NHS Cardiac Physiologist Salary 2026/27

Last updated: 25 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

What NHS cardiac physiologists earn in 2026/27: the Band 5 to Band 7 salary ranges, hourly rates, cath-lab on-call and unsocial hours, London weighting, and how NHS cardiac physiology pay compares with private cardiac work.

A cardiac physiologist spends the working day listening to hearts, in the most literal sense. The work runs from a routine ECG in a clinic room to an echocardiogram that shows a faulty valve in moving pictures, to a night-time call into the catheterisation laboratory where a blocked coronary artery needs opening within the hour. A morning might start with ambulatory monitor fittings, move to a device clinic where pacemakers are checked and reprogrammed, and end with a patient whose exercise test has just revealed ischaemia that changes their treatment plan. It is technical, patient-facing work, and the pay question sits next to a private sector that runs its own cardiac lists and device clinics.

This guide sets out the NHS pay picture in full: the 2026/27 salary at every step of Bands 5, 6 and 7, the hourly rates, unsocial hours, cath-lab on-call and overtime, London weighting, pension contributions, what the private sector comparison really looks like, and the position in Scotland, Wales and Northern Ireland. All figures are the England Agenda for Change rates for 2026/27, which include the 3.3% consolidated award effective 1 April 2026.

NHS cardiac physiologist salary 2026/27

The 2026/27 Agenda for Change rates for NHS cardiac physiologist posts in England, full-time at 37.5 hours a week, with 2025/26 for comparison:

Source: NHS Employers Agenda for Change pay circular 2026/27 (England, full-time 37.5 hours a week). Hourly rates are annual salary divided by 52.2 weeks and 37.5 hours. The 2026/27 figures include the 3.3% consolidated award effective 1 April 2026.

Band 5 is the qualified cardiac physiologist post: the physiologist who carries out ECGs, fits ambulatory monitors, performs basic echocardiography and supports routine cardiology clinics. Band 6 is the specialist level: the physiologist working in the cardiac catheterisation laboratory, in complex echocardiography, or in cardiac device follow-up, often with a specialist caseload and a role in training junior staff. Band 7 is the senior and lead level: the physiologist who leads a service or a team within a larger service, carries the most complex cases, and answers for clinical standards, waiting lists and service quality.

Monthly pay before deductions gives a clearer sense of the money. A Band 5 cardiac physiologist at entry takes £2,672.75 a month in basic pay, rising to £3,253.58 at top. At Band 6, monthly basic runs from £3,329.92 at entry to £4,009.75 at top. At Band 7, it runs from £4,115.58 at entry to £4,709.58 at top. Those are gross figures, before tax, National Insurance, pension and any student loan deduction. Part-time cardiac physiologists are paid pro rata: a 0.6 whole-time-equivalent Band 5 cardiac physiologist at entry, for example, earns 60% of £32,073, which is £19,243.80 a year.

What NHS cardiac physiologists do

Cardiac physiology sits inside healthcare science, and the working day reflects that. The core work is non-invasive testing. An ECG records the heart's electrical activity and can reveal a heart attack in progress, an arrhythmia, or a conduction block. An echocardiogram uses ultrasound to image the heart muscle, the valves and the blood flow through the chambers, and it is the test that decides whether a valve needs replacing or a ventricle is failing. Ambulatory monitors, worn for 24 hours or longer, catch intermittent symptoms that a clinic ECG misses, such as palpitations that come and go. Exercise tolerance tests stress the heart in a controlled way to reveal ischaemia that rest does not show.

The invasive side of the job happens in the cardiac catheterisation laboratory, known as the cath lab. Here the physiologist works alongside cardiologists and radiographers during angiograms, where dye and X-rays map the coronary arteries, and during stent procedures, where a blocked artery is opened and held open. The physiologist runs the recording and monitoring equipment, watches the ECG and pressures throughout the case, and documents what was done and what it showed. Cath lab work is intense and precise: the patient is awake, the team is small, and a complication needs an immediate, calm response.

