Emergency tax on your first NHS payslip

Last updated: 6 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Your first NHS payslip is always a shock, and for a lot of new starters the shock is the tax line. The gross looks right, the pension looks about right, and then a chunk of Income Tax has gone that nobody warned you about. In most cases the tax code is the reason, not a payroll error. New starters who arrive without a P45 are put on an emergency code, and an emergency code taxes each month on its own, without the personal allowance you have already built up across the tax year. The result is overpaid tax in the first month, sometimes several hundred pounds, followed by a refund once HMRC issues the correct code. This page works out the numbers: what the code means, why it overcharges you, exactly how much it costs at each band, and when the money comes back. If you want the full decoder for every code on an NHS payslip, it is on the NHS tax codes guide. If the payslip itself looks wrong in other ways, the payslip guide walks through every line.

What emergency tax is

Emergency tax is not a special tax rate. It is what happens when payroll has to tax you before HMRC has told it your proper code. When you start a job, payroll needs two things: your tax code and your earnings history for the tax year so far. A P45 from your last employer carries both. If you do not provide one, you complete a starter checklist instead, the form that replaced the P46, declaring whether this is your only job, you have another job, or you are receiving a pension. Statement A with no P45 gets you the 1257L W1/M1 emergency code; statement B typically lands you on BR. First jobs, returns from working abroad and anyone whose previous employer never issued a P45 all end up here.

The code itself tells the story. 1257L is the standard code for 2026/27: 1257 is the personal allowance of £12,570 divided by ten, and L means you get the standard personal allowance. The W1/M1 suffix is the part that matters: W1 means week 1, M1 means month 1, and together they mean the code is operating on a non-cumulative basis. Each pay period is taxed as if it were the first period of the tax year, with no regard for what you earned before. Your correct code is usually plain 1257L with no suffix, which runs cumulatively, so payroll looks at everything you have earned so far in the tax year and the allowance you have used so far.

There is a harsher variant. The genuine 0T emergency code gives no personal allowance at all, so a full month's pay is taxed from the first pound: 20% up to the basic-rate limit, then 40% above it. Payroll uses 0T when HMRC has no details for you at all, for example if you have no National Insurance number on record yet. If you see 0T on your payslip, get your P45 or starter details to payroll as fast as you can, because every month on 0T is a month of overpaid tax waiting to be reclaimed. The worked example below shows what 0T costs a Band 6 nurse.

Why the emergency code overcharges you

The overpayment comes from one number: the personal allowance. For 2026/27 the allowance is £12,570 a year, which is £1,047.50 a month. Under a normal cumulative code, the allowance you can use grows through the year: in October, the seventh month of the tax year, you have £7,332.50 of allowance available, seven months at £1,047.50. Under a W1/M1 emergency code, you get one month's allowance only, £1,047.50, whatever month you start in. The gap between those two figures is the allowance the emergency code fails to give you, and 20% of that gap is the tax you overpay, before pension relief is taken into account.

Two things follow. First, the later in the tax year you start, the bigger the overpayment, because the allowance you have accrued keeps growing while the emergency code keeps giving you the same £1,047.50. A nurse starting in October has £6,285 of allowance sitting unused; a nurse starting in April has none, because in the first month of the tax year the accrued allowance and the emergency allowance are the same figure. Second, pension relief softens the bill. Your NHS pension contribution comes off before tax is calculated, so the taxable pay the emergency code works on is your gross pay minus your pension contribution minus the £1,047.50 allowance. A Band 5 nurse at entry pays 8.3% pension, £221.84 a month, so the taxable pay under the emergency code is £2,672.75 minus £221.84 minus £1,047.50, which is £1,403.41, and the tax on that at 20% is £280.68.

The monthly thresholds payroll uses under a W1/M1 code are the annual thresholds divided by twelve. The personal allowance is £1,047.50 a month. The basic-rate band, the slice of taxable pay charged at 20%, is £3,141.67 a month, which is £37,700 a year divided by twelve. Above that, taxable pay is charged at 40% until total income reaches £125,140 a year, where the personal allowance has tapered away entirely and the 45% rate applies. In the worked examples below, the Band 7 top and Band 8b examples reach the 40% band in a single month.

How much tax you overpay in the first month

The table below is for a full-time member of staff starting in October, the seventh month of the tax year, on the 1257L W1/M1 emergency code. The tax under the correct code is nothing in every row, because these examples assume no earlier pay in the tax year: with seven months of allowance accrued, £7,332.50, a single month of pay sits entirely inside the allowance once the pension contribution is taken off. If you did earn earlier in the tax year, the correct-code figure is worked out on the year's pay to date, and the overpayment is smaller. Part-time staff should scale the monthly gross to their contracted hours: a 0.6 contract at Band 5 entry is 60% of £2,672.75, which is £1,603.65 a month, and the part-time pay guide explains how pro rata pay is worked out.

