NHS Occupational Therapist Take-Home Pay 2026/27: What OTs Keep Each Month

Last updated: 29 October 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

An occupational therapist salary is quoted gross, but nobody budgets gross. The number that matters at the end of the month is what lands in the bank after pension, tax, National Insurance and, for many recently qualified OTs, a student loan. This page works that number out step by step for every Band 5, Band 6 and Band 7 step in England in 2026/27, so an OT can find their own step, read across, and see the monthly figure that follows from the published pay scales.

Occupational therapy is unusual among NHS professions because a large share of OTs do not work for the NHS at all. Council-employed OTs are paid on local government (NJC) scales with the Local Government Pension Scheme, not Agenda for Change, so the table below does not apply to them. This page covers NHS Agenda for Change OTs only, and the council comparison is flagged wherever it changes the maths. Even inside the NHS, the setting changes the payslip. Acute OTs covering weekend discharges, stroke wards and hand therapy clinics work rotas that earn unsocial-hours enhancements. Community OTs visiting patients at home, schools-based OTs and mental health community teams mostly work weekdays, so basic pay is nearly the whole story and the rota makes little difference. Neither pattern is better paid in any fixed sense: an acute OT on a weekend rota can out-earn a community OT a band higher on basic pay alone. The headline table below starts from basic pay only, then the later sections add those elements one at a time, so OTs in every setting can build their own figure.

Every figure on this page follows the same method. Pension comes off gross pay first, and tax is calculated on what remains. That order matters, because it means pension contributions also reduce the tax bill. National Insurance is calculated on full gross pay, not on pay after pension. Student loan deductions are shown in a separate column, because they apply only to borrowers. The method is the same one used in the nurse take-home pay guide, the midwife take-home pay guide, the paramedic take-home pay guide, the pharmacist take-home pay guide, the physiotherapist take-home pay guide and the radiographer take-home pay guide.

Monthly take-home by band step: the full table

Read the table by band and step. Gross salary is the full-time 2026/27 Agenda for Change figure for England. Pension, income tax and National Insurance are monthly amounts. Take-home is what remains after those three deductions, before any student loan. The final column shows take-home after a Plan 2 student loan, the most common plan for recently qualified OTs.

Two steps deserve a second look. The move from Band 5 top to Band 6 entry is small in gross terms, just £916 a year, because the bands overlap, and take-home rises by only £48.98 a month. The real gain from reaching Band 6 is not the step itself but the higher ceiling: Band 6 top pays £48,117, against £39,043 at Band 5 top. The move from Band 6 top to Band 7 entry is also narrow, £1,270 a year gross, and both steps already pay the 9.8% pension rate, so the monthly pension deduction rises only from £392.96 to £403.33 and take-home rises by only £67.90 a month. OTs budgeting around a move to Band 7 should budget on the take-home column, not the gross column, and should weigh the rota of the new post alongside the basic pay, because a Band 7 post with no weekend cover can pay less in the bank than a Band 6 post with a regular weekend rota.

For the hourly view of the same bands, see the occupational therapist hourly pay guide, which breaks Band 5 to 7 down by the hour, including weekend rates. For the gross salary picture, including role descriptions and progression routes, see occupational therapist salary. The hourly rate calculator converts any of these salaries to an hourly figure for a different contracted hours pattern.

A worked month: the Band 5 entry payslip

Take a newly qualified OT on Band 5 entry, £32,073 a year, full-time, no student loan, standard tax code. Gross monthly pay is £2,672.75. Pension at 8.3% takes £2,662.06 a year, which is £221.84 a month, leaving £29,410.94 of pay after pension for tax purposes. Take off the £12,570 personal allowance and taxable income is £16,840.94 a year, all of it inside the 20% basic-rate band, giving annual tax of £3,368.19, or £280.68 a month. National Insurance is 8% of the £19,503 between £12,570 and the salary, giving £1,560.24 a year, or £130.02 a month, with no 2% slice because pay sits below £50,270. What is left is £24,482.51 a year, which is £2,040.21 a month. With a Plan 2 student loan, a further 9% of the £2,688 above the £29,385 threshold comes off, which is £241.92 a year, or £20.16 a month, leaving £2,020.05.

