Genetic Counsellor Salary 2026/27: Band 7-8a

Last updated: 1 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

Genetic counsellor pay 2026/27: the Band 7 and Band 8a scales

England awarded Agenda for Change staff 3.3% from 1 April 2026, and that award is already in these figures. A genetic counsellor in England in 2026/27 earns £49,387 to £56,515 at Band 7 and £57,528 to £64,750 at Band 8a, for a full-time 37.5-hour week. The step from the top of Band 7 (£56,515) to Band 8a entry (£57,528) is £1,013. That small gap at the point of promotion is normal: the gain comes from the wider spread inside Band 8a, £7,222 from entry to top, and from the seniority of the work. For the wider picture at each band, see the Band 7 salary guide and the Band 8a to 8d salary guide.

The 2026/27 England scales for a full-time 37.5-hour week. Hourly rates are annual pay divided by 52.2 weeks and then by 37.5 hours, rounded to the nearest penny, and enhancement rates on this page are calculated from that rounded hourly rate. Monthly pay is annual pay divided by 12. Weekly pay is annual pay divided by 52.2.

For comparison, the 2025/26 ranges before the 3.3% award were £47,810 to £54,710 at Band 7 and £55,690 to £62,682 at Band 8a. The award lifted every step, and no back pay was due in England because the increase was paid on time in April salaries.

What a genetic counsellor actually does

A genetic counsellor sits with patients and families at the point where a condition may run in the family. The first part of the work is the family history: who was affected, at what age, and how the pattern fits the way a condition is inherited. That history decides which test, if any, is worth offering, and it decides which relatives need to hear about the result once it arrives. A counsellor who rushes the history risks offering the wrong test, and a test that answers the wrong question helps nobody, however technically perfect the laboratory work is.

The second part is consent and choice. Genetic testing is rarely a simple yes or no. A test can return a clear answer, an uncertain result that needs interpretation, or an incidental finding about something nobody was looking for. The counsellor explains those possibilities before the sample is taken, in plain language, and checks that the patient understands what each outcome would mean for them and for their relatives. Testing a child, testing during pregnancy, and predictive testing for an adult-onset condition each raise different questions, and the counselling changes with them.

The third part is the result itself, and the work that follows it. A positive result for a cancer predisposition, a cardiac condition or a rare disorder can change screening, prevention and treatment, and it can change what relatives choose to do. The counsellor writes the letter that relatives can take to their own clinician, arranges cascade testing where relatives want it, and stays available when a result lands differently months later than it did on the day. Clinics cover cancer genetics, cardiac genetics, prenatal and paediatric genetics, and rare disease, and a counsellor often works across more than one of these, alongside clinical geneticists, laboratory scientists and the patient's own treating team. For the neighbouring healthcare science picture, see our clinical scientist salary guide.

Band 7 and Band 8a: what actually changes

At Band 7, a genetic counsellor carries a defined caseload: their own clinics, their own family histories, and responsibility for the counselling decisions in those cases, with supervision available for complex or ethically difficult situations. Band 7 is where most genetic counsellors spend the bulk of their clinical careers, and the work is face to face with patients and families every day.

At Band 8a, the brief widens to leading a service or a specialty within it: the cancer genetics clinic, the cardiac service or the paediatric strand, with the rota, the waiting list, the relationship with laboratory colleagues and the referring clinicians, and supervision of Band 7 counsellors and trainees. A Band 8a counsellor answers for the quality of the service as well as for their own cases, and handles the referrals where the genetics, the family dynamics or the ethics are hardest. For the Band 8a picture in full, see the Band 8a to 8d salary guide.

Unsocial hours, overtime and on-call

Section 2 of Agenda for Change pays time plus 30% for Saturdays and weekday nights (8pm to 6am) and time plus 60% for Sundays and bank holidays, for Bands 4 to 9. Most genetic counselling work falls in weekday clinic hours, so unsocial-hours pay is usually a smaller part of the package than it is for ward staff. The exceptions are Saturday clinics, evening clinics run to clear a waiting list, and urgent prenatal work that cannot wait until Monday, and the hours actually worked in those windows attract the enhancement. A 7.5-hour Saturday clinic at Band 7 entry pays £246.00 at the enhanced rate, against £189.23 at plain time, using the rounded hourly rates in the table.

Overtime follows the band, not the job title. At Band 7, hours above 37.5 a week are paid at time and a half, and double time on bank holidays. An overtime hour at Band 7 entry is worth £37.85 (£25.23 times 1.5), at the intermediate step £39.80, and at the top of Band 7 £43.31. At Band 8a there is no contractual overtime pay: time off in lieu only. Enhancement and overtime cannot both be claimed for the same hours, and staff may elect time off in lieu instead of overtime pay. On-call is different from both: the payment for being available, as opposed to hours actually worked when called in, is set locally by each trust, so this page quotes no on-call rate. Genetic counselling services rarely run a formal on-call rota, but where one exists, ask at interview how it works, how often call-ins happen, and how the availability payment is structured in that trust. For the full rules, see our unsocial hours and overtime guide.

