NHS London weighting calculator
The High Cost Area Supplement (HCAS) adds 5% to 20% to basic pay for English NHS staff working at Trusts in defined zones around London. This calculator shows the cash value of the supplement for every band, on the 2026/27 pay scale.
HCAS by band and zone, 2026/27
The figures below show the cash supplement on top of basic salary for each band's entry step, in each of the three HCAS zones. The supplement is the higher of the zone percentage or the zone minimum, capped at the zone maximum. The same rules apply at the top step of each band, with the cap kicking in for higher bands sooner.
| Band | Basic salary (entry) | Inner London | Outer London | Fringe |
|---|---|---|---|---|
| Band 2 | £25,272 | +£5,794 | +£4,870 | +£1,346 |
| Band 5 | £32,073 | +£6,415 | +£4,870 | +£1,604 |
| Band 6 | £39,959 | +£7,992 | +£5,994 | +£1,998 |
| Band 7 | £49,387 | +£8,746 | +£6,137 | +£2,270 |
| Band 8a | £57,528 | +£8,746 | +£6,137 | +£2,270 |
Zone rates: Inner London 20% (minimum £5794, max £8746). Outer London 15% (min £4870, max £6137). Fringe 5% (min £1346, max £2270).
Worked example: Band 5 nurse in central London
A newly qualified Band 5 nurse at a central London Trust earns £32,073 basic on the 2026/27 scale. Inner London is 20%, so the percentage calculation is £32,073 x 20% = £6,415. The Inner zone minimum is £5794 and the maximum is £8746. The supplement is the higher of (£6,415 or £5794), capped at £8746. So the nurse receives £6,415 a year, paid in 12 equal monthly instalments alongside basic salary.
The total gross salary becomes £32,073 + £6,415 = £38,488. After income tax, NI and the NHS pension contribution (now in the 9.8% tier because the higher figure pushes them up), take-home is around £2,500 a month, compared to roughly £2,175 for the same band outside the HCAS zones. That's an extra £325 a month for the London-cost-of-living premium.
When the cap kicks in
At higher bands, the percentage calculation exceeds the zone maximum, so the supplement is capped. For Inner London at 20%, the cap kicks in for any basic salary above £43730. Band 6 entry (£39,959) is below that threshold, so the percentage rules. Band 7 top (£56,515) is well above, so a Band 7 in Inner London receives the £8746 maximum regardless of pay point.
Outer London (15%) caps at salaries above roughly £40913. Fringe (5%) caps at salaries above roughly £45400. The cap effectively means the HCAS supplement as a percentage of pay shrinks as you move up the bands, which is why senior NHS staff often question whether HCAS keeps up with London's real cost of living.
Common questions
- Which NHS Trusts are in which London weighting zone?
- Annex 8 of the NHS Terms and Conditions handbook lists every Trust by zone. Inner London covers central London teaching Trusts (Guy's and St Thomas', Imperial, UCLH, King's, the Royal Free's main sites). Outer London covers the Trusts around the M25 (North Middlesex, Croydon Health, Kingston, Whittington, Hillingdon). The Fringe zone covers a wider belt including Epsom and St Helier, Watford General, Surrey and Sussex, and parts of Hertfordshire, Essex and Kent.
- Does HCAS apply if I live in London but work outside?
- No. London weighting is tied to the Trust where you work, not where you live. If you commute from central London out to a Trust outside the Fringe zone, you don't receive HCAS. If you live in Brighton and work at a Trust in the Outer zone, you do receive Outer HCAS. The rule is the Trust's location.
- Is the London weighting supplement taxed?
- Yes. HCAS is treated as part of your basic salary for income tax, National Insurance and NHS pension purposes. The full supplement is subject to income tax at your marginal rate and Class 1 NI at 8% or 2% depending on the income band. Your NHS pension contribution is calculated on basic plus HCAS combined.
- Why do high earners hit the cap?
- The supplement is the higher of two numbers (the zone percentage or the zone minimum), capped at the zone maximum. For Inner London at 20%, the supplement caps out at £8,746 for 2026/27. Any band with a salary above £43,730 (20% of which is £8,746) would otherwise exceed the cap, so the cap kicks in for Band 6 entry and above. The cap stops the supplement becoming disproportionate to actual cost-of-living differences at senior bands.
- Do other UK nations have an equivalent of London weighting?
- No. HCAS is an English NHS arrangement only. Scotland, Wales and Northern Ireland don't have a national high-cost-area supplement. Some local recruitment and retention premia exist at individual Trusts in those nations, but these are local arrangements rather than a national framework.