NHS Junior Doctor Pay 2026/27: New Contract Bands, Banding Supplements and Take-Home

The 2023 NHS junior doctor contract has reshaped pay bands across England, with significant implications for take-home salary after tax and pension contributions. This guide covers the current pay structure for Foundation Years, Core Training, and Specialty Training posts, plus banding supplements for unsociable hours work.

NHS Junior Doctor Pay Bands 2026/27

Foundation Years (FY1 and FY2)

Foundation Year 1 doctors enter the NHS on the new contract at a basic salary of GBP 32,398 annually. This is substantially higher than the pre-2023 rate and reflects the recognising of junior doctors' expertise and long hours.

Foundation Year 2 increases to approximately GBP 35,640, providing a modest step as trainees gain experience and confidence.

These baseline salaries apply to standard Monday-to-Friday, 9-to-5 working patterns. However, most foundation posts involve weekend and on-call shifts, triggering banding supplements.

Core Training (CT1-CT3)

Core training salaries range from GBP 37,935 to GBP 41,408, depending on the specialty and individual NHS trust negotiations:

• CT1: GBP 37,935
• CT2: GBP 39,670
• CT3: GBP 41,408

These posts are typically less unsociable than foundation years, though many still attract banding supplements for twilight shifts and on-call availability.

Specialty Training (ST1-ST8+)

Specialty training salaries span the widest range, reflecting the diversity of medical specialties and training durations:

• ST1: GBP 50,017
• ST2-ST3: GBP 52,000-GBP 58,000
• ST4-ST5: GBP 60,000-GBP 65,000
• ST6-ST8+: GBP 65,000-GBP 70,425

Consultant-led training in competitive specialties (e.g. cardiac surgery, neurosurgery) may offer retained house officer or senior registrar posts above GBP 70,000.

Resident Doctors (RD)

From August 2024, the NHS rebranded senior house officer roles as "resident doctors" (RD). These are fixed-term posts for international medical graduates (IMGs) or UK graduates between core and specialty training, typically on GBP 42,000-GBP 48,000 bands.

Banding Supplements: The Unsociable Hours Multiplier

Junior doctors' actual take-home salary depends heavily on banding, which reflects the proportion of unsociable hours:

A Foundation Year 1 doctor on Band 2A (typical for many hospital rotations) earns:

GBP 32,398 + (32,398 × 14%) = GBP 36,934 before tax.

Tax and National Insurance Deductions

After banding supplements are applied, junior doctors pay:

1. Income Tax: Personal Allowance GBP 12,570 (2026/27). Tax on earnings above this at 20% basic rate.
2. National Insurance (Employee): 8% on earnings between GBP 12,570 and GBP 50,270; 2% above.
3. NHS Pension: Tiered contribution from 5% to 14.5% of gross salary, depending on pay band.

Take-Home Example: FY1 on Band 2A

Gross salary (banding included): GBP 36,934

• Income tax (on GBP 36,934 - GBP 12,570): GBP 24,364 × 20% = GBP 4,873
• Employee NI: (GBP 36,934 - GBP 12,570) × 8% = GBP 1,949
• NHS Pension (Band 2, 8.5%): GBP 36,934 × 8.5% = GBP 3,139

Net monthly take-home: GBP 2,495

This assumes no student loan repayments. Many junior doctors carry student debt, which adds an additional 9% deduction on earnings above GBP 27,750.

Regional Variations: Scotland, Wales and Northern Ireland

Pay scales vary slightly across the UK's nations:

• England: New 2023 contract (as detailed above)
• Scotland: Scottish Health Service pays on separate bands, broadly aligned but with Scottish-specific supplements
• Wales: NHS Wales uses similar structures with separate terms and conditions
• Northern Ireland: Northern Ireland Executive sets independent pay bands, typically slightly lower than England

Always check your devolved nation's NHS pay circulars for exact figures.

NHS Pension: Long-term Savings

Junior doctors automatically enrol in the NHS Pension Scheme (defined benefit, 1/43.1st final salary equivalent). Contributions are:

The NHS matches contributions generously--for every 1% you pay, the employer adds approximately 2-3% to your pension pot. This represents excellent value and should be factored into total remuneration.

Key point: Do not underestimate your pension contributions as a deferred salary. Over a 40-year career, they often exceed the base salary earned in year one.

Supplementary Pay: Locum and Out-of-Hours Work

Many junior doctors supplement their salary through:

1. Locum shifts: Paid at standard locum rates (typically 1.5× banding supplement).
2. Out-of-hours (OOH) work: Independent out-of-hours cooperatives (e.g. Voiceofyoung Doctors) pay GBP 30-50/hour.
3. Research awards: Trust research training fellowships add GBP 5,000-15,000 annually.
4. Teaching: Medical school teaching sessions, GBP 25-40/hour.

Supplementary income is taxable and counts toward the Annual Allowance (GBP 60,000) for pension purposes.

Calculating Your Exact Take-Home Salary

Use our

to input your:

• Gross salary (including banding)
• Student loan debt (if applicable)
• Spouse/partner allowance (marriage allowance)
• Any additional income

The calculator will show your exact monthly net pay, tax bill, and National Insurance.

Key Takeaways

Comparing NHS Pay to Private Practice

Some junior doctors consider private practice early in their careers. However, private locums typically earn only GBP 40-60/hour vs. salaried NHS rates of GBP 25-30/hour. The hidden value of NHS employment is the pension scheme, which private practitioners must replicate via personal contributions (tax relief capped at 20%, not the effective 40-50% value of the NHS pension).

For most junior doctors, the NHS salaried route offers superior long-term financial security and work-life balance compared to constant locum chasing.

Planning Your First Payslip

Your first month as an FY1 doctor can be financially shock absorbing. Many trusts delay the first payslip by 4-6 weeks while payroll systems process starter forms. Budget your living expenses accordingly, and do not assume you will receive full pay in your first calendar month.

Check with your hospital HR team for the exact pay schedule and confirm your banding level in writing before you start work.

Further Reading

• NHS Official Pay Circulars: Check your devolved nation's NHS pay guidance
• BMA Junior Doctors' Handbook: Career progression and pay scales
• NHS Pensions: Detailed retirement planning tools
• Student Loan Repayment Calculator: If you have Plan 2 debt

Your junior doctor salary is a solid foundation for financial planning. Combine this knowledge with tax-efficient savings strategies (ISAs, pensions) to build long-term wealth while serving the NHS.