Source: NHS Employers 2026/27 pay award; Health Careers NHS, Agenda for Change pay rates; GOV.UK, Income Tax rates and Personal Allowances.

Read the overpaid column and the pattern is clear. At the bottom of the scale the overpayment is modest: a Band 2 healthcare assistant overpays £184.32, and a Band 3 receptionist at entry overpays £191.93. In the middle, where most staff sit, a Band 5 nurse overpays £280.68 at entry and £377.45 at the top, a Band 6 nurse overpays £391.22 at entry and £513.86 at the top. At the top of the table, a Band 7 nurse at the top overpays £634.93, because £16.48 of that month's taxable pay falls in the 40% band on top of the 20% slice. The pension column matters here: the higher your contribution rate, the lower the taxable pay the emergency code works on, which is why the overpayment grows more slowly than the salary does.

Worked example: Band 5 nurse starting in October

Take a newly qualified nurse in England, full-time, Band 5 entry step: £32,073 for 2026/27, which is £2,672.75 a month. No enhancements this month, no London weighting, Plan 2 student loan. The first payslip on the 1257L W1/M1 emergency code runs like this. Pension first: Band 5 entry sits in the 8.3% tier, so the contribution is £221.84 a month. Tax next: taxable pay is £2,672.75 minus £221.84 minus the £1,047.50 monthly allowance, which is £1,403.41, and 20% of that is £280.68. National Insurance is 8% of pay above the £1,047.50 monthly threshold, which is 8% of £1,625.25, or £130.02. Student loan is 9% of pay above the Plan 2 threshold of £29,385 a year, £2,448.75 a month, which is 9% of £224.00, or £20.16. Take-home is £2,672.75 minus £221.84 minus £280.68 minus £130.02 minus £20.16, which is £2,020.05.

On the correct cumulative code, the same payslip looks different in exactly one place. The pension is still £221.84, National Insurance is still £130.02, and the student loan is still £20.16, because none of those depend on the tax code. The tax is nothing, because the cumulative allowance available in October is £7,332.50 and the month's pensionable pay is only £2,450.91, so no tax is due yet. Take-home is £2,300.73, which is £280.68 more than the emergency-code payslip. That £280.68 is the whole of the emergency tax overpayment for the month, and it is the figure that comes back once the code is corrected.

A Band 2 healthcare assistant starting in the same month shows the same shape at a smaller scale. Monthly gross is £2,106.00, pension at 6.5% is £136.89, taxable pay under the emergency code is £921.61, and the tax is £184.32. National Insurance is £84.68. There is no student loan, because £2,106.00 a month is below the Plan 2 monthly threshold of £2,448.75. Take-home on the emergency code is £1,700.11, against £1,884.43 on the correct code, a difference of £184.32.

Worked example: the 0T code

Now take a Band 6 nurse at entry, £39,959 a year, £3,329.92 a month, starting in January, the tenth month of the tax year, on the 0T code. Pension at 9.8% is £326.33 a month. Under 0T there is no personal allowance at all, so taxable pay is £3,329.92 minus £326.33, which is £3,003.59, and 20% of that is £600.72. National Insurance is 8% of £2,282.42, which is £182.59. Take-home is £3,329.92 minus £326.33 minus £600.72 minus £182.59, which is £2,220.28.

On the correct cumulative code, the tax is nothing. By January the accrued allowance is ten months at £1,047.50, which is £10,475.00, and the month's pensionable pay of £3,003.59 sits comfortably inside it. Take-home is £2,821.00, which is £600.72 more than the 0T payslip. The gap is larger than the 1257L W1/M1 example at the same band, £391.22 for a Band 6 entry starting in October, because 0T withholds the whole allowance instead of one month of it. That is why 0T is worth fixing first, before anything else on the payslip.

When emergency tax bites hardest

Three things make the overpayment bigger: a higher band, a later start in the tax year, and the 0T code. The band effect is straightforward, because a bigger salary means more taxable pay after the single month of allowance. The start-month effect is the one people miss. In April the overpayment is nothing, because the emergency allowance and the accrued allowance are the same £1,047.50. By October the accrued allowance is £7,332.50 and the gap is £6,285. By February it is £11,522.50 and the gap is £10,475.00. A nurse who starts in February on the emergency code overpays more in the first month than a nurse who starts in October on the same band, and the refund that follows is bigger too.