That worked month doubles as a cross-check on the whole table, because the same method produces every row. An OT who gets a different payslip figure can start by looking for a different tax code, a student loan plan, or unsocial hours, overtime and weekend cover on top of basic pay, rather than doubting the arithmetic. Rounded to the pound, the two anchor figures are £2,040.21 a month at Band 5 entry and £3,308.99 at Band 7 top. The OT salary page itself quotes the same two anchors, £2,040 a month at Band 5 entry and £2,866 at Band 6 top, which matches this table exactly.

Pension: the deduction that also cuts the tax bill

Pension is the largest deduction for most OTs, and it is also the one that does quiet work elsewhere. Because contributions come off before tax is calculated, every pound of pension contribution saves 20p of basic-rate tax at these income levels, and 40p once taxable income passes into the higher rate. The contribution tiers for 2026/27 are provisional, calculated from the published 2025/26 thresholds, and the employer adds 23.7% on top of every member contribution. The full tier set is:

OTs face one pension tier change inside Band 5: entry and intermediate pay 8.3%, but the top step pays 9.8%. A second tier change comes at Band 7 top, where the rate rises to 10.7%, and it stays at 10.7% with London weighting, because even the inner London total of £65,261 sits below the £67,668 boundary for the 12.5% tier. That makes the Band 6 journey unusually clean to budget for: every step in the band pays 9.8%, so each step rise flows through to take-home at the same pension rate, with only tax and National Insurance taking their share.

Full pension tier tables by band are in the pension contributions by band guide, and the wider pension picture is in NHS pension contributions. Opting out of the pension would lift take-home in the short term, but it would also give up the employer 23.7% contribution and the pension itself, so this page treats pension membership as the normal case and does not present an opt-out figure as a recommendation. Council OTs in the LGPS face a different contribution structure entirely, which is one more reason the two sectors cannot be compared on headline pay alone.

Student loans: the fifth deduction

Student loan repayments are not tax and they are not pension, but they come off the same payslip, so they belong in any honest take-home figure. The table below shows Plan 2 only, because it is the plan most recently qualified OTs carry. Plan 2 takes 9% of pay above £29,385 a year in 2026/27. Older plans and postgraduate loans use different thresholds, and an OT on one of those plans should run the threshold for their own plan rather than reading the Plan 2 column as their figure.

At Band 5 entry the loan costs £20.16 a month, a modest slice of a £2,040.21 take-home. By Band 7 top it costs £203.48 a month, because 9% of a much larger amount above the threshold is deducted. The loan does not change the tax or pension figures: it is calculated on gross pay above its own threshold and deducted after tax. An OT whose loan is paid off will see take-home jump by the full deduction, which is why the headline table and the loan column are shown side by side. The full student loan rules for NHS staff are in the student loan repayments guide.

Unsocial hours: what weekend work adds to take-home

Basic pay is only the starting point for OTs on rotas. Under Agenda for Change Section 2, Bands 4 to 9 get 30% on top of plain time for Saturday and weekday night hours, from 8pm to 6am, and 60% on top for Sunday and bank holiday hours. A Band 5 OT at entry earns £16.38 an hour plain time, so a Saturday or night hour is worth an extra £4.91 and a Sunday or bank holiday hour an extra £9.83. A Band 6 OT at entry earns £20.41 an hour, so the same enhancements are worth £6.12 and £12.25 an hour. A Band 7 OT at entry earns £25.23 an hour, so the enhancements are worth £7.57 and £15.14 an hour.

Put those rates against a realistic month and the effect becomes concrete. A Band 6 entrant who works one extra Saturday shift of 7.5 hours and one extra Sunday shift of 7.5 hours in a month, on top of a normal rota, earns an extra £137.78 in gross pay: 7.5 Saturday hours at £6.12 plus 7.5 Sunday hours at £12.25. Annualised, pensionable pay rises to £41,612.30, still inside the 9.8% pension tier, and monthly take-home rises to £2,518.17, a gain of £88.39 after pension (£339.83), tax (£416.07) and National Insurance (£193.62). The gain is roughly two thirds of the gross uplift, because every extra pound is itself pensionable, taxable and subject to National Insurance. OTs choosing between a weekday community post and an acute post with regular weekend cover should compare on this basis: the rota post pays more, but the gap in the bank is smaller than the gap in the rota enhancements suggests. The full unsocial hours rules are in the unsocial hours and overtime guide.

