NHS doctor salary 2026/27
NHS doctor salaries in England for 2026/27 run from £40,190 at Foundation Year 1 to £150,569 at the top consultant threshold. Resident doctors progress through five nodal points on the 2016 contract pay scale; SAS doctors and consultants have separate salary scales. The 2026 pay award adds 3.5% to basic salary across England, with 3.75% for resident doctors in Scotland.
Resident doctor salary (2016 contract — nodal point system)
Resident doctor basic salary in England is set by the nodal point system introduced in the 2016 contract. The 14 stages of training (FY1 through ST8) map onto five nodal points. Salary moves to the next nodal point on transition to the next stage, not annually. The figures below are the 2026/27 basic salary; on-call availability allowance, weekend allowance, 37% unsocial hours enhancement and flexible pay premia are paid on top.
| Stage | Grade | Nodal point | Basic salary |
|---|---|---|---|
| Foundation | Foundation Year 1 | 1 | £40,190 |
| Foundation | Foundation Year 2 | 2 | £45,994 |
| Core training | Core Training Year 1 | 3 | £54,499 |
| Core training | Core Training Year 2 | 3 | £54,499 |
| Core training | Core Training Year 3 | 4 | £67,325 |
| Core training | Core Training Year 4 | 4 | £67,325 |
| Specialty training | Specialty Registrar ST1 | 3 | £54,499 |
| Specialty training | Specialty Registrar ST2 | 3 | £54,499 |
| Specialty training (higher) | Specialty Registrar ST3 | 4 | £67,325 |
| Specialty training (higher) | Specialty Registrar ST4 | 4 | £67,325 |
| Specialty training (higher) | Specialty Registrar ST5 | 4 | £67,325 |
| Specialty training (higher) | Specialty Registrar ST6 | 5 | £76,582 |
| Specialty training (higher) | Specialty Registrar ST7 | 5 | £76,582 |
| Specialty training (higher) | Specialty Registrar ST8 | 5 | £76,582 |
Effective 2026-04-01. Dentists in training follow the same nodal point structure with grade codes MC51-MC53 (Dental Core Training) and MS11-MS18 (Dental Specialty Training).
SAS doctor salary (specialty and specialist)
Specialty and Associate Specialist (SAS) doctors are non-training senior doctors. The 2021 contract reformed the SAS framework into two grades: Specialty Doctor (the working entry grade) and Specialist (a senior grade for experienced SAS doctors with significant responsibility). The older 2008 Specialty Doctor and Associate Specialist grades are closed to new entrants but current post-holders remain on those scales.
Specialty Doctor (2021 contract)
| Years experience | Basic salary |
|---|---|
| 0–2 | £63,696 |
| 3–5 | £73,383 |
| 6–8 | £81,804 |
| 9–11 (post-threshold) | £90,548 |
| 12+ | £102,689 |
Specialist (2021 contract)
| Years experience | Basic salary |
|---|---|
| 0–2 | £104,401 |
| 3–5 | £108,484 |
| 6+ | £115,341 |
SAS doctors are eligible for on-call and out-of-hours work paid through their employer's local rota arrangements. Some Trusts pay additional supplements for hard-to-fill specialties or particularly demanding rotas; these are local arrangements outside the national contract.
Consultant salary (2003 contract)
Consultant basic salary in England follows the 2003 contract with four pay thresholds. New consultants enter at Threshold 1 and progress through the thresholds at fixed time intervals, reaching the top consultant salary threshold (£150,569) after 14 years of consultant service. Consultant pay rises by between £3,400 and £14,900 at each threshold transition.
| Threshold | Years as consultant | Basic salary |
|---|---|---|
| 1 | 0-2 | £113,565 |
| 2a | 3 | £120,249 |
| 2b | 4-7 | £123,672 |
| 3 | 8-13 | £135,645 |
| 4 | 14+ | £150,569 |
Consultants typically work a 10-Programmed-Activity job plan, where one PA is 4 hours of direct clinical care or supporting work. Additional PAs are paid extra, often at one tenth of basic salary per PA. Many consultants supplement their NHS salary with private practice work outside contracted hours, which can add significantly to total earnings depending on specialty and location.
National Clinical Impact Awards
| Award level | Annual value |
|---|---|
| Level 1 | £21,000 |
| Level 2 | £31,500 |
| Level 3 | £42,000 |
National Clinical Impact Awards (formerly Clinical Excellence Awards) are awarded for sustained contribution above contracted duties. Awards run for a fixed 5-year term and are renewable. Pensionable. About 3,000-4,000 consultants nationally hold a national award at any time.
Salaried GP salary
Salaried GPs employed under the model Salaried GP contract sit in a national salary range. For 2026/27 the GP salary range runs from £78,699 minimum to £118,759 maximum, a 3.5% uplift on the previous year. The starting GP salary within that range is set locally between the GP and the employing practice. Progression up the range is by agreement with the employer; there is no automatic annual increment.
