NHS Consultant Take-Home Pay 2026/27
Last updated: 25 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.
What NHS consultants actually keep each month in 2026/27: take-home pay at every threshold of the England consultant scale, after income tax, National Insurance and the 12.5% NHS pension contribution, with extra programmed activities, clinical awards, student loans and London weighting worked through.
Not Agenda for Change. Consultants in England are employed on national medical and dental terms and conditions, a separate pay framework from Agenda for Change. This page is a guide to NHS medical pay: what consultants actually keep each month after deductions.
A consultant salary sounds simple until the first payslip arrives. The headline figure, £113,565 at entry and £150,569 after fourteen years, is gross basic pay for a full-time ten programmed activity contract. What lands in the bank is a different number, shaped by four deductions and one quirk of the tax system that only bites above £100,000. This page works through the whole journey, threshold by threshold, so a consultant starting out, a senior registrar weighing a consultant post, and a Threshold 4 consultant checking a payslip can all see exactly where the money goes.
Every figure here follows one stated method, the same method used on our junior doctor take-home pay page. Pension contributions come off first, which reduces taxable income. Income tax is then calculated on what is left, using the 2026/27 personal allowance of £12,570, the 20% basic rate, the 40% higher rate and the 45% additional rate above £125,140. National Insurance is charged on full gross pay, at 8% between £12,570 and £50,270 and 2% above. Student loans are shown separately, because not every consultant still carries one. All figures are for basic pay only. Extra programmed activities, awards and London weighting are covered as additions, not folded into the headline table.
Consultant basic pay 2026/27
The England consultant scale under the 2003 contract, after the 3.5% Doctors and Dentists Review Body award effective 1 April 2026, as set out in NHS Employers Pay and Conditions Circular (M&D) 1/2026, revised 30 June 2026:
| Threshold | Years as consultant | 2026/27 basic | Monthly gross |
|---|---|---|---|
| Threshold 1 | Entry | £113,565 | £9,464 |
| Threshold 2a | After 3 years | £120,249 | £10,021 |
| Threshold 2b | After 4 years | £123,672 | £10,306 |
| Threshold 3 | After 8 years | £135,645 | £11,304 |
| Threshold 4 | After 14 years | £150,569 | £12,547 |
Two features of the scale matter for everything that follows. First, progression is back-loaded: the early thresholds arrive quickly, £6,684 more by year three and £10,107 more by year four, then six years at Threshold 3 before the final step of £14,924 to Threshold 4. Second, the jump into the consultant grade is large. A top registrar on £77,348 moves to £113,565 on taking up a consultant post, a rise of £36,217 in gross basic pay. That jump is also what pushes a new consultant straight into higher-rate tax and, once pension relief is accounted for, to the very edge of the personal allowance taper. For the full scale and the route into the grade, see our consultant salary guide and the doctor pay scales hub.
How take-home pay is calculated
Four deductions come out of a consultant's gross pay before it reaches the bank, with a student loan as a possible fifth:
- NHS pension contributions, 12.5%. At consultant income, above £67,669, the member contribution rate is 12.5% of pensionable pay. Pension contributions are deducted before income tax is calculated, which reduces the tax bill and, crucially, reduces adjusted income for the personal allowance taper.
- Income tax. The personal allowance is £12,570, taxed at 20% on taxable income up to £37,700, 40% above that, and 45% on taxable income above £125,140. Because pension comes off first, taxable income is lower than gross pay. The allowance itself tapers away above £100,000 of adjusted income, which is where consultant tax gets complicated.
- National Insurance. Employee contributions are 8% on earnings between £12,570 and £50,270 and 2% above. Unlike pension, National Insurance is charged on full gross pay, including the amount that goes into the pension.
- Student loan. Repayments are 9% of earnings above the plan threshold, or 6% above £21,000 for a postgraduate loan. Plan thresholds for 2026/27 are £26,900 for Plan 1, £29,385 for Plan 2, £33,795 for Plan 4 and £25,000 for Plan 5.