Overtime works on top of the same base, with one split that matters on this ladder. Bands 5, 6 and 7 pay time and a half for overtime, and double time on bank and public holidays, with overtime starting above 37.5 hours a week. A Band 5 OT at entry on £16.38 an hour therefore earns £24.57 an overtime hour and £32.76 on a bank holiday, while a Band 6 OT at entry earns £30.62 and £40.82 and a Band 7 OT at entry earns £37.85 and £50.46. Bands 8 to 9 are different: they get no contractual overtime pay, only time off in lieu, which matters for OTs moving into Band 8a service lead or consultant posts. Overtime and an unsocial hours enhancement cannot both be claimed for the same hour. Part-time OTs should note the threshold rule: hours above contracted hours up to 37.5 are paid at plain time, plus any unsocial enhancement that applies, and overtime rates only start beyond 37.5.

Weekend working and on-call: the OT pattern

OT is less shift-heavy than nursing or physiotherapy, and that shows up directly in take-home. Acute OTs covering weekend discharges, hand therapy or splinting clinics on Saturdays, and stroke ward cover earn Section 2 enhancements as worked through above. Community, schools-based and mental health community OTs working weekdays earn few or none, which is the trade-off for predictable hours. On-call is a smaller story still: a few services run on-call cover, for example urgent splinting after hand surgery, and Agenda for Change pays an availability payment for the on-call period plus call-out payments at overtime rates when you attend, but the availability payments are set locally and vary by trust, so this page quotes no on-call figure rather than inventing one. Community OTs should also separate mileage from pay: travel to home visits is reimbursed as an expense under the rules in the mileage rates guide, not counted as earnings, and it does not build pension. When comparing two OT posts, ask directly whether the rota includes weekend or on-call cover, because that answer changes take-home more than any other single factor.

London weighting: take-home with HCAS

High Cost Area Supplement is pensionable, so it lifts both gross pay and, where it crosses a tier boundary, the pension rate. Inner London pays 20% of basic pay with a minimum of £5,794 and a maximum of £8,746, outer London pays 15% with a minimum of £4,870 and a maximum of £6,137, and the fringe zone pays 5% with a minimum of £1,346 and a maximum of £2,270. The minimums matter at Band 5 entry: 20% of £32,073 is £6,414.60, inside the inner range, while 15% is £4,810.95, below the outer minimum, so the outer supplement is £4,870 instead, and 5% is £1,603.65, inside the fringe range, so no minimum or maximum binds at Band 5 entry in the inner or fringe zones.

At Band 7 top the caps bind in every zone. Inner London 20% of £56,515 would be £11,303, but the £8,746 maximum caps it, giving total pay of £65,261. Outer London is likewise capped at £6,137, giving £62,652, and fringe at £2,270, giving £58,785. None of those totals crosses a pension tier boundary: all three sit inside the 10.7% tier that runs to £67,668, so the pension rate stays at 10.7% and the monthly pension deductions are £581.91, £558.65 and £524.17, against £503.93 with no supplement. Even so, the inner London Band 7 top OT takes home £3,684.92 a month, against £3,308.99 with no supplement. The full London weighting rules are in the London weighting HCAS guide, and the HCAS calculator works out the supplement for any band and zone.

Part-time occupational therapist take-home pay

Part-time OT work is common, in hospital posts, community teams and schools-based services alike, and part-time take-home does not scale in a straight line from full-time take-home, because the pension tier follows actual pay. A senior OT at the top of Band 6 working three days a week (22.5 hours, 0.6 WTE) earns £28,870.20 actual pay, which sits in the 8.3% pension tier, while a Band 6 entrant on 0.8 WTE earns £31,967.20 actual pay, also in the 8.3% tier, and on 0.6 WTE earns £23,975.40 actual pay, which drops to the 6.5% tier. Tax and National Insurance also fall, because both are calculated on actual pay.

Two practical points follow. First, a part-time OT whose actual pay falls below the Plan 2 threshold of £29,385 pays no Plan 2 deduction at all, which is the case at Band 6 entry on 0.6 WTE and at Band 6 top on 0.6 WTE here. Second, hours worked above contracted hours up to 37.5 a week are paid at plain time, not overtime rates, so a part-time OT picking up extra shifts should check whether those hours are plain time or overtime before budgeting on them. The part-time pay guide and the part-time pay calculator cover the pro-rata maths in full.