The salaried GP figures are for a notional full-time post (9 sessions a week). Part-time salaried GPs receive a pro-rata share based on sessions worked. GP partners are not on this scale at all: their income is a share of practice profit, which varies enormously with practice size, list, dispensing status and locality. The BMA general practitioners' committee publishes annual guidance on partner profit ranges, typically £80,000-£150,000 for an average practice.
Scotland: resident doctor salary scales
Scotland keeps the legacy incremental pay-point system for resident doctors (Foundation House Officer, Senior House Officer, Specialty Registrar, Specialist Registrar) rather than the nodal-point system used in England since 2016. Consultant and SAS doctor scales for 2026/27 will be published in an addendum to this circular.
Scotland's basic pay scales for resident doctors are below. The full Scottish circular table includes banding supplements (1C 1.2x, 1B 1.4x, 1A and 2B 1.5x, 2A 1.8x, Band 3 2.0x) which multiply basic salary for posts on a banded rota.
| Grade | Minimum | Maximum | Incremental points |
|---|---|---|---|
| Foundation House Officer Year 1 | £37,316 | £41,977 | 3 |
| Foundation House Officer Year 2 | £46,286 | £52,340 | 3 |
| Senior House Officer / Senior Dental House Officer | £46,286 | £64,445 | 7 |
| Specialist Registrar | £51,348 | £77,389 | 10 |
| Specialty Registrar (full-time) | £49,217 | £77,389 | 10 |
| Specialty Registrar (Core Training) | £49,217 | £65,112 | 6 |
Source: NHS Circular PCS(DD)2026/01 — Scottish Government. Scotland's consultant and SAS doctor scales for 2026/27 will be published in an addendum to this circular.
Allowances and supplements
Basic pay is only one part of NHS doctor earnings. The 2016 contract for resident doctors in England includes several additional payments that materially increase take-home pay.
On-call availability allowance
Payable to resident doctors working an on-call rota. Annual values scale with nodal point.
| Nodal point | Annual allowance |
|---|---|
| NP1 | £3,216 |
| NP2 | £3,680 |
| NP3 | £4,360 |
| NP4 | £5,386 |
| NP5 | £6,127 |
Weekend allowance
Payable to doctors rostered to work at the weekend at a minimum frequency of 1 in 8 across the rota cycle. The allowance is expressed as a percentage of full-time basic salary.
| Weekend frequency | % of basic |
|---|---|
| 1 in 2 | 15.0% |
| <1 in 2 – 1 in 3 | 10.0% |
| <1 in 3 – 1 in 4 | 7.5% |
| <1 in 4 – 1 in 5 | 6.0% |
| <1 in 5 – 1 in 6 | 5.0% |
| <1 in 6 – 1 in 7 | 4.0% |
| <1 in 7 – 1 in 8 | 3.0% |
| <1 in 8 | No allowance |
37% unsocial hours enhancement
Hours worked at night (9pm to 7am) and at weekends (Saturday after 7am or before 9pm, and all of Sunday and public holidays) attract a 37% enhancement on the basic hourly rate. The enhancement is paid through the standard rota pay calculation, not as a separate payslip line. It replaced the older banding system from the 2016 contract reform.
Flexible Pay Premia
Annual supplements paid to doctors training in hard-to-fill specialties. General Practice trainees receive £11,508 a year during placements. Emergency Medicine, Psychiatry, Histopathology and Academic posts also receive premia at varying values from £3,500 to £5,600 a year. Dual qualification in Oral and Maxillofacial Surgery attracts a premium dependent on training programme length.
Less Than Full Time (LTFT) allowance
A £1,000 annual allowance paid to resident doctors training on a less than full time basis. Paid in monthly instalments on top of pro-rata basic salary.
Common questions
- What is the NHS doctor salary in 2026/27?
- NHS doctor basic salary in England runs from £40,190 at Foundation Year 1 to £150,569 at the top consultant threshold. Resident doctors progress through five nodal points: FY1 £40,190, FY2 £45,994, ST1-2 £54,499, ST3-5 £67,325 and ST6+ £76,582. SAS specialty doctors start at £63,696 and reach £102,689. SAS specialists earn £104,401-£115,341. Consultants start at £113,565 and progress through four thresholds to £150,569 over 14 years. Salaried GPs sit in a band £78,699-£118,759. These are basic salary figures — actual take-home depends on on-call, weekend rotas, banding supplements, Clinical Impact Awards and additional sessions.
- What is a resident doctor and how is it different from a junior doctor?
- Resident doctor is the new official term replacing 'junior doctor' from late 2024. It covers every doctor in training between graduating from medical school and becoming a consultant or GP, including Foundation Year 1 and 2, core trainees, and specialty registrars. The name change was negotiated between the BMA, NHS Employers and DHSC to recognise that 'junior' was an inaccurate descriptor for doctors who could have 10+ years of post-graduate experience. The pay scales, training programmes and contracts (including the 2016 Terms and Conditions of Service) are unchanged — only the title.
- How does the nodal point system work?
