UK and other international news - What do they mean by "banding" and how does it work?

by Lara Garzón



In this new blog series, Lara shares her experience as an oversea-trained physiotherapist working in the UK. From guidance on the HCPC registration process to discussion around UK and international physio news, she hopes to provide help to foreign physios looking to work in the UK - and to connect with those of you who already are!

All episodes from Lara's blog series ››


The first thing we all do, when searching the internet in our quest to be UK physiotherapists, is to search for job offers, even though we know we probably cannot be eligible for them yet.

So you find a few offers and you see things like: Physiotherapist Band 5; or Band 6 Rotational Physiotherapist, or even one that says Clinical Specialist Band 8a. You obviously have no idea what the bands are but you guess that the higher the better as the salary next to those bands increases as their number increases. So your next question is: can I apply for any of them? You obviously want to go for the yummy one band 8a, since it looks like you could be earning £40'000 yearly.

Well, I am sorry to bring you back to reality but unless you have tons of experience in the specific speciality or in management - and somehow without being in the UK you know how the system works - I am afraid dear friend that you need to be looking for lower bands! Let me explain how it works and what my experience on the subject has been like.

First I want to point out that banding is mainly an aspect of NHS (National Health Service) jobs, if you would like to apply/work in the private sector this could be different, although for most clinical private jobs they will often advertise as 'equivalent to band...'



In 2004, a new plan was implemented for most NHS professions called Agenda for Change (AfC). Job descriptions were looked at and evaluated to then be given the appropriate pay. Yearly professional reviews were also set up to ensure professionals were meeting their job descriptions and that they were able to go up in pay points accordingly. They created 9 bands with different pay points within each band.

The main idea was to promote equality among professional roles and ensure fair pay was spread across the board.



This is a table about the banding in the NHS and how it looks for this financial year (click to enlarge).


If you have recently finished your physio degree/qualification or if you don't have much experience in a setting similar to the NHS you are most likely to qualify for a band 5 position. These positions are normally designed for new starters.

Band 6 is already considered a specialist job. For a band 6 position you are expected to have a good knowledge of the specific speciality and also about the system around it (i.e.: how doctors refer to your service, the role of your service amongst other multidisciplinary services in the hospital/centre, your scope of practice and of those working with you...). You are also often asked to supervise more junior staff and students.

Band 7 can get a bit confusing, as different hospitals use it differently. In many cases, a band 7 will be a team leader and a senior clinical specialist, in other cases, it could be used to describe a senior clinical specialist only. You will probably be required to have around 3 years of experience as a band 6 in the same speciality.

Band 8's are highly specialist (like some physio consultants) or service managers. For example:

  • In my hospital, some band 8a physios are what we call advanced physiotherapist practitioners (APPs). Some examples I have met are physiotherapists specialised in a specific joint (knee, shoulder...) from a musculoskeletal and orthopaedic perspective, and they work very closely with the orthopaedic surgeon specialist in that joint. They can use their advanced knowledge and clinical reasoning to screen what patients would be appropriate candidates for surgery and who will do better with physiotherapy for instance.
  • On the other hand, there is also an 8b that is the service manager. She is a physiotherapist and although she does some clinics, her main role is to manage all therapies across the hospital... basically my big boss.

Please do not take this literally, these are just examples. It can vary greatly from place to place.



Many of you have asked me if once you get HCPC-registered you will be told what banding you are. The answer is no. Banding is not something given. You are either suitable for a role or you are not.

The way to know which band to apply for is to have a close look to each job description and person specification documents for the job you want to apply for. If you meet the criteria from that job description, then you are suitable for that position. If you do not, you have a look at something lower.

Here's an example of a job description and person specification for a Band 5 Rotational Physiotherapist job for instance.

My advice, from my own experience and from helping other physios in the past, is to go for a band 5 job if you are new to the UK system. A lot of physios come with extra qualifications and they want to go straight to a band 6, very understandably, especially if you are already specialised. However, if like me, you would like to explore all the different specialities, get to know how everything works... I strongly recommend to start with a band 5. You will be much more supported, you will not have the pressure of having to supervise other people that often...

You will go up pay points every year if you meet professional goals set by yourself and your reviewer. And will be able to go for a band 6 role more confidently later down the line.



I have come from somewhere were career progression is very limited or diffused. Even specialising is something that they are still working on setting up. For me, knowing that your pay will increase as you meet your professional goals and that you will get chances of progressing to a bigger role in your team is a dream.

I have been through a band 4 role up to a band 6 now. This has made me value the role of each band, and aspire to keep growing. I get to my yearly reviews really motivated, ready to set new goals for the new year. I think in other systems where you may not have this progression, there are many chances that people will get stuck or demotivated.



You might think you have missed something in this article as I have mentioned I went from a band 4 to a band 5 and 6 positions. Apologies as I have skipped the explanation of what a band 4 is.

In physiotherapy services there are also figures called physiotherapy assistants or physiotherapy technical instructors (band 3 and band 4 respectively) that help with the delivery of the service. PA's can assist with rehabilitation and as a band 4 sometimes you can also assess new patients and lead the discharge from hospital. They also help with the maintenance of equipment and with the treatment of complex patients where more than one hand is needed.

This is a great option to start with, since it can help you to get to know the system and to get good references for your HCPC registration. However, these roles are limited and after I had been a band 4 for a few months I was ready to work as a qualified physiotherapist. From a band 4 perspective you cannot assess new neuro patients, or treat respiratory patients (from a chest perspective) and I wanted to learn and experience all of these. Also, being a band 5 or above gives you the chance to explore specialities you might not do a as 4, such as msk, women's health, some areas of paediatrics...

If you don't feel confident to start as a registered physio these jobs might be a good option but do not forget the endless possibilities that you can experience once you are registered!


If you have any other questions or are in the process of applying for jobs give QualifiedPhysio a shout as we can give you guidance either way. Good luck!



About the author

Lara Garzón

Lara is a Spanish physiotherapist who has been working in the UK for the past 3 years. Having worked as a rotational physiotherapist over here, she's had experience in a wide range of specialities and now works as a Band 6 Physiotherapist. However, it hasn't always been easy finding her way and adjusting to the UK system. She's since been sharing her experience and helping other foreign-trained physios to come and settle here; firstly through her own blog, and now as part of the QP team!