Scotland, Wales and Northern Ireland

The rates on this page are for England. Scotland agreed a 3.75% award from 1 April 2026 and moved to a 36 hour week, with its own pay scale, for example Band 5 at £34,494 to £42,977, and its own income tax bands. Scotland also has a nine-tier pension structure from 5.7% to 12.7%, but the tier thresholds are not in the verified data file, so this page quotes no Scotland take-home figure rather than estimating one from the England tiers. Wales applied the 3.3% award with Band 5 steps of £32,557, £35,114 and £39,631, so a Welsh OT on the same band and step has different gross pay from an England OT even though income tax and National Insurance rates are the same. Northern Ireland had the 3.3% award recommended but not implemented at the last check, so do not budget on it. For the devolved picture, see the Scotland pay guide, the Wales pay guide and the Northern Ireland pay guide.

What the figures leave out

These are basic-pay figures for full-time contracts unless a section says otherwise, and real OT income is usually higher and messier. Agency and private OT work pays by the session with no benefits, but there is no national rate card and rates vary widely by region, setting and specialism, so this page quotes no agency figure. The Agenda for Change rate is still the right benchmark, because it is the pension-building foundation: every agency hour worked outside substantive employment is an hour that does not build NHS pension in the same way, and the substantive post also carries annual leave, sick pay and the other Agenda for Change terms that sessional work does not. Mileage for community OTs is an expense reimbursement, not pay, and is covered in the mileage rates guide rather than counted in take-home here. Any local recruitment premia are also left out, because they are local payments, not basic pay. A payslip that differs from this page by a small amount usually differs because of a different tax code, a student loan plan, or unsocial hours, overtime and weekend cover on top of basic pay. Monthly components are rounded to the penny, so adding rounded monthly components can differ from the monthly take-home by 1p.

OTs on maternity leave, sick leave or a career break should not read these monthly figures as leave pay: maternity pay, sick pay and the career break guide each follow different rules. Annual leave entitlement itself does not change take-home in a normal month, but the annual leave guide sets out the 27, 29 and 33 day tiers plus bank holidays by length of service.

Frequently asked questions

How much does an NHS occupational therapist take home each month in 2026/27?

In England in 2026/27, a full-time occupational therapist on Band 5 takes home £2,040.21 a month at the entry step (£32,073 a year), £2,177.41 at the intermediate step (£34,592) and £2,380.80 at the top of the band (£39,043), after income tax, National Insurance and NHS pension contributions and before any student loan. A Band 6 occupational therapist takes home £2,429.78 at entry (£39,959), £2,547.99 at the intermediate step (£42,170) and £2,865.96 at the top (£48,117). A Band 7 occupational therapist takes home £2,933.86 at entry (£49,387), £3,078.24 at the intermediate step (£51,932) and £3,308.99 at the top (£56,515). A Plan 2 student loan takes a further £20.16 a month at Band 5 entry and £203.48 at Band 7 top. Weekend working, covered below, lifts those basic-pay figures for OTs on acute rotas, while community and schools-based OTs mostly work weekdays and earn few enhancements.

How is NHS occupational therapist take-home pay calculated?

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 on taxable income up to £37,700 and the 40% higher rate above that. 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 occupational therapist still carries one. All figures on this page use a standard tax code and basic pay only, with unsocial hours, overtime and London weighting covered as additions. Council-employed OTs are outside this table: local authority OTs are paid on local government (NJC) scales with a different pension scheme, so their take-home follows different numbers.

What pension contribution comes off an occupational therapist's pay?

Under the provisional 2026/27 tiers, a Band 5 occupational therapist pays 8.3% of pensionable pay at entry and at the intermediate step, which is £221.84 a month at entry and £239.26 at the intermediate step, but 9.8% at the top of the band, £318.85 a month, because its £39,043 salary crosses the £35,155 tier boundary. Band 6 pays 9.8% at every step, from £326.33 a month at entry to £392.96 at the top. Band 7 entry and intermediate also pay 9.8%, £403.33 and £424.11 a month, but Band 7 top pays 10.7%, £503.93 a month, because its £56,515 salary crosses the £52,778 tier boundary. The employer adds 23.7% on top in each case. The tiers are provisional for 2026/27, calculated from the published 2025/26 thresholds, so treat the monthly pension figures as the best current estimate rather than a final published rate.

