Your NHS payslip can look confusing — with multiple deductions, pension rates, and regional allowances.
Understanding how take-home pay is calculated helps you know what you actually earn each month after tax and pension.

Step 1: Start with Your Gross Salary
Your gross salary is your band + pay step amount from the NHS pay scale.
Example (2025):
- Band 5 Step 1 → £28,407/year
- Band 6 Step 2 → £37,350/year
This is your base before deductions.
Step 2: Add Allowances
If you work in London or other High-Cost Areas, add your supplement (HCAS):
| Region | % of Base Pay | Range | 
|---|---|---|
| Inner London | 20% | £5,200–£7,400 | 
| Outer London | 15% | £4,300–£5,600 | 
| Fringe Area | 5% | £1,100–£2,000 | 
Step 3: Subtract NHS Pension Contribution
The NHS Pension Scheme deducts between 5.2%–12.5%, depending on income.
Most Band 5–6 staff contribute 7.7–9.8%.
Step 4: Deduct Income Tax and National Insurance
Tax bands for 2025/26:
| Band | Taxable Income | Rate | 
|---|---|---|
| Personal Allowance | £0–£12,570 | 0% | 
| Basic Rate | £12,571–£50,270 | 20% | 
| Higher Rate | £50,271–£125,140 | 40% | 
National Insurance (NI) 2025:
| Monthly Pay | NI Rate | 
|---|---|
| Up to £1,048 | 0% | 
| £1,048–£4,189 | 8% | 
| Over £4,189 | 2% | 
Step 5: Result = Take-Home Pay
Example (Band 5 Step 1 – Non-London)
- Gross Pay: £28,407
- Pension (7.7%): −£2,187
- Tax & NI: −£3,870
- Net Pay: £22,350/year or ~£1,862/month
Why It Matters
Knowing your real pay helps plan your budget, pension, and savings.
Your take-home pay may change if you:
- Work overtime
- Join a salary sacrifice scheme
- Move to a higher band
More Topics
NHS Salary Breakdown (Gross vs Net Pay)
FAQs
Q1: Do all deductions appear on my payslip?
Yes — including tax, NI, pension, and salary sacrifice items.
Q2: Why is my take-home pay lower than expected?
You might be paying higher NI or student loan deductions.
Q3: Does location affect net pay?
Yes — London staff earn more gross but also pay slightly higher deductions.
