NHS Doctor Pay Scales 2026/27: From Foundation Year to Consultant
Last updated: 24 October 2026 · Figures verified against the NHS Employers 2026/27 medical and dental pay circulars.
The 2026/27 doctor pay award
The Doctors' and Dentists' Review Body recommended 3.5% for 2026/27, and the government accepted it in full. The award was announced on 25 March 2026, took effect from 1 April 2026 in England, and lifted every medical and dental pay point on the national scales. It is a separate award from the 3.3% uplift that Agenda for Change staff received under the NHS Pay Review Body, because doctors and dentists are not on AfC at all.
That structural point is the one most people get wrong. Nurses, midwives, allied health professionals, healthcare assistants and the corporate workforce are paid under Agenda for Change, bands 2 to 9. Doctors and dentists have their own pay body (the DDRB), their own contracts and their own NHS Employers pay and conditions circulars. A newly qualified nurse and a newly qualified doctor do not share a pay system, a working week or a pay structure.
The other change to know about for 2026/27 is the nodal-point reform agreed in June 2026. The old nodal points 3, 4 and 5 were each split into sub-points (3a/3b, 4a/4b/4c, 5a/5b/5c), which is why the resident doctor scale below has ten rows instead of five. The June-2026 deal also ended the resident doctor strikes, offered all locally employed doctors 2016-contract terms, introduced enhanced appraisal for locally employed doctors from October 2026, and made exam and royal college membership fees reimbursable from April 2026. Clinical-academic flexible pay premia rise from £5,600 to £10,000 from April 2027.
Resident doctor pay scales 2026/27
Resident doctors (the new name for junior doctors) in England are paid on the 2016 contract, which uses nodal points instead of pay bands. Each training grade maps to a nodal point with a fixed basic salary, and doctors move up the points as they progress through training. The basic contract is a 40-hour week, which is why doctor hourly figures are calculated differently from AfC: hourly pay is basic salary divided by 40 hours divided by 52.143 weeks.
An FY1 doctor on £41,226 therefore earns £19.77 an hour at plain time (£41,226 / 40 / 52.143), or about £3,435.50 a month before tax. Hours worked on top of the basic contract are paid at plain time during waking hours, with a 37% premium for hours between 9pm and 7am or on Sundays. Those premiums are where the rota makes a real difference: an FY1 covering regular nights and Sundays can take home noticeably more than one on a standard day-heavy rota at the same nodal point.
| Nodal point | Typical stage | 2026/27 basic | 2025/26 basic |
|---|---|---|---|
| Nodal point 1 | Foundation Year 1 | £41,226 | £38,831 |
| Nodal point 2 | Foundation Year 2 | £47,610 | £44,439 |
| Nodal point 3a | CT1 / ST1 | £55,355 | £52,656 |
| Nodal point 3b | CT2 / ST2 | £55,355 | £52,656 |
| Nodal point 4a | CT3 / ST3 | £67,325 | £65,048 |
| Nodal point 4b | CT4 / ST4 | £67,998 | £65,048 |
| Nodal point 4c | ST5 | £67,998 | £65,048 |
| Nodal point 5a | ST6 | £76,582 | £73,992 |
| Nodal point 5b | ST7 | £77,348 | £73,992 |
| Nodal point 5c | ST8 | £77,348 | £73,992 |
The jump between nodal points is where the pay story lives. Moving from FY1 (£41,226) to FY2 (£47,610) adds £6,384 a year, and the step from nodal point 3 to nodal point 4 (£55,355 to £67,325) is worth £11,970. By contrast, the sub-point splits introduced in 2026 are small: NP3a and NP3b pay identically, as do NP5b and NP5c, because the split was about contract structure rather than a pay rise. Our foundation doctor pay guide works through the FY1 and FY2 figures in detail, and junior doctor take-home pay shows what each nodal point means after tax, National Insurance and pension.
GP registrars sit on this same scale rather than having a separate one. GPST1 and GPST2 doctors are paid at £55,355 (nodal point 3), and GPST3 at £67,325 (nodal point 4a), before any out-of-hours supplement. The salaried and partner GP world beyond training is covered separately in salaried vs partner GP pay.
Trust-grade and locally employed doctors
Not every hospital doctor is in a training post. Trust-grade doctors (locally employed doctors, LEDs) are employed directly by a trust outside the national training programme, and their pay has historically been set locally. The June-2026 deal changed the picture: all locally employed doctors were offered 2016-contract terms, with nodal points mirrored from the resident scale.
