Consultant Clinical Impact Awards 2026/27: What Each Level Pays
Last updated: 7 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.
What are Clinical Impact Awards?
National Clinical Impact Awards are the national awards paid to NHS consultants in England and Wales whose work has impact beyond their own job plan. They replaced National Clinical Excellence Awards on 1 April 2022, and the current scheme is run under the Advisory Committee on Clinical Impact Awards, with the values and rules set out in the GOV.UK employers' guide for the 2026 awards round. The award is a fixed annual sum paid on top of the consultant's basic pay, and it is separate from everything else on the payslip: separate from the threshold salary, separate from extra programmed activities, and separate from any on-call payment. A consultant's threshold sets the basic pay, and the award sits on top of it unchanged for the whole term of the award.
The scheme matters because the sums are large enough to change a consultant's total pay by a third. A National 3 award of £42,000 is worth 36.98% of a Threshold 1 basic salary of £113,565, and even the smallest national award, National 1 at £21,000, is worth 18.49% of that same basic salary. At the top of the scale the award is a smaller share, because basic pay rises while the award stays flat, but it is still worth 27.89% of a Threshold 4 basic salary of £150,569. Consultants are outside Agenda for Change, so none of this follows the band system: consultant pay is recommended by the Review Body on Doctors' and Dentists' Remuneration, the DDRB, which recommended the 3.5% award for 2026/27, announced on 25 March 2026 and effective from 1 April 2026. Our NHS consultant salary guide sets out the thresholds themselves, and our doctor pay scales hub compares every medical scale from FY1 to consultant in one place.
One warning belongs at the top of this page. The award figures here are the national values, and they are not the whole story for every consultant. Older awards from the previous scheme keep different values, local awards follow different rules, and Scotland runs its own consultant contract, so a consultant should check which scheme their own award sits in before budgeting on any figure on this page. The sections below take each scheme in turn, with the figures for each, so the comparison is explicit rather than assumed.
The 2026/27 values
The table below gives the annual value of each National Clinical Impact Award level in 2026/27, with the monthly equivalent alongside. The values apply from 1 April 2025, which is when the current five-year award terms began, and they are the same figures quoted in the GOV.UK employers' guide for the 2026 awards round. Every level is non-pensionable, which is the single most important fact about the scheme, and the pension section below works through what that costs over a career.
| Level | Annual value | Monthly value | Term | Pensionable |
|---|---|---|---|---|
| National 1 | £21,000 | £1,750.00 | 5 years | No |
| National 2 | £31,500 | £2,625.00 | 5 years | No |
| National 3 | £42,000 | £3,500.00 | 5 years | No |
| National 0 (Wales) | £10,500 | £875.00 | 5 years | No |
Three features of the scale stand out. First, the steps are even: National 2 at £31,500 is exactly one and a half times National 1 at £21,000, and National 3 at £42,000 is exactly double National 1. Second, the Wales level is a quarter of the top level: National 0 at £10,500 is a quarter of National 3, and half of National 1. Third, the scale is short. There are only three national levels in England, and the difference between the bottom and the top is £21,000 a year, which is a large sum in absolute terms but a narrow range for a scheme that covers every consultant in the country. The old scheme had four levels with wider ranges, and the legacy table below shows how much wider they were.
Up to 600 new awards are made a year in England. That number is a cap on new awards, not a count of holders: with a five-year term, the scheme can carry up to around 3,000 current holders at a time if every round fills, which is a small share of the consultant workforce. The award is competitive, and the figures on this page are the values for holders, not an average across all consultants. Most consultants hold no award at all, and their pay is the threshold basic alone, which is why the consultant salary guide and the consultant take-home pay guide both start from basic pay and treat the award as an addition.