Device follow-up is the third strand. Patients with pacemakers and implantable cardioverter defibrillators attend device clinics where the physiologist interrogates the device, reads the stored data on heart rhythm and device function, adjusts settings, and decides whether the patient needs a cardiology review or a device replacement. Remote monitoring has changed this work: many devices now transmit data from home, so the physiologist triages alerts between clinics and brings forward the patients whose data shows a problem. A device clinic also involves difficult conversations, because a defibrillator shock, or the decision to deactivate a device at the end of life, is never routine for the patient.

One boundary worth knowing: cardiac physiologists are not cardiologists, and they do not diagnose in isolation. The physiologist performs and reports the test, and the cardiologist acts on the result with the wider clinical picture. That division is also the pay picture below: the physiologist's salary follows the Agenda for Change band for the post, while the cardiologist sits on a separate medical contract outside Agenda for Change.

NHS cardiac physiology vs the private sector

The private sector is hard to ignore, because it runs cardiac lists of its own. Private hospitals offer echocardiography, angiography and device implantation, and cardiac device companies employ physiologists to support implants and follow-up clinics. A qualified cardiac physiologist can walk into private or device-company work with a salary that looks competitive against the Band 5 and Band 6 figures on this page. Per session, private work can pay more, because the patient or insurer pays for the procedure and the service, and the provider sets the fee.

The comparison is less clear once the full picture is counted. Private income depends on lists and sessions: cancelled lists, quiet weeks, holidays and sick days all cut income, and the costs of professional registration, indemnity and travel between sites come out of the same pot. NHS pay, by contrast, is steady and pensionable, with paid annual leave, sick pay, employer pension contributions and a team around you. A Band 6 cardiac physiologist at top earns £48,117 a year whether the cath lab lists are full or half empty, and the employer pays 23.7% of pensionable pay into the NHS Pension Scheme on top of that.

There is also a scope difference that matters for the career, not just the payslip. NHS cardiac physiology covers the full range, from routine ECGs to emergency primary PCI lists to complex device work, which the private sector covers only in part. A physiologist who moves entirely into private work narrows their practice, and moving back into a specialist NHS post later may need retraining or a period at a lower band. Many cardiac physiologists end up doing both: a substantive NHS post for stability and breadth, with private or device-company work on the side, within the rules on second jobs and conflicts of interest. For those rules, see our guide to NHS second job rules. The honest summary is this: private work can beat NHS pay per session, but it rarely beats the NHS package once pension, leave, sick pay and income stability are counted, and it carries the full risk of a quiet list.

Unsocial hours, cath-lab on-call and overtime

Cardiac physiology is one of the few healthcare science professions where nights and weekends are a core part of the job, not an exception. The reason is primary PCI: when a patient arrives with a blocked coronary artery, the cath lab team is called in to open it, whatever the hour. Physiologists on a primary PCI on-call rota therefore work a pattern of on-call nights and weekends on top of their daytime lists, and catheterisation laboratories also run Saturday lists for routine angiograms and device implants. Under Agenda for Change Section 2, Bands 4 to 9 receive time plus 30% for Saturdays and weekday nights (8pm to 6am) and time plus 60% for Sundays and bank holidays.

In hourly terms, that means a Band 5 cardiac physiologist at entry earns £21.29 an hour for a Saturday or a weekday night hour and £26.21 an hour for a Sunday or bank holiday hour, against a plain-time rate of £16.38. At Band 5 top, the rates are £25.94 and £31.92 an hour. At Band 6 entry, they are £26.53 and £32.66 an hour, and at Band 6 top, £31.95 and £39.33. At Band 7 top, they are £37.53 and £46.19 an hour. These enhancements apply only to hours actually worked in the unsocial windows, and they cannot be claimed for the same hours as overtime pay.