The mirrored grade codes run MT01 (nodal point 1, £41,226) through MT10 (nodal point 5c, £77,348): MT02 is nodal point 2 (£47,610), MT03 is nodal point 3a and MT06 is nodal point 3b (both £55,355), MT04 is nodal point 4a (£67,325), MT07 is nodal point 4b and MT08 is nodal point 4c (both £67,998), MT05 is nodal point 5a (£76,582), and MT09 is nodal point 5b (both £77,348 for MT09 and MT10). The important caveat is that employers may mirror these points: pay for trust-grade posts is locally determined, so the mirrored figures are a reference point, not a guarantee. Always check the pay stated in the job advert. For the career-grade alternative, see SAS doctor pay.
Consultant pay 2026/27
Consultants in England are paid on the 2003 contract, which uses time-served thresholds rather than performance-related steps. There are five thresholds, and progression between them is essentially automatic with years of consultant service. The 3.5% DDRB award took the scale from £113,565 at entry to £150,569 at threshold 4.
| Threshold | Years as consultant | 2026/27 basic |
|---|---|---|
| Threshold 1 | Entry | £113,565 |
| Threshold 2a | After 3 years | £120,249 |
| Threshold 2b | After 4 years | £123,672 |
| Threshold 3 | After 8 years | £135,645 |
| Threshold 4 | After 14 years | £150,569 |
In monthly terms, that is roughly £9,463.75 at threshold 1, £10,020.75 at threshold 2a, £10,306 at threshold 2b, £11,303.75 at threshold 3 and £12,547.42 at threshold 4, before tax. A full-time consultant contract is 10 programmed activities (PAs) a week, each worth about four hours. Consultants who work extra PAs are paid for them, with each extra PA worth roughly a tenth of basic salary: around £11,356.50 a year at threshold 1, rising to about £15,056.90 at threshold 4.
The devolved nations run their own consultant scales. Scotland pays £115,331 to £153,247 across 8 points, with 20 years to reach the top; Wales pays £114,099 to £166,585. In England, the 2003 contract also carries a London weighting of £2,162 a year. The full picture, including how thresholds interact with pensions, is in our consultant salary guide.
Dentist pay scales 2026/27
Employed NHS dentists have their own scales under the DDRB, separate from both AfC and the doctor nodal points. Foundation dentists, the dental equivalent of FY1 doctors, are on £43,896 for a 35-hour week in 2026/27, pensionable and paid through a lead-employer trust, plus a £13,392 training grant. That is up from £42,408 in 2025/26.
Salaried primary-care dentists received a 3.75% uplift from 1 April 2026 and sit in three bands. Band A (LD01) runs from £54,502 to £84,781 across 7 points, with point 7 acting as the entry point to Band B and an extended competency point at the top of the band. Band B (LD11) runs from £84,781 to £99,163 across points 7 to 12, with point 13 as the entry to Band C and an extended competency point at the top of Band B. Band C (LD21) runs from £101,434 to £116,573 across points 13 to 18; managerial posts cap at different points by complexity (standard posts at point 16, medium at 17, high at 18, with current assistant clinical directors at points 13 to 15).
Dentists in training use the 2016 contract nodal scale alongside doctors. Dental core training pays £55,355 at CT1 and CT2 and £67,325 at CT3; dental specialty training starts at £67,325 (ST1), then £67,998 (ST2 and ST3), £76,582 (ST4) and £77,348 (ST5 to ST8), because dental specialty training begins at nodal point 4a. One fact that surprises people outside dentistry: most high-street NHS dentists are self-employed contractors paid through the UDA system, not salaried staff at all. The scales above cover employed NHS dentists only. For the full detail, see our NHS dentist salary guide.
Doctors vs Agenda for Change: the key differences
It helps to see the two systems side by side, because they differ on almost every dimension that matters to a payslip.
| Feature | Agenda for Change | Medical and dental |
|---|---|---|
| Pay body | NHS Pay Review Body | Doctors' and Dentists' Review Body |
| 2026/27 award | 3.3% | 3.5% |
| Full-time week | 37.5 hours | 40 hours (resident doctors); 10 PAs (consultants) |
| Pay structure | Bands 2 to 9, entry/intermediate/top steps | Nodal points / time-served thresholds |
| Entry point (England) | £25,272 (Band 2) | £41,226 (FY1) |
| Top of scale (England) | £129,783 (Band 9) | £150,569 (consultant threshold 4) |
The longer full-time week for resident doctors is easy to miss and it matters: a 40-hour basic week means the headline salary buys more hours than an AfC salary of the same size. That is why the FY1 hourly figure (£19.77) looks modest next to a Band 5 hourly rate, even though the annual salary is higher. Agenda for Change explained covers how the band system works for everyone else.