What the award adds to a consultant's pay
The table below adds the largest award, National 3 at £42,000, to each consultant threshold in England in 2026/27. The thresholds run from £113,565 at Threshold 1, on entry, to £150,569 at Threshold 4, after 14 years as a consultant, with Threshold 2a at £120,249 after three years, Threshold 2b at £123,672 after four years, and Threshold 3 at £135,645 after eight years. The total column is basic pay plus the award, and the final column shows the award as a percentage of basic pay, which falls as the consultant climbs the scale.
| Threshold | Basic 2026/27 | National 3 | Total with National 3 | Monthly total | Award as % of basic |
|---|---|---|---|---|---|
| Threshold 1 | £113,565 | £42,000 | £155,565 | £12,963.75 | 36.98% |
| Threshold 2a | £120,249 | £42,000 | £162,249 | £13,520.75 | 34.93% |
| Threshold 2b | £123,672 | £42,000 | £165,672 | £13,806.00 | 33.96% |
| Threshold 3 | £135,645 | £42,000 | £177,645 | £14,803.75 | 30.96% |
| Threshold 4 | £150,569 | £42,000 | £192,569 | £16,047.42 | 27.89% |
A Threshold 1 consultant with a National 3 award earns £155,565 a year, which is £12,963.75 a month before deductions, and a Threshold 4 consultant with the same award earns £192,569 a year, which is £16,047.42 a month before deductions. The gap between the two is £37,004 a year, exactly the same as the gap in basic pay, because the award is flat: it adds the same £42,000 at every threshold. That flatness is why the award is worth more, in relative terms, early in a consultant career. At Threshold 1 it is 36.98% of basic pay, at Threshold 2a it is 34.93%, at Threshold 2b it is 33.96%, at Threshold 3 it is 30.96%, and at Threshold 4 it is 27.89%. A consultant who wins the award early gets the largest proportional lift, and the lift shrinks in percentage terms with every threshold step, even though the cash stays the same.
It helps to compare the award with the other way consultants raise their pay, extra programmed activities. Each extra programmed activity is paid at one tenth of basic pay, which is £11,356.50 a year at Threshold 1 and £15,056.90 a year at Threshold 4. A National 1 award of £21,000 is worth nearly two extra activities at Threshold 1, and a National 3 award of £42,000 is worth nearly four, at 3.70 times the extra-activity rate. At Threshold 4 the same National 3 award is worth nearly three extra activities, at 2.79 times the rate. The comparison is not exact, because extra activities are pensionable and the award is not, and because extra activities mean extra hours while the award does not, but it gives a sense of scale: a National 3 award is worth roughly the same as three or four extra programmed activities a week, without the extra hours. Our consultant take-home pay guide works out what one extra activity is worth after tax at each threshold.
The old National Clinical Excellence Awards
National Clinical Excellence Awards were replaced by National Clinical Impact Awards on 1 April 2022, and no new awards are made under the old scheme. Consultants who already held an award keep transitional values, and the table below gives those values with the totals they produce at the bottom and the top of the consultant scale. The old scheme had four levels, Bronze, Silver, Gold and Platinum, and the top two levels were ranges rather than single figures, set by national level, which is why the table shows ranges for Gold and Platinum.
| Level | Annual value | Monthly value | Total at Threshold 1 | Total at Threshold 4 |
|---|---|---|---|---|
| Bronze | £36,192 | £3,016.00 | £149,757 | £186,761 |
| Silver | £47,582 | £3,965.17 | £161,147 | £198,151 |
| Gold | £47,582–£59,477 | £3,965.17–£4,956.42 | £161,147–£173,042 | £198,151–£210,046 |
| Platinum | £47,582–£77,320 | £3,965.17–£6,443.33 | £161,147–£190,885 | £198,151–£227,889 |
The largest total on this page comes from the old scheme, not the new one. A Threshold 4 consultant holding a Platinum award at the top of its range earns £227,889 a year, which is £18,990.75 a month before deductions, against £192,569 a year, or £16,047.42 a month, for the same consultant with a new National 3 award. The difference is £35,320 a year. At the bottom of the old scale, a Bronze award of £36,192 is worth more than a new National 2 award of £31,500, by £4,692 a year, and it is worth 31.87% of a Threshold 1 basic salary, against 27.74% for National 2. The old scheme was more generous at the top, and its holders keep that generosity for as long as their transitional award runs. Silver at £47,582 is worth 41.90% of a Threshold 1 basic salary, which is more than any new national award at that threshold, and Gold at the top of its range, £59,477, is worth 39.50% of a Threshold 4 basic salary, against 27.89% for a new National 3 award.
