NHS Paramedic Take-Home Pay 2026/27: What Paramedics 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

A paramedic 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 paramedics, a student loan. This page works that number out step by step for every Band 5 and Band 6 step in England in 2026/27, so a paramedic can find their own step, read across, and see the monthly figure that follows from the published pay scales.

Paramedics sit on Agenda for Change bands 5 to 7 for most clinical posts: Band 5 for newly qualified paramedics, Band 6 for paramedics in autonomous practice, Band 7 for specialist paramedics in urgent care, critical care or primary care. The gross salaries are the same numbers as for nurses and midwives on the same band and step, because Agenda for Change sets pay by band, not by profession. What differs for paramedics is the pattern of work around the basic pay: nights, weekends and bank holidays are built into ambulance rotas in a way that makes unsocial hours a larger share of total pay than in almost any other NHS role. The headline table below starts from basic pay only, then the later sections add those elements one at a time.

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 and the midwife take-home pay guide, and the Band 5 entry row cross-checks against the site take-home calculator: the homepage calculator, run for a Band 5 entrant on the same inputs, gives the same £2,040.21 a month net, to the penny.

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 paramedics.

The step that catches most paramedics by surprise is the move from Band 5 intermediate to Band 5 top. Gross pay rises by £4,451, but the pension rate also rises, from 8.3% to 9.8%, because Band 5 top crosses the provisional tier boundary at £35,155. Take-home still rises, from £2,177.41 to £2,380.80 a month, but by less than the gross rise suggests. The move from Band 5 top to Band 6 entry is smaller still 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.

For the hourly view of the same bands, see the paramedic hourly pay guide, which breaks Band 5 to 7 down by the hour, including night, weekend and overtime rates. For the gross salary picture, including role descriptions and progression routes, see paramedic 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 paramedic 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. A paramedic who gets a different payslip figure can start by looking for a different tax code, a student loan plan, or unsocial hours and overtime on top of basic pay, rather than doubting the arithmetic. The paramedic salary guide quotes the same two anchor figures in rounded form, £2,040 a month at Band 5 entry and £2,866 at Band 6 top, which match the table here to the pound.

Pension: the deduction that also cuts the tax bill

Pension is the largest deduction for most paramedics, 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. 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:

The tier boundary between Band 5 intermediate (£34,592) and Band 5 top (£39,043) is the one that bites first. Crossing it lifts the pension rate from 8.3% to 9.8%, so the monthly pension deduction jumps from £239.26 to £318.85. Neither jump makes a promotion pay less overall, but both narrow the monthly gain, and paramedics budgeting around a move to Band 6 should budget on the take-home column.

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.

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 paramedics carry. Plan 2 takes 9% of pay above £29,385 a year in 2026/27. Older plans and postgraduate loans use different thresholds, and a paramedic 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 small slice of a £2,040.21 take-home. By Band 6 top it costs £140.49 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. A paramedic 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 and night work adds to take-home

Basic pay is only the starting point for paramedics 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 paramedic 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, worked from the rounded hourly rate as on the site's other hourly guides. A Band 6 paramedic at entry earns £20.41 an hour, so the same enhancements are worth £6.12 and £12.25 an hour.

Put those rates against a realistic month and the effect becomes concrete. A Band 6 entrant who works two extra 12 hour night shifts and one extra 12 hour Sunday shift in a month, on top of a normal rota, earns an extra £293.88 in gross pay: 24 night hours at £6.12 plus 12 Sunday hours at £12.25. Annualised, pensionable pay rises to £43,485.56, still inside the 9.8% pension tier, and monthly take-home rises to £2,618.33, a gain of £188.55 after pension (£355.13), tax (£444.23) and National Insurance (£206.10). The gain is roughly two thirds of the gross uplift, because every extra pound is itself pensionable, taxable and subject to National Insurance. Paramedics choosing between a weekday clinic post and a frontline rota post 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. Bands 1 to 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 entrant on £16.38 an hour therefore earns £24.57 an overtime hour and £32.76 on a bank holiday, while a Band 6 paramedic at entry earns £30.62 and £40.82 and at the top of the band £36.87 and £49.16. Overtime and an unsocial hours enhancement cannot both be claimed for the same hour. Part-time paramedics 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. Ambulance staff should also check their own contract: some ambulance roles have locally agreed arrangements that sit alongside Section 2, and the contract rate prevails where it differs from the standard table. Rest-day working to cover sickness or vacancies is typically paid at overtime rates, and many trusts offer additional incentive payments during periods of extreme pressure. These are local and time-limited, so they should be treated as a bonus rather than budgeted income.

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 payment is lifted to £4,870.