The 40% band is the third way the bill grows. Take a Band 8b manager at the top, £77,368 a year, £6,447.33 a month, starting in October. Pension at 12.5% is £805.92. Taxable pay under the emergency code is £6,447.33 minus £805.92 minus £1,047.50, which is £4,593.91. The first £3,141.67 of that is taxed at 20%, which is £628.33, and the remaining £1,452.24 is taxed at 40%, which is £580.90, giving £1,209.23 of tax in the first month. On the correct code the tax is nothing, because £5,641.41 of pensionable pay sits inside the £7,332.50 of accrued allowance. The overpayment is £1,209.23, more than four times the Band 5 figure, and it is the 40% slice that does most of the damage.

Back pay is the other situation where an emergency code hurts. A lump sum of arrears is taxed in the month it is paid, so a large arrears payment can push that month's taxable pay over the 40% threshold. Under a normal cumulative code, PAYE rebalances over the remaining months and refunds the extra automatically. On a non-cumulative W1/M1 code, the extra tax is not automatically rebalanced, which is another reason to get off an emergency code promptly. The back pay guide explains how arrears appear on a payslip, and the tax codes guide covers the 40% threshold in detail.

What emergency tax does not touch

Only Income Tax is affected, and it helps to know what is safe, because a first payslip has several lines that look wrong until you understand them. National Insurance is calculated on each pay period on its own and is never cumulative, so an emergency code cannot change it. A Band 5 nurse at entry pays £130.02 a month whether the code is 1257L W1/M1 or plain 1257L. Your NHS pension contribution is a percentage of your pay, 6.5% at Band 2, 8.3% at Band 5 entry, 9.8% at Band 6 entry and 12.5% above £67,669, and it comes off at the same rate whatever your tax code is. The employer pays 23.7% on top, and the pension contributions guide carries the current tiers with worked examples.

Student loan repayments are also unaffected, because they are worked out from your pay, not your tax code: 9% of pay above the plan threshold. For Plan 2 the threshold is £29,385 a year, £2,448.75 a month, so a Band 5 nurse at entry pays £20.16 a month, and a Band 2 healthcare assistant pays nothing, because £2,106.00 a month is below the threshold. Plan 1, Plan 4 and Plan 5 have different thresholds, £26,900, £33,795 and £25,000 a year, and the Postgraduate Loan is 6% above £21,000 a year. The student loan repayments guide covers every plan. If your student loan line looks wrong, the plan is the first thing to check, not the tax code.

Getting the money back

In almost all cases you do not need to do anything to get the overpaid tax back. Once HMRC issues your correct cumulative code, usually within a few weeks of starting, payroll applies it and PAYE recalculates your tax for the whole tax year to date. The overpayment comes back through your wages, usually as a month with little or no tax deducted, and the payslip will show the corrected code with no W1/M1 suffix. Check the next two or three payslips for that change: the code line is the proof the fix has landed, and the tax line is the proof the money has come back.

If the tax year ends before the code is fixed, HMRC reconciles it with a P800 calculation in the summer, which compares what you paid against what you owed and refunds the difference or asks for any shortfall. Keep your P45, your starter checklist details and every payslip until it is resolved, because those are the records HMRC asks for if the figures do not agree. If the code is still wrong after a couple of months, ask payroll to check the code HMRC holds for you, and make sure your starter checklist answers were recorded correctly: a statement B recorded as statement A, or the other way round, is the commonest reason a code stays wrong. If the payslip still looks wrong after that, the pay disputes guide explains how to raise it and what evidence to keep.

Emergency tax and second jobs

A second job does not get an emergency code. HMRC splits your personal allowance across your employments instead: your main job usually keeps 1257L and the second job gets a BR code, which taxes everything at 20% with no allowance, or a D0 code, which taxes everything at 40%. That is normal, not an error, but do check the split is right, because if the allowance lands on the wrong job you can overpay or underpay across the year. Bank work, agency shifts and a second NHS post all count as second employments for this purpose, and the second-job guide explains the declarations, the working-time limits and the tax. If you have two NHS jobs, the pension contributions by band guide shows the tier that applies to each salary.

One more thing to check on a second job is the starter checklist. If you ticked statement B, that you have another job, payroll should put the second job on BR, not on an emergency code. If the second job shows 1257L W1/M1 instead, payroll has the wrong statement on file, and the fix is a corrected starter checklist, not a new tax code request. The tax codes guide decodes BR, D0 and the emergency codes side by side, and the newly qualified nurse guide shows what a first payslip should look like once the code is right.