That generosity is one reason the old values still matter. A consultant comparing a new award with an old one is not comparing like with like, and the cash figures alone do not settle the comparison, because the pension treatment differs too. The pension section below works through the case where the old award wins on pension even when it pays less cash, which is the comparison that catches out most holders. The pension annual allowance guide is also worth reading alongside this section, because total pay at these levels is high enough for the annual allowance to bite, and the award counts towards the income that decides it.
Local Clinical Excellence Awards
Local Clinical Excellence Awards come from a different scheme again, and it is closed. The local scheme paid awards decided within each trust, and legacy awards from it are pensionable, with levels 1 to 9 running from £3,092 to £36,192 a year. The level-by-level figures for the legacy local awards have not been verified against an official source, so this page quotes only the range, not a figure per level. At the top of the range, £36,192 is the same figure as a Bronze national award, and at the bottom, £3,092 is worth 2.72% of a Threshold 1 basic salary, a small addition that is easy to overlook on a payslip but still counts as pensionable pay.
New local awards made since 2018 follow different rules: they are time-limited to one to three years, they are non-pensionable, and they are paid as a lump sum rather than as an annual addition to salary. That makes them a different kind of payment from both the national awards and the legacy local awards, and they should not be compared pound for pound with either. A lump sum of, say, £10,000 paid once is not the same as £10,000 a year for five years, and the tax treatment differs too, because a lump sum lands in a single tax year.
The rule that ties the schemes together is simple: a consultant cannot hold a local Clinical Excellence Award and a National Clinical Impact Award at the same time. The two schemes do not stack. That rule forces a choice for any consultant who holds a legacy local award and is offered a national one, and the right choice is not always the larger cash figure, because the pension treatment can reverse the comparison. The pension section below works through exactly that choice with real figures, and it is the section to read before giving up a legacy award.
Pension: the difference that matters
New National Clinical Impact Awards are not pensionable. That one fact shapes everything else about them. Pension contributions stay at 12.5% of basic pay only, because consultant income sits in the top pension tier, which starts at £67,669. A Threshold 1 consultant on £113,565 pays £14,195.63 a year into the pension, which is £1,182.97 a month, and a Threshold 4 consultant on £150,569 pays £18,821.13 a year, which is £1,568.43 a month. Those figures do not move when an award is added: a National 3 award of £42,000 raises gross pay by £42,000 and raises the pension contribution by nothing. The employer contribution of 23.7% behaves the same way. It is £26,914.91 a year at Threshold 1 and £35,684.85 a year at Threshold 4, paid on basic pay only, and the award adds nothing to it.
Legacy pensionable local awards work the other way. A Threshold 1 consultant holding a legacy Bronze award of £36,192 has pensionable pay of £149,757, and pays 12.5% of that, which is £18,719.63 a year, or £1,559.97 a month. That is £4,524.00 a year, or £377.00 a month, more than the same consultant pays with a non-pensionable national award. The employer contribution rises too, to £35,492.41 a year on the same pensionable pay. The extra contribution buys pension, so it is not money lost, but it is money that does not reach the bank account each month, and it changes the comparison between awards in a way the headline values hide.
The comparison is worth spelling out, because it looks wrong until the pension is checked. Take a Threshold 1 consultant with a National 2 award of £31,500. Gross pay is £145,065, and take-home pay is £6,738.60 a month. Now take the same consultant with a legacy Bronze award of £36,192 instead. Gross pay is £149,757, which is £4,692 a year higher, and take-home pay is £6,738.48 a month, which is 12p a month lower. The consultant with the larger gross pay keeps less cash each month, by 12p, because the pension contribution is £377.00 a month higher. Over a year the Bronze holder pays £4,524.00 more into the pension and keeps £1.44 less in cash. That is a good trade if the pension is what matters, and a bad trade if cash now is what matters, but it is a trade the headline award values never show. Our pension contributions guide sets out the tiers in full, and the pension calculator will project a pension from any salary.