- Since the 2016 contract reform, English resident doctor basic pay is set by which of five nodal points you sit at, rather than by year of service. FY1 = NP1, FY2 = NP2, ST1-2 and CT1-2 = NP3, ST3-5 and CT3-4 = NP4, ST6+ = NP5. Each nodal point has a fixed annual basic pay. You move to the next nodal point when you progress to the next stage of training, not on an annual increment. The system replaced the older incremental scales that increased every year regardless of grade. Scotland kept the older incremental system rather than adopting nodal points.
- What are SAS doctors?
- Specialty and Associate Specialist (SAS) doctors are non-training, non-consultant senior doctors who have completed core training and chosen not to (or not been able to) progress to consultant level. The 2021 contract created two SAS grades: Specialty Doctor (basic £63,696-£102,689) and Specialist (basic £104,401-£115,341). The older 2008 Specialty Doctor and Associate Specialist grades are closed to new entrants but existing post-holders remain. SAS doctors carry significant clinical responsibility, often equivalent to consultants in specific specialties, but without the requirement to lead a service or hold a Certificate of Completion of Training.
- What is a Clinical Impact Award and how much is it worth?
- Clinical Impact Awards (formerly Clinical Excellence Awards, reformed in April 2022) are additional payments made to consultants for sustained contributions to the NHS above and beyond their contracted duties. There are three national levels: Level 1 worth £21,000 a year, Level 2 worth £31,500 and Level 3 worth £42,000. They are not retirement-payable like the old gold and silver CEAs, but they are pensionable. Awards run for a fixed term (currently 5 years) and need to be renewed. Local Clinical Excellence Award values are frozen at their pre-reform amounts and continue for the lifetime of the original award. About 3,000-4,000 consultants nationally hold a national award at any time.
- How is the salaried GP pay range structured?
- Salaried GPs employed on the model Salaried GP contract sit in a pay band that, for 2026/27, runs from £78,699 minimum to £118,759 maximum. The actual starting salary within the range is set locally between the GP and the employing practice, taking into account experience, sessions worked and any responsibilities like training, lead roles or research. Movement up the range is by agreement with the employer, not automatic. Salaried GPs working part-time get a pro-rata share. Partner GPs are not on this scale: they receive a share of practice profit, which varies widely with practice list size and dispensing status. The BMA salaried GP guidance has detailed advice on starting salary negotiation.
- Do doctors get an on-call or out-of-hours supplement?
- Yes. Resident doctors on a rota involving on-call duties receive an annual on-call availability allowance, ranging from £3,216 at nodal point 1 to £6,127 at nodal point 5 in England. Doctors working weekends at a frequency of 1 in 8 or more often get a weekend allowance set as a percentage of full-time basic salary, from 3% (less than 1 in 8) up to 15% (1 in 2). Hours worked at unsocial times (night shifts, 7pm-7am, weekends, bank holidays) attract a 37% enhancement on the basic hourly rate. Consultants do not have an automatic on-call rate; their on-call work is built into their job plan and remunerated through additional Programmed Activities or local arrangements.
- How does doctor pay differ across the four UK nations?
- England, Wales and Northern Ireland use the same 2016 nodal-point system with broadly identical basic figures. Scotland negotiates separately and kept the older incremental pay-point system, with annual progression through 3 to 10 increments depending on grade, plus banding supplements (1.2x, 1.4x, 1.5x, 1.8x or 2.0x basic). Scotland's FHO1 starts at £37,316 vs England's FY1 £40,190, but banded posts can reach significantly higher total pay because the banding supplement is applied to the whole salary. Wales and NI publish their own circulars annually that mirror the English rates with very small variances. For specific Scottish figures, see the section below.
- What is the 37% enhancement and when does it apply?
- Resident doctors in England working at certain unsocial hours receive a 37% enhancement on their basic hourly rate. This applies to hours worked at night (between 9pm and 7am), and to any hour worked on a Saturday after 7am or before 9pm, and to any hour worked on a Sunday or public holiday. The enhancement is on top of basic salary and is paid through the standard rota pay calculation; it does not appear as a separate line item but is reflected in the monthly pay calculation. The enhancement was introduced as part of the 2016 contract reform and replaced the older banding system that had multiplied basic pay by a single percentage for the whole rotation.
- Are doctors on Agenda for Change like nurses?
- No. Doctors and dentists are on a completely separate national pay framework called the 'Medical and Dental Terms and Conditions of Service' (the 2016 contract for resident doctors, 2003 for consultants, 2021 for SAS doctors, and so on). Agenda for Change covers nurses, allied health professionals, healthcare assistants, administrative and managerial NHS staff. The two frameworks have different pay scales, different progression rules, different on-call and unsocial hours payments, and different leave entitlements. Both sit under the same NHS Pension Scheme.
Sources: NHS Employers Pay and Conditions Circular (M&D) 1/2026 and NHS Circular PCS(DD)2026/01 — Scottish Government. Wales and Northern Ireland publish their own circulars; basic pay tracks England closely with minor variations. Doctors and dentists are paid under the Medical and Dental Terms and Conditions of Service, separately from the Agenda for Change framework that covers nurses, midwives, allied health professionals and other NHS staff.