On-call deserves a separate note, because cath-lab on-call pay is not a single national rate. Some trusts pay an availability payment for being on call plus the unsocial-hours enhancement for hours actually worked when called in, and the exact arrangement varies by trust and by rota. This guide therefore quotes no on-call rate: check the trust's on-call policy and the job description before assuming on-call adds a fixed amount to the salary. What can be said plainly is that on-call is frequent, it disrupts sleep and weekends, and it is the part of the job that most affects work-life balance. For the full overtime and unsocial rules, see our guide to unsocial hours and overtime pay.

Overtime rules are straightforward at these bands. At Bands 5, 6 and 7, overtime above 37.5 hours a week is paid at time and a half, and at double time on bank holidays. A Band 5 cardiac physiologist at entry on £16.38 an hour therefore earns £24.57 an hour for weekday overtime, and a Band 7 cardiac physiologist at top on £28.87 earns £43.31 an hour. Part-time physiologists are paid at plain time for hours above their contracted hours up to 37.5, with overtime rates only above that threshold.

London weighting (HCAS)

Cardiac physiologists in London trusts receive the High Cost Area Supplement on top of basic pay: 20% in inner London, 15% in outer London and 5% in the fringe zone, each subject to a minimum and a maximum. The inner London minimum is £5,794 and the maximum is £8,746. The outer London minimum is £4,870 and the maximum is £6,137. The fringe minimum is £1,346 and the maximum is £2,270.

Worked examples show how the zones work in practice. A Band 5 cardiac physiologist at entry in inner London earns £32,073 + £6,414.60 = £38,487.60 a year, because 20% of £32,073 sits inside the cap. The same cardiac physiologist in outer London would get 15% of £32,073, which is £4,810.95, but the outer London minimum is £4,870, so the supplement rises to the minimum and the total is £32,073 + £4,870 = £36,943. In the fringe zone, the same cardiac physiologist earns £32,073 + £1,603.65 = £33,676.65. At Band 7 top, 20% of £56,515 would be £11,303, so the supplement is capped at £8,746 and the total is £56,515 + £8,746 = £65,261. For the full zone rules, see our London weighting (HCAS) guide.

Pension contributions

Cardiac physiologists in the NHS Pension Scheme pay a tiered member contribution based on whole-time equivalent pensionable pay, and the employer contributes a further 23.7% of pensionable pay. The 2026/27 tiers used here are provisional, calculated from the published tier boundaries rather than yet published as final, so treat them as the best current guide and check your payslip against them.

The tier boundary explains the jump at Band 7 top: the 9.8% tier runs to £52,778, and the 10.7% tier runs from £52,779 to £67,668, so Band 7 intermediate at £51,932 still pays 9.8% while Band 7 top at £56,515 pays 10.7%. Employer contributions are substantial: at Band 7 top, the employer pays 23.7% of £56,515, which is £13,394.06 a year into the scheme. For the full tier table, see our guide to NHS pension contributions. Cardiac physiologists in uniform should also note the flat-rate expense rules: the default rate for a uniformed job not separately listed is £60 a year, worth £12 at the basic tax rate or £24 at the higher rate, claimable where the employer provides no laundry service or allowance.

Pay in Scotland, Wales and Northern Ireland

The figures above are the England rates. Scotland agreed a two-year deal with 3.75% from 1 April 2026 and a 36-hour week from April 2026, which changes the hourly maths and the overtime threshold for Scottish staff. Wales implemented 3.3% from 1 April 2026, with a Real Living Wage floor of £13.45 an hour applied to the lowest bands. Northern Ireland is the exception: the 3.3% award has been recommended but not yet implemented, so Northern Ireland staff should not budget on the new rates until implementation is confirmed. For the national pictures, see NHS Scotland pay, NHS Wales pay and NHS Northern Ireland pay. Annual leave follows the England Section 13 tiers of 27, 29 and 33 days plus 8 bank holidays by length of service; see our annual leave guide for the part-time pro rata rules.

Frequently asked questions

How much does an NHS cardiac physiologist earn?