Tax and take-home pay
The award is taxable income and it is subject to National Insurance, and because it is not pensionable, no pension contribution shelters any of it. The table below shows what a consultant keeps each month with each national award level, worked out for England and Wales tax, Category A National Insurance, and the 12.5% pension contribution on basic pay only. Pension contributions are deducted before income tax is calculated, National Insurance is calculated on gross pay, and the student loan is left out of the headline figures, as it is on the consultant take-home page. The personal allowance is £12,570, taxed at 20% up to £50,270, 40% up to £125,140 and 45% above, and it falls by £1 for every £2 of adjusted income above £100,000, reaching zero at £125,140. Adjusted income here means gross pay less pension contributions, which is why a Threshold 1 consultant keeps the full allowance on basic pay alone.
| Threshold and award | Gross pay | Pension / month | Income tax / month | National Insurance / month | Take-home / month |
|---|---|---|---|---|---|
| Threshold 1, no award | £113,565 | £1,182.97 | £2,264.98 | £356.83 | £5,658.98 |
| Threshold 1 + National 1 | £134,565 | £1,182.97 | £3,304.47 | £391.83 | £6,334.49 |
| Threshold 1 + National 2 | £145,065 | £1,182.97 | £3,757.85 | £409.33 | £6,738.60 |
| Threshold 1 + National 3 | £155,565 | £1,182.97 | £4,151.60 | £426.83 | £7,202.35 |
| Threshold 4, no award | £150,569 | £1,568.43 | £3,790.80 | £418.50 | £6,769.70 |
| Threshold 4 + National 1 | £171,569 | £1,568.43 | £4,578.30 | £453.50 | £7,697.20 |
| Threshold 4 + National 2 | £182,069 | £1,568.43 | £4,972.05 | £471.00 | £8,160.95 |
| Threshold 4 + National 3 | £192,569 | £1,568.43 | £5,365.80 | £488.50 | £8,624.70 |
| Threshold 1 + Bronze (legacy) | £149,757 | £1,559.97 | £3,764.15 | £417.15 | £6,738.48 |
The kept share of the award is the figure to remember. A Threshold 1 consultant keeps 38.60% of a National 1 award, an extra £675.51 a month, 41.13% of a National 2 award, an extra £1,079.62 a month, and 44.10% of a National 3 award, an extra £1,543.37 a month. A Threshold 4 consultant keeps 53.00% of a National 3 award, an extra £1,855.00 a month. The kept share rises with the threshold because the Threshold 4 consultant has already lost the personal allowance and is already paying 45% on the top slice, so the award itself is taxed at a steady marginal rate, while the Threshold 1 consultant loses part of the personal allowance as the award pushes adjusted income over £100,000. On basic pay alone a Threshold 1 consultant keeps the full £12,570 allowance, because £113,565 less 12.5% pension is £99,369. With a National 1 award the allowance falls to £2,385, and with a National 2 or National 3 award it falls to zero. That taper is the main reason the kept share is lowest at Threshold 1, and it is also why the jump from no award to National 1 is the most expensive step in tax terms.
Two more deductions sit outside the table. A Plan 2 student loan takes 9% of earnings above the £29,385 threshold, which is £631 a month at Threshold 1 basic pay and £909 a month at Threshold 4 basic pay, and the award raises it further, by £157.50 a month on a National 1 award and £315.00 a month on a National 3 award. Our student loan repayments guide sets out every plan and threshold. The other is the pension annual allowance, which limits how much pension can be built tax-free each year. Total pay at these levels is high enough for the allowance to bite, especially where a legacy pensionable award pushes pensionable pay up, and our pension annual allowance guide works through the tapered allowance for high earners. The tax code guide explains how the personal allowance taper shows up on a payslip, and the same taper is what makes the £100,000 to £125,140 zone the most expensive part of the consultant scale.
How long awards last
A new National Clinical Impact Award lasts five years. The award is paid annually at the level value, £21,000, £31,500 or £42,000 in England, or £10,500 at National 0 in Wales, for the full five years, and it does not change the consultant's threshold, which is set by years as a consultant and moves on its own timetable. It does not count as pensionable pay at any point in the five years, so the pension built over those five years is the pension on basic pay alone, and a consultant who holds an award for a full five years at National 3 receives £210,000 in total, which is five times £42,000, without any of it counting towards the pension.