The figures below use 2026/27 thresholds, a standard tax code, and no student loan unless a column says otherwise. If a future Budget changes a threshold, the numbers shift slightly, but the structure stays the same. All figures are for basic pay only. Extra programmed activities, awards and London weighting are additions covered separately below.
Monthly take-home by threshold: the full table
| Threshold | Basic salary | Pension / month | Income tax / month | NI / month | Take-home / month | With Plan 2 loan |
|---|---|---|---|---|---|---|
| Threshold 1 (entry) | £113,565 | £1,183 | £2,265 | £357 | £5,659 | £5,028 |
| Threshold 2a (3 years) | £120,249 | £1,253 | £2,547 | £368 | £5,853 | £5,172 |
| Threshold 2b (4 years) | £123,672 | £1,288 | £2,697 | £374 | £5,947 | £5,240 |
| Threshold 3 (8 years) | £135,645 | £1,413 | £3,220 | £394 | £6,277 | £5,480 |
| Threshold 4 (14 years) | £150,569 | £1,568 | £3,791 | £418 | £6,770 | £5,861 |
Monthly figures are rounded, and annual calculations divide by twelve. Three patterns stand out. First, the pension contribution is the largest single deduction at every threshold, from £1,183 a month at entry to £1,568 at the top. Second, the tax column grows far faster than gross pay: a £37,004 rise in basic pay from Threshold 1 to Threshold 4 produces a £1,526 rise in monthly tax, because the higher thresholds lose personal allowance and cross into the 45% rate. Third, the share of gross pay kept falls as pay rises. A Threshold 1 consultant keeps about 60% of gross basic pay, £67,908 of £113,565 a year. A Threshold 4 consultant keeps about 54%, £81,236 of £150,569. That six-point slide is the taper and the additional rate doing their work.
A worked month: the entry consultant payslip
Take a Threshold 1 consultant on £113,565, full-time, no student loan, standard tax code. The month looks like this. Gross monthly pay is £9,463.75. Pension at 12.5% takes £1,182.97. Adjusted income for tax purposes is £113,565 less £14,195.63 of annual pension, which is £99,369, just under the £100,000 taper threshold, so the full £12,570 personal allowance survives. Taxable income is £86,799.38: £37,700 at 20%, which is £7,540 a year, plus £49,099.38 at 40%, which is £19,639.75, giving annual tax of £27,179.75, or £2,264.98 a month. National Insurance is 8% of £37,700, which is £3,016 a year, plus 2% of the £63,295 above £50,270, which is £1,265.90, giving £4,281.90 a year, or £356.82 a month. What is left is £67,907.73 a year, which is £5,658.98 a month, rounded to £5,659.
With a Plan 2 student loan, a further 9% of the £84,180 above the £29,385 threshold comes off, which is £7,576.20 a year, or £631.35 a month, leaving £5,028 a month. That single line is the difference between the headline figure and the bank balance for most new consultants, since medical degrees are long and loans are large. The loan column in the main table uses Plan 2 because it is the most common plan for doctors who studied in England. The student loan section below gives the other plans.
The personal allowance taper
The taper is the least understood part of consultant tax, and it is worth spelling out because it explains why take-home rises so slowly in the middle of the scale. The personal allowance is £12,570, but for every £2 of adjusted income above £100,000, £1 of allowance is withdrawn. Adjusted income here means gross pay less pension contributions. The allowance reaches zero when adjusted income hits £125,140. Inside the taper zone, each extra £2 of income is taxed at 40% and also loses £1 of allowance that is then taxed at 40%, which is why the zone is often described as an effective 60% marginal rate.