How much does a student loan take from occupational therapist pay?

A Plan 2 loan takes 9% of pay above the 2026/27 threshold of £29,385 a year. That is £20.16 a month at Band 5 entry, £72.43 at Band 5 top and £203.48 at Band 7 top. Plan 1, Plan 4, Plan 5 and postgraduate loans use different thresholds, so the Plan 2 column is a guide for the most common case among recently qualified occupational therapists, not a figure for every borrower. The full student loan rules for NHS staff are in the student loan repayments guide.

Do occupational therapists get unsocial hours pay?

Where the rota qualifies, yes. Under Agenda for Change Section 2, Bands 4 to 9 get 30% on top of plain time for Saturday and weekday night hours, from 8pm to 6am, and 60% on top for Sunday and bank holiday hours. A Band 5 occupational therapist at entry earns £16.38 an hour plain time, so a Saturday or night hour is worth an extra £4.91 and a Sunday or bank holiday hour an extra £9.83. A Band 6 occupational therapist at entry earns £20.41 an hour, so the same enhancements are worth £6.12 and £12.25 an hour. A Band 7 occupational therapist at entry earns £25.23 an hour, so the enhancements are worth £7.57 and £15.14 an hour. At Band 5 top (£19.95 an hour) a Sunday shift is worth £31.92 an hour, and at Band 6 top (£24.58) it is £39.33. Acute OTs covering weekend discharges and Saturday hand therapy or splinting clinics earn these; community, schools-based and social-care OTs working weekdays typically earn few or none. The worked example in the unsocial hours section puts those rates against a realistic month.

Do occupational therapists get on-call pay?

Some do, but on-call is not a standard income stream in occupational therapy the way it is in radiography or theatre. A few services run on-call cover, for example urgent splinting after hand surgery, and Agenda for Change pays an availability payment for the on-call period plus call-out payments at overtime rates when you attend, but the availability payments are set locally and vary by trust, so this page quotes no on-call figure. Community OTs should also separate mileage from pay: travel to home visits is reimbursed as an expense under the mileage rules in the mileage rates guide, not counted as earnings, and it does not build pension. When comparing two OT posts, ask directly whether the rota includes weekend or on-call cover, because that answer changes take-home more than any other single factor.

What does an occupational therapist take home in London?

With High Cost Area Supplement, a Band 5 occupational therapist at entry takes home £2,351.10 a month in inner London, £2,268.52 in outer London and £2,127.56 in the fringe zone, against £2,040.21 with no supplement. A Band 7 occupational therapist at the top takes home £3,684.92 a month in inner London, £3,572.78 in outer London and £3,406.56 in the fringe zone. London weighting is pensionable, so it also lifts the pension contribution. At Band 5 entry the outer London minimum binds: 15% of £32,073 is £4,810.95, below the £4,870 minimum, so the supplement is £4,870 and total pay is £36,943. At Band 7 top the caps bind in every zone: inner London is capped at £8,746, outer London at £6,137 and the fringe at £2,270.

What does a part-time occupational therapist take home?

A Band 6 occupational therapist at entry on 0.8 WTE (30 hours) takes home £2,034.45 a month on actual pay of £31,967.20, and £1,627.93 on 0.6 WTE (22.5 hours, £23,975.40). A Band 6 occupational therapist at the top on 0.6 WTE takes home £1,865.76 a month on actual pay of £28,870.20. A Band 7 occupational therapist at the top on 0.8 WTE takes home £2,710.64 a month (£45,212 actual pay) and £2,140.21 on 0.6 WTE (£33,909). The pension tier follows actual pay, not full-time pay, which is why the part-time Band 6 figures sit in different tiers: 0.8 WTE drops to 8.3%, while 0.6 WTE drops to 6.5%. A part-time occupational therapist whose actual pay falls below the Plan 2 threshold of £29,385 pays no Plan 2 deduction at all, which is the case at Band 6 entry on 0.6 WTE and at Band 6 top on 0.6 WTE here.