Up to 600 new awards are made a year in England. That is a cap on new awards, not a count of holders, and with a five-year term the scheme can carry up to around 3,000 current holders at a time if every round fills. The award is competitive, and most consultants hold no award at all. A consultant who holds a legacy local award and is offered a national one has to give up the local award, because the two cannot be held together, and the pension comparison in the section above is the calculation to do before deciding. The consultant salary guide sets out the thresholds the award sits on top of, and the consultant take-home pay guide works out the monthly figures for basic pay alone, so the two guides together give the full picture with and without an award.
Scotland and Wales
The figures on this page are for England under the 2003 consultant contract, and they should not be assumed to apply elsewhere. Scotland runs its own consultant contract, with eight pay points from £115,331 to £153,247 over twenty years to the top, and Scotland also has its own income tax bands, so the England take-home figures on this page do not transfer. Wales runs from £114,099 to £166,585, and Wales has its own National 0 award level worth £10,500 a year, which is 9.20% of the Wales entry salary and 6.30% of the Wales top salary. The National 1, 2 and 3 values quoted above are the England and Wales national levels, and the 600 new awards a year figure is for England. The nation guides are NHS Scotland pay, NHS Wales pay and NHS Northern Ireland pay, and staff in the devolved nations should check the local pay circular for the exact figures rather than budgeting on the England rates.
What the award does not change
The award does not change the consultant's threshold, which is set by years as a consultant: Threshold 1 on entry, Threshold 2a after three years, Threshold 2b after four years, Threshold 3 after eight years, and Threshold 4 after 14 years. It does not change the value of an extra programmed activity, which stays at one tenth of basic pay, £11,356.50 a year at Threshold 1 and £15,056.90 a year at Threshold 4. It does not count towards the pension, and it does not change the pension tier, which is 12.5% for every consultant because every threshold sits above the £67,669 tier boundary. And it does not replace the other additions to consultant pay. Consultants on on-call rotas may also receive an availability supplement, which is a separate payment from the award and is not included in any figure on this page, and our on-call allowance guide covers on-call pay. The award is one addition among several, and it is the largest single addition most consultants will ever hold, but it is still only one part of total pay.
Keep exploring consultant pay
Clinical Impact Awards are the largest addition to consultant pay. See NHS consultant salary for the thresholds the award sits on top of, consultant take-home pay for what basic pay means each month after tax, National Insurance and pension, pension annual allowance for how total pay at these levels interacts with the tapered allowance, compare every NHS doctor pay scale from FY1 to consultant in one hub, on-call allowance for the separate availability payment, or junior doctor take-home pay for what the same calculation looks like at the bottom of the medical scale.
Frequently asked questions
How much is a National Clinical Impact Award in 2026/27?
In England in 2026/27, a National Clinical Impact Award pays £21,000 a year at National 1, £31,500 a year at National 2 and £42,000 a year at National 3, on top of basic consultant pay. In Wales there is also a National 0 level worth £10,500 a year. The values apply from 1 April 2025, new awards last five years, and the awards are not pensionable, so they do not count towards pension contributions or the pension built up. Up to 600 new awards are made a year in England.
Are Clinical Impact Awards pensionable?
No. New National Clinical Impact Awards are not pensionable, so pension contributions stay at 12.5% of basic pay only: £1,182.97 a month for a Threshold 1 consultant on £113,565 and £1,568.43 a month for a Threshold 4 consultant on £150,569, whether or not they hold an award. The employer contribution of 23.7% is also paid on basic pay only. The exception is legacy local Clinical Excellence Awards that are pensionable: those still count as pensionable pay, which is why a Threshold 1 consultant holding a legacy Bronze award of £36,192 pays £1,559.97 a month into the pension, £377.00 a month more than a consultant on the same basic pay with a non-pensionable National 2 award.
What is the difference between a National Clinical Impact Award and a local Clinical Excellence Award?