Here is how the taper plays out across the consultant scale, with adjusted income after 12.5% pension:
| Threshold | Basic salary | Adjusted income | Personal allowance kept |
|---|---|---|---|
| Threshold 1 (entry) | £113,565 | £99,369 | £12,570 (full) |
| Threshold 2a (3 years) | £120,249 | £105,218 | £9,961 |
| Threshold 2b (4 years) | £123,672 | £108,213 | £8,464 |
| Threshold 3 (8 years) | £135,645 | £118,689 | £3,225 |
| Threshold 4 (14 years) | £150,569 | £131,748 | £0 |
The entry position is a near miss that matters. Without pension relief, a Threshold 1 consultant on £113,565 would already be £13,565 into the taper zone and would lose £6,783 of allowance. Pension contributions of £14,196 pull adjusted income back to £99,369, just £631 under the threshold, so the full allowance survives. That is a concrete reason the pension contribution is worth more than its face value at this level: it protects the allowance as well as buying pension. By Threshold 4, adjusted income of £131,748 is past the £125,140 point where the allowance vanishes entirely, and the slice of taxable income above £125,140 is charged at 45%.
Extra programmed activities
A full-time consultant contract is ten programmed activities, each roughly a half day. Additional programmed activities are paid at one tenth of basic pay per activity. At Threshold 1, one extra activity is worth £11,356.50 a year in gross pay. At Threshold 4, it is £15,056.90 a year. Those gross figures flatter the real gain, because extra activities are pensionable, taxable and subject to National Insurance, and at entry they also push adjusted income into the taper zone.
Recomputed in full, an eleventh programmed activity lifts monthly take-home by about £323 at Threshold 1, from £5,659 to £5,982, and by about £579 at Threshold 4, from £6,770 to £7,348. The entry figure is the smaller of the two despite the same one-tenth rule, because the extra activity drags adjusted income from £99,369 to about £109,306, which costs £4,653 of personal allowance on top of the ordinary tax. At Threshold 4 the allowance is already gone, so the extra activity suffers no taper penalty and keeps more of its value. A consultant weighing an eleventh or twelfth activity should therefore judge it on its after-tax value, not its headline tenth of basic pay. For how programmed activities fit into the contract, see the programmed activities section of our consultant salary guide.
Clinical impact awards and local awards
Beyond basic pay and extra activities, consultants can hold awards for work of national impact. National Clinical Impact Awards replaced National Clinical Excellence Awards on 1 April 2022. New awards last five years, up to 600 are made a year in England, and the annual non-pensionable values from 1 April 2025 are £21,000 for National 1, £31,500 for National 2 and £42,000 for National 3, with a Wales National 0 value of £10,500. Older transitional awards from the previous scheme carry values of £36,192 for Bronze, £47,582 for Silver, £47,582 to £59,477 for Gold and £47,582 to £77,320 for Platinum, by national level. Local clinical excellence awards from the closed scheme carry legacy pensionable levels from £3,092 to £36,192. New local awards since 2018 are time-limited to one to three years, non-pensionable, and paid as a lump sum. A consultant cannot hold a local award and a National Clinical Impact Award at the same time.
The tax treatment is what makes awards interesting for take-home. New National Clinical Impact Awards are non-pensionable, so no 12.5% pension contribution comes off them, but they are fully taxable and subject to National Insurance, and they push adjusted income further into the taper zone or the additional rate. Worked through, a Threshold 1 consultant holding a National 1 award of £21,000 keeps about £6,334 a month, which is £675 more than the £5,659 basic-only figure. The same consultant with a National 3 award of £42,000 keeps about £7,202 a month. An award, in other words, is worth roughly a third of its headline value in extra monthly take-home at entry, because tax and National Insurance take the rest and the taper takes a further slice. Legacy pensionable local awards behave differently: pension contributions apply, which softens the tax, but level-by-level frozen values for the old scheme are not published in a verified form, so this page quotes only the range.