Take-home pay and pensions
Once doctors climb past roughly £67,669 of pensionable income, they land in the top NHS pension contribution tier of 12.5%, which is where consultants sit: the consultant member pension rate is 12.5%. Resident doctors in the lower nodal points pay the lower tiers, and the tiered structure is the same one that applies across the NHS. NHS pension contribution tiers shows the full set of thresholds.
Tax is the other big bite. A consultant at threshold 4 (£150,569) is well into higher-rate tax territory. The monthly gross figures above are the starting point for any take-home calculation; junior doctor take-home pay walks through the deductions at each nodal point, and our pension guide explains how the contribution tiers interact with net pay.
Compare every doctor pay scale
This page brings the national scales together, but each group has its own detailed guide with worked examples, rota pay and progression:
- Foundation doctor pay (FY1 and FY2): the nodal points 1 and 2 figures in detail.
- Junior doctor take-home pay: what each nodal point means after tax, NI and pension.
- SAS doctor pay: the career-grade alternative to training.
- Salaried vs partner GP pay: where the GP registrar scale leads after training.
- Consultant salary: thresholds, PAs and the devolved-nation scales in full.
- NHS dentist salary: employed dentist pay, foundation to salaried primary care.
Frequently asked questions
Are NHS doctors on Agenda for Change?
No. Doctors and dentists sit outside Agenda for Change. They have their own pay body (the Doctors' and Dentists' Review Body, DDRB), their own contracts and their own NHS Employers pay and conditions circulars. The AfC bands 2 to 9 cover nurses, midwives, allied health professionals, healthcare assistants and the rest of the non-medical NHS workforce.
What was the 2026/27 pay award for doctors?
The DDRB recommended 3.5% for 2026/27, and the government accepted it in full. It was announced on 25 March 2026 and took effect from 1 April 2026 in England, lifting every medical and dental pay point. AfC staff received a separate 3.3% award under the NHS Pay Review Body.
What is a nodal point?
Nodal points are the pay steps of the 2016 junior doctor contract, now used for all resident doctors in England. Each training grade maps to a nodal point with a fixed basic salary, and doctors move up the points as they progress through training. The June-2026 reform split the old nodal points 3, 4 and 5 into sub-points (3a/3b, 4a/4b/4c, 5a/5b/5c), so the 2026/27 scale has ten points from £41,226 to £77,348.
What is the FY1 salary for 2026/27?
Foundation Year 1 doctors (nodal point 1) are on £41,226 basic for a 40-hour week in 2026/27, about £3,435.50 a month before tax. That works out at £19.77 an hour (basic divided by 40 hours divided by 52.143). Extra hours are paid at plain time in waking hours, with a 37% premium for hours between 9pm and 7am or on Sundays.
How do consultant pay thresholds work?
Consultants on the 2003 contract move through five time-served thresholds: threshold 1 on appointment (£113,565), 2a after 3 years (£120,249), 2b after 4 years (£123,672), 3 after 8 years (£135,645) and 4 after 14 years (£150,569). Full-time is 10 programmed activities, and each extra programmed activity pays roughly a tenth of basic salary on top.
What is a programmed activity (PA)?
A programmed activity is the unit of consultant working time, roughly four hours. A full-time consultant contract is 10 PAs a week. Consultants who work extra PAs are paid for them, with each extra PA worth about a tenth of their basic salary: around £11,356.50 a year for a threshold 1 consultant, rising to about £15,056.90 at threshold 4.
Are trust-grade doctors on national pay scales?
Trust-grade (locally employed) doctors have their own pay determination, but the June-2026 deal offered them 2016-contract terms with nodal points mirrored from the resident scale (MT01 to MT10, from £41,226 to £77,348). Employers may mirror the national points, but pay is locally set, so the mirrored figures are a reference rather than a guarantee.
Do NHS dentists use the same pay scales as doctors?
Employed NHS dentists have their own scales rather than sharing the doctor scales. Foundation dentists are on £43,896 for a 35-hour week plus a £13,392 training grant, salaried primary-care dentists sit in three bands from £54,502 to £116,573, and dentists in training use the 2016 contract nodal points. Most high-street NHS dentists are self-employed contractors paid through the UDA system, not salaried staff.