A National Clinical Impact Award is a national award under the current scheme, which replaced National Clinical Excellence Awards on 1 April 2022. New awards last five years, are not pensionable, and up to 600 are made a year in England, with values of £21,000, £31,500 and £42,000 at National 1, 2 and 3, plus a Wales National 0 level of £10,500. A local Clinical Excellence Award comes from the closed local scheme. Legacy local awards are pensionable and run from £3,092 to £36,192 across levels 1 to 9, while new local awards made since 2018 are time-limited to one to three years, non-pensionable and paid as a lump sum. A consultant cannot hold a local Clinical Excellence Award and a National Clinical Impact Award at the same time.
How much does a consultant earn with a National 3 award?
A Threshold 1 consultant on £113,565 basic pay earns £155,565 a year with a National 3 award of £42,000, which is £12,963.75 a month before deductions. A Threshold 4 consultant on £150,569 earns £192,569 a year with the same award, which is £16,047.42 a month before deductions. After income tax, National Insurance and pension, the Threshold 1 consultant keeps about £7,202 a month and the Threshold 4 consultant keeps about £8,625 a month, before any student loan. The National 3 award is worth 36.98% of basic pay at Threshold 1 and 27.89% at Threshold 4, because basic pay rises while the award stays flat.
What happened to the old National Clinical Excellence Awards?
National Clinical Excellence Awards were replaced by National Clinical Impact Awards on 1 April 2022, and no new awards are made under the old scheme. Consultants who already held an award keep transitional values: Bronze £36,192, Silver £47,582, Gold £47,582 to £59,477 and Platinum £47,582 to £77,320, by national level. At the top of the range, a Threshold 4 consultant holding a Platinum award earns £227,889 a year, which is £18,990.75 a month before deductions. Local Clinical Excellence Awards from the closed local scheme also continue at their legacy values, from £3,092 to £36,192.
How long does a Clinical Impact Award last?
A new National Clinical Impact Award lasts five years. Up to 600 new awards are made a year in England, so with a five-year term the scheme can carry up to around 3,000 current holders at a time. The award is paid annually at the level value, £21,000, £31,500 or £42,000 in England, or £10,500 at National 0 in Wales, for the full five years. It does not change the consultant's threshold, which is set by years as a consultant, and it does not count as pensionable pay at any point in the five years.
Can a consultant hold two awards at the same time?
A consultant cannot hold a local Clinical Excellence Award and a National Clinical Impact Award at the same time. The two schemes do not stack: holding one means not holding the other. That rule matters when comparing an old award with a new one, because a legacy pensionable local award can be worth more in pension terms than a larger non-pensionable national award, even when the national award pays more cash each month. A Threshold 1 consultant with a legacy Bronze award of £36,192 keeps £6,738.48 a month and pays £1,559.97 a month into the pension, while the same consultant with a National 2 award of £31,500 keeps £6,738.60 a month and pays only £1,182.97 a month into the pension.
How much of a Clinical Impact Award do you keep after tax?
Less than half at the bottom of the consultant scale, and just over half at the top. A Threshold 1 consultant keeps 38.60% of a National 1 award, an extra £675.51 a month, 41.13% of a National 2 award, an extra £1,079.62 a month, and 44.10% of a National 3 award, an extra £1,543.37 a month. A Threshold 4 consultant keeps 53.00% of a National 3 award, an extra £1,855.00 a month. The award is taxable income and subject to National Insurance, and it is not pensionable, so no pension contribution shelters any of it. At Threshold 1 the award also cuts the personal allowance, from the full £12,570 on basic pay alone to £2,385 with a National 1 award and to zero with a National 2 or National 3 award, which is why the kept share is lowest there. A Plan 2 student loan takes a further 9% of the award above the £29,385 threshold, which is £315.00 a month on a National 3 award.
Sources and independence
Source: GOV.UK, Employers' guide: 2026 awards round (Advisory Committee on Clinical Impact Awards).
Source: GOV.UK, Income Tax rates and bands.
NHS Bands Pay is an independent guide and is not affiliated with the NHS. Figures were verified against official sources on 7 November 2026 and can change, always confirm with the relevant official body before making financial decisions.