Student loans: the fifth deduction
Student loans deserve their own section because they are large, long-lived and easy to forget when comparing gross salaries. Repayments are 9% of earnings above the plan threshold for Plans 1, 2, 4 and 5, and 6% above £21,000 for a postgraduate loan. At Threshold 1 basic pay of £113,565, the monthly deduction is:
| Loan plan | Threshold | Monthly deduction at Threshold 1 |
|---|---|---|
| Plan 1 | £26,900 | £650 |
| Plan 2 | £29,385 | £631 |
| Plan 4 | £33,795 | £598 |
| Plan 5 | £25,000 | £664 |
| Postgraduate loan | £21,000 | £463 |
On Plan 2, the deduction rises from £631 a month at Threshold 1 to £909 a month at Threshold 4, because the whole of the pay rise sits above the threshold. A consultant with both an undergraduate Plan 2 loan and a postgraduate loan pays both deductions. Loans are not reduced by pension contributions: the repayment is calculated on gross earnings above the threshold, not on pay after pension. For most consultants the loan eventually clears or is written off, at which point monthly take-home jumps by the full deduction, which is why the headline table and the loan column are shown side by side.
London weighting, Scotland and Wales
Consultants in London trusts on the 2003 contract receive London weighting of £2,162 a year, which is about £180 a month in gross pay before tax, National Insurance and any pension treatment. It is a flat amount, not a percentage of basic pay, so it matters most at entry and least at the top of the scale. For the percentage-based London supplement that applies to Agenda for Change staff, see our London weighting guide, which is a different system and does not apply to consultants.
Scotland and Wales run separate consultant contracts. Scotland runs from £115,331 to £153,247 across eight points, taking twenty years to reach the top. Wales runs from £114,099 to £166,585. The England take-home figures on this page do not apply in either nation: the pay points differ, and Scotland has its own income tax bands, so a Scottish consultant on a similar gross salary keeps a different net amount. Northern Ireland consultants face a further complication, since the 3.3% award there is recommended but not implemented, and budgeting on it before confirmation would be unwise. For the devolved picture, see our Scotland pay guide, Wales pay guide and Northern Ireland pay guide.
Pension and the annual allowance
The 12.5% contribution buys membership of the NHS Pension Scheme, with the employer contributing on top. At consultant income the contribution is the largest single deduction, but it also does quiet work elsewhere: it cuts the tax bill, it keeps a new consultant's adjusted income under the taper threshold, and it builds inflation-protected pension. Consultants also need to watch the pension annual allowance, because high pension growth in a year can create a tax charge even though the contribution itself is only 12.5%. The allowance rules, tapering and carry-forward mechanics are covered in our pension annual allowance guide, and the contribution tiers for Agenda for Change staff, which use different thresholds, are in our pension contributions guide. A consultant who opts out of the pension keeps the 12.5% in gross pay but pays more tax on it and loses the employer contribution, so opting out is rarely the gain it first appears to be.
What the figures leave out
These are basic-pay figures for a full-time contract, and real consultant income is usually higher and messier. Private practice income varies by specialty and arrangement and is taxed separately, so it is not included here. On-call and additional duties beyond the programmed activities in the contract are paid on top of basic pay under local arrangements, and their value depends on the rota. Part-time consultants are paid pro rata, and the same method applies: pension at 12.5% of actual pensionable pay, tax on what is left, National Insurance on gross. A less-than-full-time consultant may also sit below the taper threshold, which makes each pound of extra work worth more net than it is for a full-time colleague at the same threshold.
The comparison that matters most is not between thresholds but between career stages. A registrar at the top of the resident scale on £77,348 keeps far less than a new consultant on £113,565, even after the higher tax, because the gross rise of £36,217 dwarfs the extra deductions. That is the financial shape of becoming a consultant: a large gross step, a smaller but still substantial net step, and then slow net growth as the taper and the additional rate claim a growing share of each further rise. For the registrar side of that comparison, see junior doctor take-home pay, FY1 and FY2 doctor salary, trust grade doctor salary and SAS doctor salary.
Frequently asked questions
How much does an NHS consultant take home each month?