Frequently asked questions

What is emergency tax on an NHS payslip?

Emergency tax is the temporary Income Tax code payroll uses when HMRC has no record of your earnings for the tax year, usually because you started without a P45. The code is normally 1257L on a week 1/month 1 (W1/M1) basis, or 0T if your details are missing entirely. W1/M1 means each month is taxed in isolation, without looking at what you earned earlier in the tax year, so you overpay in the first month. It is not a fine and it is not permanent: once HMRC issues your correct cumulative code, PAYE refunds the overpayment automatically through your pay.

How do I know if I am on emergency tax?

Look at the tax code line on your payslip. An emergency code shows as 1257L W1/M1, or as 0T. The W1/M1 part is the giveaway: it means the code is operating on a non-cumulative basis. Your correct code is usually plain 1257L with no W1/M1 suffix. If the code line shows BR or D0 instead, that is not emergency tax: those codes are used for a second job, where all pay is taxed at 20% or 40% with no personal allowance.

How much emergency tax will I pay?

It depends on your band and the month you start, because the overpayment is the tax on the personal allowance you have accrued but the emergency code does not give you. Starting in October, a Band 2 healthcare assistant overpays £184.32 in the first month, a Band 5 nurse at entry overpays £280.68, a Band 6 nurse at entry overpays £391.22, and a Band 7 nurse at the top overpays £634.93. Starting in April, the overpayment is nothing, because the emergency code and the correct code give the same allowance in the first month of the tax year. The full table by band is on this page.

Will I get emergency tax back?

Yes, in almost all cases without doing anything. Once your correct cumulative tax code replaces the emergency W1/M1 code, usually within a few weeks of starting, PAYE recalculates your tax for the whole tax year to date and refunds any overpayment through your wages. If a balance remains after 5 April, HMRC reconciles it with a P800 calculation in the summer. Keep your P45, starter checklist details and payslips until it is resolved. If the code is still wrong after a couple of months, ask payroll to check the code HMRC holds for you.

Does emergency tax affect my pension or National Insurance?

No. Only Income Tax is affected. Your NHS pension contribution is a percentage of your pay, 8.3% at Band 5 entry and 6.5% at Band 2 in 2026/27, and it comes off at the same rate whatever your tax code is. National Insurance is calculated on each pay period on its own and is never cumulative, so an emergency code cannot change it: a Band 5 nurse at entry pays £130.02 a month. Student loan repayments are also unaffected, because they are 9% of pay above the plan threshold, not a tax code calculation. A Band 5 nurse at entry on Plan 2 pays £20.16 a month either way.

What if I start in April?

Then emergency tax costs you nothing extra. In the first month of the tax year, the allowance the emergency code gives you, £1,047.50 for the month, is exactly the allowance you have accrued, so the W1/M1 calculation and the cumulative calculation give the same tax. A Band 5 nurse at entry pays £280.68 of tax in that first month either way. The code still needs correcting for the months ahead, so check that the W1/M1 suffix disappears from a later payslip, but the first payslip itself is right.

What is the 0T tax code?

0T is the harsher emergency code: it gives no personal allowance at all, so every pound of pay is taxed, 20% up to the basic-rate limit and 40% above it. Payroll uses it when HMRC has no details for you at all, for example if you have no National Insurance number on record yet. A Band 6 nurse at entry on 0T, starting in January, pays £600.72 of tax in the first month against a correct-code figure of nothing, and takes home £2,220.28 instead of £2,821.00. If you see 0T, get your P45 or starter details to payroll as fast as you can, because every month on 0T is a month of overpaid tax waiting to be reclaimed.

I have two NHS jobs: is the second one on emergency tax?

No. A second job does not get an emergency code. HMRC splits your personal allowance across your employments: your main job usually keeps 1257L and the second job gets a BR code, which taxes everything at 20% with no allowance, or a D0 code, which taxes everything at 40%. That is normal, not an error, but do check the split is right, because if the allowance lands on the wrong job you can overpay or underpay across the year. The second-job guide explains the rules and the working-time limits.

Sources and independence

Source: NHS Employers 2026/27 pay award.

Source: Health Careers NHS, Agenda for Change pay rates.

Source: GOV.UK, Income Tax rates and Personal Allowances.

NHS Bands Pay is an independent information website. It is not affiliated with, endorsed by, or acting on behalf of the National Health Service, NHS Employers, HMRC or the Pay Review Body. The tax bands and thresholds on this page are the 2026/27 England, Wales and Northern Ireland figures. Scotland sets its own Income Tax rates, so the exact overpayment differs there, but the emergency-code mechanism is the same.