NHS London weighting (HCAS)
English NHS staff working at Trusts inside the London commuter belt get a High Cost Area Supplement on top of basic pay. Three zones (Inner, Outer, Fringe), each with its own percentage plus a minimum and maximum cash value. London weighting only applies in England.
Zones and rates, 2026/27
| Zone | Percentage | Minimum | Maximum |
|---|---|---|---|
| Inner London. Central London Trusts. | 20% | £5,794 | £8,746 |
| Outer London. Trusts in zones immediately around central London. | 15% | £4,870 | £6,137 |
| Fringe. Trusts in the outer London commuter belt. | 5% | £1,346 | £2,270 |
How HCAS is calculated
The supplement is the higher of two figures: the zone percentage applied to your basic salary, or the zone minimum. The result is then capped at the zone maximum. So if you're a Band 2 healthcare assistant earning £25,272 at an Inner London Trust, the percentage calculation (20% × £25,272 = £5,054) is lower than the Inner minimum (£5,794), so you get the minimum. If you're a Band 7 ward manager on £56,515, the percentage (20% × £56,515 = £11,303) is higher than the maximum (£8,746), so you get the maximum.
The whole supplement is treated as basic salary for pension and tax purposes. It counts towards your pensionable pay in the 2015 scheme and is subject to income tax and Class 1 National Insurance in the normal way. Unsocial hours premia and overtime are calculated on the combined basic + HCAS figure, so the supplement effectively increases all your other earnings too.
When HCAS doesn't apply
HCAS is an English NHS arrangement only. Welsh, Scottish and Northern Irish NHS staff don't receive London weighting regardless of where they live or work. Within England, the supplement is tied to the Trust's location rather than your home address. If you live in central London and commute out to a Buckinghamshire Trust outside the Fringe zone, you don't get HCAS. If you live in Brighton and work at a central London Trust, you do.
Bank and agency workers on Agenda for Change rates working at Trusts inside the zones usually get HCAS folded into their hourly rate. The exact mechanism varies by Trust and agency: some pay the percentage uplift on each hour, others build the annualised supplement into the headline rate. Check your contract or pay agreement to confirm.
Common questions
- Do all NHS staff in London get London weighting?
- Only English NHS staff working at Trusts inside one of the three defined HCAS zones get the supplement. Welsh, Scottish and Northern Irish NHS staff don't receive HCAS regardless of where they work. The zones are defined by Trust location rather than where you live, so a London-resident nurse who commutes to a Buckinghamshire Trust outside the Fringe zone wouldn't get HCAS.
- Which NHS Trusts are in each HCAS zone?
- The full list is published in Annex 8 of the NHS Terms and Conditions of Service handbook. Inner London covers the central London teaching Trusts like Guy's and St Thomas', Imperial, UCLH and King's. Outer London covers the Trusts around the M25 like North Middlesex, Croydon Health, Kingston and Whittington. The Fringe zone covers a wider belt including Epsom and St Helier, Watford, Surrey and Sussex and the Royal Free's outer sites.
- Is HCAS pensionable?
- Yes. The HCAS supplement is treated as basic salary for NHS Pension Scheme purposes, so your pension contribution is calculated on the basic plus HCAS combined. The supplement is also subject to income tax and Class 1 National Insurance in the normal way. The supplement counts towards your final pensionable pay in the 2015 scheme.
- Does HCAS apply to unsocial hours and overtime?
- Unsocial hours premia and overtime are calculated on basic pay plus the HCAS supplement, so the supplement effectively increases your unsocial hours rate. Overtime worked above contracted hours is paid at the basic + HCAS hourly rate plus any applicable unsocial hours uplift. The cap on HCAS (the zone maximum) is applied to the annualised supplement, not to the per-hour calculation.
- Why does HCAS have a minimum and maximum?
- The minimum protects low-paid staff: 5% to 20% of a Band 2 salary would otherwise produce a tiny supplement that doesn't really cover the higher cost of living in London. The maximum caps the supplement for high earners: 20% of a Band 9 salary would be over £20,000, which the framework considers disproportionate. The minimum and maximum keep the supplement broadly meaningful across all bands.
- What's the cash value of HCAS for a typical Band 5 nurse?
- On the {yearLabel} pay scale, a Band 5 newly qualified nurse at entry (£32,073) working at an Inner London Trust would receive 20% as a percentage (£6,414), capped against the zone minimum of £5,794 and maximum of £8,746. The percentage is higher than the minimum and below the maximum, so they receive £6,414 a year on top of their basic salary. That's roughly £535 a month gross, equivalent to about £370 a month take-home after tax, NI and pension.
Source: Pay scales for 2026/27 — HCAS rates.