London weighting: the HCAS cap binds at every step

Genetic counsellors in London trusts receive the High Cost Area Supplement on top of basic pay: 20% of basic 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). At Bands 7 and 8a the percentage figure exceeds the maximum in every zone at every step, so the supplement is the cap figure in each zone: £8,746 inner, £6,137 outer and £2,270 fringe. A genetic counsellor at the top of Band 8a in inner London earns £64,750 + £8,746 = £73,496 a year, and at Band 7 entry in inner London £49,387 + £8,746 = £58,133. For the full zone rules, see our London weighting guide.

Pension: what comes off the payslip

Genetic counsellors are in the NHS Pension Scheme, and the member contribution is the largest regular deduction after tax. On the provisional 2026/27 England and Wales tiers: Band 7 entry sits in the 9.8% tier at £4,839.93 a year or £403.33 a month on £49,387; Band 7 intermediate sits in the 9.8% tier at £5,089.34 a year or £424.11 a month on £51,932; Band 7 top sits in the 10.7% tier at £6,047.11 a year or £503.93 a month on £56,515; Band 8a entry sits in the 10.7% tier at £6,155.50 a year or £512.96 a month on £57,528; Band 8a intermediate sits in the 10.7% tier at £6,464.62 a year or £538.72 a month on £60,417; Band 8a top sits in the 10.7% tier at £6,928.25 a year or £577.35 a month on £64,750. The employer contributes 23.7% on top, which is £11,704.72 a year at Band 7 entry and £15,345.75 a year at the top of Band 8a. The 2026/27 tiers are provisional, calculated from the published 2025/26 tiers, so treat the tier boundaries as subject to confirmation. For the full tier table, see our pension contributions guide.

Part-time work, leave, mileage and uniform relief

Part-time genetic counselling work is pro rata of the full-time equivalent salary. A 0.8 WTE counsellor at Band 7 entry earns 80% of £49,387, which is £39,509.60 a year, and a 0.6 WTE counsellor at the top of Band 8a earns 60% of £64,750, which is £38,850.00 a year, before any enhancements. Part-time staff accrue annual leave pro rata, and hours above contracted hours up to 37.5 are paid at plain time plus any unsocial enhancement that applies; only above 37.5 does the overtime rule bite. For the leave rules in full, see our annual leave guide and our part-time pay guide.

Annual leave in England follows the Agenda for Change tiers: 27 days plus 8 bank holidays for up to 4 years of service, 29 plus 8 from 5 years, and 33 plus 8 from 10 years. Some genetic counselling work involves travel between sites, for example to outreach clinics in other hospitals, and that travel is claimable under Agenda for Change Section 17. The 2026/27 car rates are 59p a mile for the first 4,500 business miles in the mileage year and 36p a mile above that, with 30p for motorcycles, 20p for pedal cycles and 5p for passengers. A counsellor who drives 6,000 business miles in a year claims 4,500 miles at 59p (£2,655) plus 1,500 miles at 36p (£540), a total of £3,195. Travel between home and the normal place of work is not claimable. For the full rates, see our mileage rates guide. Genetic counsellors do not usually wear a uniform, so HMRC flat-rate expenses rarely apply; where a uniform is required and the employer provides no laundry service or allowance, the default for a uniformed job not separately listed is £60 a year, worth £12 a year at the basic tax rate and £24 at the higher rate, backdatable up to 4 tax years on form P87.

Scotland, Wales and Northern Ireland

Scotland has its own Agenda for Change scale and a 36-hour week from April 2026, after a 3.75% award from 1 April 2026. The Scotland Band 5 range is £34,494 to £42,977, which works out at £18.36 to £22.87 an hour on the 36-hour week. Scotland Band 7 and Band 8a steps are not quoted here because the full Scotland scales for those bands are not in the verified data file, and this page does not guess at them. Wales awarded 3.3% from 1 April 2026, and the Wales Band 5 steps are £32,557, £35,114 and £39,631, slightly above the England steps at entry and intermediate. Northern Ireland is different: the 3.3% award was recommended but had not been implemented at the time of writing, so Northern Ireland genetic counsellors should not budget on the new rates until implementation is confirmed. For the nation guides, see NHS Scotland pay, NHS Wales pay and NHS Northern Ireland pay.

The honest picture: senior pay for work that is mostly listening

Genetic counsellor pay in 2026/27 is strong, nationally set and transparent: anyone can look up the band, find the step and know the basic salary to the penny, and the ladder runs to Band 8a and beyond £64,000 at the top. What it does not do is pay a premium for the specialism itself. There is no genetics supplement in the national Agenda for Change scale, and a genetic counsellor at Band 7 earns the same basic as a senior nurse at Band 7. The unsocial-hours additions are also smaller here than in ward or on-call specialties for most of the working week, because clinics run in daytime hours. The value of the role sits elsewhere: in the conversation that stops a family being tested for the wrong thing, in the letter that lets a relative get screened in time, and in the result explained well enough that a patient can act on it. When comparing genetic counsellor posts, confirm the band and step, ask which specialty the post covers and how large the caseload is, ask about supervision and about any evening or Saturday clinics, ask about the HCAS zone, and check whether the post carries a service lead brief. Those answers tell you more about the real pay and the real job of a post than the job title alone ever will.