At Band 6 top the caps bind. Inner London 20% of £48,117 would be £9,623.40, but the £8,746 maximum caps it, giving total pay of £56,863. Outer London is likewise capped at £6,137, giving £54,254, and fringe at £2,270, giving £50,387. Even capped, the inner London Band 6 top paramedic takes home £3,323.95 a month, against £2,865.96 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 paramedic take-home pay

Part-time paramedic work is less common than in ward nursing, but it exists, 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 paramedic on 0.8 WTE at Band 5 entry earns £25,658.40 actual pay, which sits in the 6.5% pension tier, not the 8.3% tier of the full-time figure. A paramedic on 0.6 WTE at Band 6 top earns £28,870.20 actual pay, which sits just above the 6.5% tier ceiling of £28,854, so it pays 8.3%, not 6.5%. Tax and National Insurance also fall, because both are calculated on actual pay.

Two practical points follow. First, a part-time paramedic 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 5 entry on both 0.8 and 0.6 WTE here, and at Band 6 top on 0.6 WTE. Second, hours worked above contracted hours up to 37.5 a week are paid at plain time, not overtime rates, so a part-time paramedic 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 paramedic on the same band and step has different gross pay from an England paramedic 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 paramedic income is usually higher and messier. Bank and agency shifts pay above the Agenda for Change rate in most areas, but there is no national rate card and rates vary widely by region, urgency and specialty, so this page quotes no bank or agency figure. The Agenda for Change rate is still the right benchmark, because it is the pension-building foundation: every bank or 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 and rapid-response paramedics is an expense reimbursement, not pay, and is covered in the mileage rates guide rather than counted in take-home here. Uniform tax relief of £185 a year for ambulance staff (worth £37 at the basic rate and £74 at the higher rate) and any local recruitment premia are also left out, because they are expenses or 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 and overtime 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.

Paramedics 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 paramedic take home each month in 2026/27?

In England in 2026/27, a full-time paramedic 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 paramedic 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 Plan 2 student loan takes a further £20.16 a month at Band 5 entry and £140.49 at Band 6 top.

How is NHS paramedic 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 paramedic 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.

What pension contribution comes off a paramedic's pay?

Under the provisional 2026/27 tiers, a Band 5 paramedic at entry or the intermediate step pays 8.3% of pensionable pay, which is £221.84 a month at entry and £239.26 at the intermediate step. Band 5 top and every Band 6 step pay 9.8%, from £318.85 a month at Band 5 top to £392.96 at Band 6 top. 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 paramedic 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, £140.49 at Band 6 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 paramedics, not a figure for every borrower. The full student loan rules for NHS staff are in the student loan repayments guide.

Do night and weekend shifts change paramedic take-home pay much?

Yes, and for paramedics the effect is among the largest in the NHS, because ambulance rotas are unsocial by design. 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 paramedic at entry earns £16.38 an hour plain time, so a Saturday or night hour is worth an extra £6.12 and a Sunday or bank holiday hour an extra £9.83. A Band 6 paramedic at entry earns £20.41 an hour, so the same enhancements are worth £6.12 and £12.25 an hour. The worked example in the unsocial hours section puts those rates against a realistic month.

What does a paramedic take home in London?

With High Cost Area Supplement, a Band 5 paramedic 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 6 paramedic at the top takes home £3,323.95 a month in inner London, £3,181.45 in outer London and £2,987.91 in the fringe zone. London weighting is pensionable, so it also lifts the pension contribution, and at Band 6 top the inner London total is capped by the £8,746 maximum.

What does a part-time paramedic take home?

A Band 5 paramedic at entry on 0.8 WTE (30 hours) takes home £1,721.62 a month on actual pay of £25,658.40, and £1,364.54 on 0.6 WTE (22.5 hours, £19,243.80). A Band 6 paramedic at the top on 0.8 WTE takes home £2,351.42 a month (£38,493.60 actual pay) and £1,865.76 on 0.6 WTE (£28,870.20). The pension tier follows actual pay, not full-time pay, which is why the part-time Band 5 figures sit in the 6.5% tier. Note the part-time Band 6 top figure on 0.6 WTE: actual pay of £28,870.20 sits just above the 6.5% tier ceiling of £28,854, so it pays 8.3%, not 6.5%.

Why does my payslip differ from the figures on this page?

The usual reasons are a different tax code, a student loan plan, unsocial hours or overtime on top of basic pay, London weighting, or a part-time fraction. Salary sacrifice for a car or pension, a previous employment in the same tax year, and arrears or back pay in a single month can also move one month away from the steady monthly figure. If the gap is small and steady, check the tax code first. If it is large, check whether unsocial hours or London weighting are included in the gross figure being compared, because this page starts from basic pay only.