In 2026/27, NHS cardiac physiologists in England typically earn £32,073 to £39,043 a year at Band 5, £39,959 to £48,117 at Band 6 for specialist roles, and £49,387 to £56,515 at Band 7 for senior and lead posts, for a full-time 37.5-hour week under Agenda for Change.

What band is an NHS cardiac physiologist?

Most NHS cardiac physiologist posts sit at Band 5 on qualification, for physiologists carrying out ECGs, ambulatory monitoring and basic echocardiography in a cardiology service. Specialist cardiac physiologists, including those working in the cardiac catheterisation laboratory, complex echocardiography and cardiac device follow-up, typically sit at Band 6. Senior cardiac physiologists, clinical leads and heads of service sit at Band 7. The band follows the scope, complexity and responsibility of the post, not the physiologist's qualifications alone.

What does an NHS cardiac physiologist do?

NHS cardiac physiologists test how the heart works. They record and interpret ECGs, fit ambulatory heart monitors, carry out echocardiograms that image the heart with ultrasound, run exercise tolerance tests, and support invasive work in the cardiac catheterisation laboratory, including angiograms and stent procedures. They also follow up patients with pacemakers and implantable defibrillators, checking the device, adjusting its settings and acting on what the stored data shows.

What is the hourly rate for an NHS cardiac physiologist?

In 2026/27, the Band 5 hourly rates in England are £16.38 at entry, £17.67 at the intermediate step and £19.95 at top, for a 37.5-hour week. At Band 6, the hourly rates are £20.41 at entry, £21.54 at the intermediate step and £24.58 at top. At Band 7, they are £25.23 at entry, £26.53 at the intermediate step and £28.87 at top. Unsocial hours add 30% for Saturdays and weekday nights and 60% for Sundays and bank holidays.

Do NHS cardiac physiologists get London weighting?

Yes. Cardiac physiologists in London trusts receive the High Cost Area Supplement: 20% of basic pay in inner London (minimum £5,794, maximum £8,746), 15% in outer London (minimum £4,870, maximum £6,137) and 5% in the fringe zone (minimum £1,346, maximum £2,270). A Band 5 cardiac physiologist at entry in inner London earns £32,073 + £6,414.60 = £38,487.60 a year; at Band 7 top, inner London pay is capped at £56,515 + £8,746 = £65,261.

What pension do NHS cardiac physiologists pay?

Cardiac physiologists in the NHS Pension Scheme pay a tiered member contribution based on whole-time equivalent pensionable pay. On the provisional 2026/27 tiers, Band 5 cardiac physiologists pay 8.3% at entry and the intermediate step (£221.84 to £239.26 a month) and 9.8% at top (£318.85 a month). Band 6 cardiac physiologists pay 9.8% at every step (£326.33 to £392.96 a month), and Band 7 cardiac physiologists pay 9.8% at entry and the intermediate step and 10.7% at top (£503.93 a month). The employer contributes a further 23.7% of pensionable pay.

Is private cardiac work better paid than the NHS?

Per session, private cardiac work can pay more, because the private hospital or device company sets the fee and the patient or insurer pays for the procedure and the service. Once the cost of quiet lists, cancelled sessions, holidays and sick days is counted, and pension, paid annual leave and sick pay are added on the NHS side, the NHS package usually comes out ahead for employed staff. Many cardiac physiologists combine a substantive NHS post with private or device-company work on the side, within the rules on second jobs and conflicts of interest.

Do NHS cardiac physiologists work nights and weekends?

Many do, because heart attacks do not keep office hours. Cardiac physiologists on a primary PCI on-call rota can be called in overnight and at weekends when a patient needs an emergency stent, and catheterisation laboratories also run Saturday lists. Where the Section 2 enhancements apply, Bands 5 to 7 receive time plus 30% for Saturdays and weekday nights and time plus 60% for Sundays and bank holidays. On-call availability payments themselves are set locally, so check the trust's on-call policy rather than assuming a fixed amount.