Frequently asked questions

What band is a genetic counsellor in the NHS?

In England in 2026/27, genetic counsellor posts sit mainly at Band 7 and Band 8a on Agenda for Change. Band 7 pays £49,387 at entry, £51,932 at the intermediate step and £56,515 at the top. Band 8a pays £57,528 at entry, £60,417 at the intermediate step and £64,750 at the top, for a full-time 37.5-hour week. Genetic counsellors work in genomic medicine services alongside clinical geneticists and laboratory scientists, and the exact band is set by the job evaluation for each post, so check the advert rather than assuming the band from the title.

What does a genetic counsellor do?

A genetic counsellor helps patients and families understand inherited conditions, the choices around genetic testing, and what a result means for relatives as well as for the person tested. The work starts with a detailed family history, which decides which test, if any, is worth offering. It continues through consent, where the counsellor explains that a test can return a clear answer, an uncertain result, or an incidental finding about something nobody was looking for. After the result, the counsellor explains what it changes for screening, prevention and treatment, writes the letter that relatives can take to their own clinician, and arranges cascade testing where relatives want it. Clinics cover cancer genetics, cardiac genetics, prenatal and paediatric genetics, and rare disease.

How much does a genetic counsellor earn a month?

In England in 2026/27, a full-time genetic counsellor at Band 7 earns £4,115.58 a month at entry, £4,327.67 at the intermediate step and £4,709.58 at the top, before tax, National Insurance and pension deductions. At Band 8a the monthly figures are £4,794.00 at entry, £5,034.75 at the intermediate step and £5,395.83 at the top. Those are gross figures for a full-time 37.5-hour week, before any unsocial-hours enhancement or London weighting.

Do genetic counsellors get unsocial hours pay?

Genetic counsellors are on Agenda for Change, so Section 2 enhancements apply to hours actually worked in the unsocial windows: time plus 30% for Saturdays and weekday nights (8pm to 6am) and time plus 60% for Sundays and bank holidays, for Bands 4 to 9. Most counselling work falls in weekday clinic hours, so unsocial-hours pay is usually a smaller part of the package than it is for ward staff. The exceptions are Saturday clinics, evening clinics run to clear a waiting list, and urgent prenatal work that cannot wait until Monday. Overtime above 37.5 hours a week is paid at time and a half at Band 7 and double time on bank holidays, while Band 8a receives time off in lieu only, and staff may elect time off in lieu instead of overtime pay.

Do genetic counsellors get on-call pay?

Genetic counselling services rarely run a formal on-call rota, and on-call payments are set locally rather than in the national Agenda for Change scale, so this page quotes no on-call rate. What can be said nationally is that hours actually worked when called in attract the Section 2 enhancement for the window they fall in: time plus 30% for Saturdays and weekday nights and time plus 60% for Sundays and bank holidays at Bands 7 and 8a. If a post includes on-call, ask at interview how the rota works, how often call-ins happen, and how the availability payment is structured in that trust, because the local arrangement is what determines the real value of the rota.

Do genetic counsellors get London weighting?

Yes, where the post is based in a London trust. Genetic counsellors receive the High Cost Area Supplement: 20% of basic 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). At Bands 7 and 8a the percentage figure exceeds the maximum in every zone at every step, so the supplement is the cap figure in each zone: £8,746 inner, £6,137 outer and £2,270 fringe. A genetic counsellor at the top of Band 8a in inner London earns £64,750 + £8,746 = £73,496 a year, and at Band 7 entry in inner London £49,387 + £8,746 = £58,133.

How much pension does a genetic counsellor pay?

On the provisional 2026/27 England and Wales tiers, Band 7 entry sits in the 9.8% tier at £403.33 a month on £49,387, Band 7 intermediate sits in the 9.8% tier at £424.11 a month on £51,932, and Band 7 top sits in the 10.7% tier at £503.93 a month on £56,515. Band 8a entry sits in the 10.7% tier at £512.96 a month on £57,528, Band 8a intermediate sits in the 10.7% tier at £538.72 a month on £60,417, and Band 8a top sits in the 10.7% tier at £577.35 a month on £64,750. The employer contributes 23.7% on top. The 2026/27 tiers are provisional, calculated from the published 2025/26 tiers, not yet published as final.

How do you become a genetic counsellor?

The usual route is a degree in a relevant science or health subject, followed by postgraduate training in genomic counselling and supervised practice in a genomic medicine service. Adverts set the essential criteria per post, so read them post by post rather than assuming one route fits every vacancy. From Band 7, progression runs to Band 8a service lead posts within genomic medicine, covering a specialty such as cancer genetics, cardiac genetics or paediatric genetics, with senior clinical scientist and consultant-level leadership as the longer-term direction for those who move toward service-wide roles.