On 2026/27 basic pay in England, a consultant keeps about £5,659 a month at Threshold 1 (£113,565) and about £6,770 a month at Threshold 4 (£150,569), after income tax, National Insurance and 12.5% pension contributions and before any student loan. A Plan 2 student loan takes a further £631 a month at entry and £909 at the top threshold.
Why does consultant take-home pay rise more slowly than gross pay?
Two tax effects bite as consultants climb the scale. The personal allowance shrinks once adjusted income passes £100,000, falling to zero at £125,140, and income above £125,140 is taxed at 45%. A Threshold 4 consultant keeps about 54% of gross basic pay, against about 60% at Threshold 1, even though gross pay is £37,004 higher.
What is the personal allowance taper for consultants?
The personal allowance is £12,570, but it falls by £1 for every £2 of adjusted income above £100,000 and reaches zero at £125,140. Pension contributions reduce adjusted income, so a Threshold 1 consultant keeps the full £12,570 allowance, because £113,565 less 12.5% pension is £99,369. At Threshold 2a the allowance is £9,961, at Threshold 3 it is £3,225, and at Threshold 4 it is zero.
How much is one extra programmed activity worth after tax?
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 at Threshold 4. Recomputed in full, one extra activity lifts monthly take-home by about £323 at Threshold 1 and about £579 at Threshold 4, after pension, tax, National Insurance and the allowance taper. The entry figure is lower because the extra activity pushes adjusted income into the taper zone.
Do clinical impact awards change take-home pay?
Yes. National Clinical Impact Awards are taxable and subject to National Insurance but are not pensionable, so the whole award is exposed to tax. A Threshold 1 consultant holding a National 1 award of £21,000 a year keeps about £6,334 a month, which is £675 more than the £5,659 basic-only figure. A National 3 award of £42,000 a year lifts the same consultant to about £7,202 a month. A consultant cannot hold a local clinical excellence award and a National Clinical Impact Award at the same time.
How much does a student loan take from consultant pay?
Student loan repayments are 9% of earnings above the plan threshold, or 6% above £21,000 for a postgraduate loan. At Threshold 1 basic pay of £113,565, the monthly deduction is £650 on Plan 1, £631 on Plan 2, £598 on Plan 4, £664 on Plan 5 and £463 on a postgraduate loan. On Plan 2 the deduction rises to £909 a month at Threshold 4. The loan is the only deduction in this guide that is left out of the headline take-home figures.
Do consultants in Scotland and Wales take home the same as in England?
No. Scotland and Wales run separate consultant contracts with different pay points: Scotland runs from £115,331 to £153,247 across eight points over twenty years to the top, and Wales from £114,099 to £166,585. Scotland also has its own income tax bands, so the England take-home figures on this page do not transfer. The England figures here apply to the 2003 contract thresholds in the NHS Employers circular.
Is consultant pay part of Agenda for Change?
No. Consultants in England are employed on national medical and dental terms and conditions, a separate pay framework from Agenda for Change. That is why consultant thresholds, programmed activities and the 12.5% pension rate look nothing like the Agenda for Change bands, and why this page uses medical pay figures throughout rather than band salaries.
Keep exploring medical pay
See consultant salary, junior doctor take-home pay, doctor pay scales, trust grade doctor salary, or pension annual allowance.
Sources and independence
Basic pay thresholds and the 3.5% award are from NHS Employers Pay and Conditions Circular (M&D) 1/2026, revised 30 June 2026. Income tax rates, thresholds and the personal allowance taper, National Insurance rates and student loan thresholds are from GOV.UK: Income Tax rates and Personal Allowances and National Insurance. National Clinical Impact Award values are from the GOV.UK employers guide to the 2026 awards round. Take-home figures are estimates using 2026/27 thresholds with a standard tax code. Actual payslips vary with tax code, student loan plan, extra programmed activities, awards and local arrangements. NHS Bands Pay is an independent information website and is not affiliated with, endorsed by, or acting on behalf of the National Health Service.