Psychiatry is a consultant-led NHS specialty with a well-defined training pathway and, in most subspecialties, strong job security given a persistent national shortage of consultants. Pay progresses from around £32,000 in core training through specialty registrar grades to a consultant base above £99,500, with additional programmed activities, on-call supplements, clinical excellence awards and (for many consultants) private practice pushing total gross well beyond £150,000. This guide sets out realistic UK pay by training stage and consultant seniority, shows estimated take-home after Income Tax and National Insurance for 2026/27, and explains the pension, student loan and London weighting factors that affect psychiatrists specifically. All figures are estimates -- use the linked calculators for your own numbers.
Psychiatrist Salary Scale UK 2026/27
Indicative UK ranges following NHS medical and dental pay scales. Banding supplements for on-call and out-of-hours work apply to trainees and are excluded here unless noted. Private practice income is additional to NHS pay for consultants who undertake it.
Level
Grade
Typical salary
Notes
Foundation / Core Psychiatry Training (CT1-CT2)
Core trainee
£32,000-£44,000
Foundation year equivalent through CT2; banding supplements apply for on-call and shift work
Specialty Registrar (ST4-ST6)
StR mid-senior
£50,000-£62,000
Higher training; subspecialty choice (general adult, CAMHS, forensic, old age, liaison) made at this stage
Newly appointed consultant
Consultant (entry)
~£99,532-£110,000
Consultant pay scale entry point; HCAS supplement additional in London and South East
Mid-career consultant
Consultant (mid)
£105,000-£130,000
Base plus typical APAs; on-call and Section 12 approved doctor supplements additional
NHS consultant salary plus private consultations, medico-legal reports and expert witness fees
Estimates only. Verify current NHS medical pay scales at nhsemployers.org and Royal College of Psychiatrists guidance. Figures exclude pension contributions, on-call supplements, clinical excellence awards and private practice income.
Psychiatrist Take-Home Pay Breakdown 2026/27
2026/27 England rates. Personal Allowance £12,570 (tapered above £100,000). No pension deductions or student loan applied. The £125,000 and £155,000 rows sit inside or above the Personal Allowance taper.
Scenario
Gross/yr
Income tax
NI
Net/yr
Net/mo
Keep %
CT1-CT2 core trainee
£38,000
£5,086
£2,034
£30,880
£2,573/mo
81%
ST4-ST6 registrar
£58,000
£10,632
£3,171
£44,197
£3,683/mo
76%
Newly appointed consultant
£105,000
£30,432
£4,111
£70,457
£5,871/mo
67%
Mid-career consultant
£125,000
£42,432
£4,511
£78,057
£6,505/mo
62%
Senior consultant / Clinical Director
£155,000
£55,953
£5,111
£93,936
£7,828/mo
61%
Newly appointed and mid-career consultant pay sits inside the £100,000-£125,140 Personal Allowance taper, producing a 60-62% effective marginal rate. For your exact position use the take-home pay calculator.
Pension Contributions for Psychiatrists
Most NHS psychiatrists are members of the NHS Pension Scheme (2015 CARE scheme). Consultants who move into wholly private practice need to make their own pension arrangements.
--NHS Pension Scheme (2015 CARE): pension accrues at 1/54 of pensionable pay each year. Employee contributions are tiered by salary, ranging from approximately 5.1% at lower salaries to 12.5% for earnings above £75,633. The employer contributes approximately 23.7%.
--Auto-enrolment (private practice / locum via umbrella): the statutory minimum is 3% employer + 5% employee (total 8%) on qualifying earnings between £6,240 and £50,270. Locums working through agencies often remain outside the NHS Pension Scheme unless the assignment is via an NHS-affiliated staff bank.
--Annual allowance taper: high-earning consultants (threshold income above £200,000 or adjusted income above £260,000) face a tapered annual allowance reducing permitted pension contributions to as little as £10,000 (the Money Purchase Annual Allowance). NHS pension growth is tested against the defined-benefit annual allowance rules, which can catch consultants with significant private practice income on top of NHS pensionable pay.
--Salary sacrifice / additional pension contributions: where available, sacrificing salary in the basic-rate band saves 20% tax + 8% NI = 28p per £1. In the higher-rate band the saving is 40% tax + 2% NI = 42p per £1, and within the £100,000-£125,140 taper zone the effective saving rises to around 62p per £1.
60% trap alert: Newly appointed and mid-career consultant psychiatrists earning £100,000-£125,140 face a 60-62% effective marginal rate due to the Personal Allowance taper. Additional pension contributions in this band attract substantial tax relief. NHS members should check annual allowance headroom -- particularly if private practice income is added on top -- before making large additional voluntary contributions.
Student Loan Repayments for Psychiatrists
Medical degrees typically take five or six years, meaning most psychiatrists carry substantial student debt from undergraduate and Foundation training. Repayments are income-contingent and deducted through PAYE:
Plan
Who
Threshold
Rate
At £58k
At £105k
At £155k
Plan 2
England/Wales (pre-Aug 2023)
£27,295
9%
-£230/mo
-£583/mo
-£958/mo
Plan 5
England (post-Aug 2023)
£25,000
9%
-£248/mo
-£600/mo
-£975/mo
Postgraduate Loans (for those who borrowed for a master's, common among psychiatrists who studied neuroscience or psychology before medicine) are repaid separately at 6% above £21,000. Use our student loan calculator to model projected repayments under your specific plan.
Regional Pay and London Weighting
NHS psychiatrist pay is nationally negotiated, but High Cost Area Supplements (HCAS) recognise the higher cost of living in London and surrounding areas:
Zone
HCAS rate
Cap
At £105k base
Approx total gross
Inner London
20%
£8,176
+£8,176
£113,176
Outer London
15%
£5,373
+£5,373
£110,373
London fringe
5%
£2,011
+£2,011
£107,011
Rest of England
N/A
N/A
--
£105,000
HCAS caps mean the supplement is proportionally less significant at consultant salaries above £100,000. Private practice fees in London are generally higher than elsewhere, which can make the capital significantly more lucrative for senior psychiatrists than the headline NHS salary difference suggests. Scotland, Wales and Northern Ireland operate their own pay structures and do not apply HCAS.
2026/27 Income Tax and NI Rates -- Key Thresholds
Income range
IT rate
NI rate
PA taper
Effective marginal
Up to £12,570
0%
0%
None
0%
£12,570-£50,270
20%
8%
None
28%
£50,270-£100,000
40%
2%
None
42%
£100,000-£125,140
40%
2%
+20% (PA taper)
62%
Above £125,140
45%
2%
None (PA gone)
47%
Scottish taxpayers pay Scottish Income Tax rates (starter 19%, basic 20%, intermediate 21%, higher 42%, advanced 45%, top 48%), which differ from the England/Wales/Northern Ireland figures above. Use our take-home pay calculator to model your exact position.
Frequently Asked Questions
Frequently Asked Questions
What is the take-home pay for a Psychiatrist in 2026/27?
Core trainee (£38,000 gross): approximately £30,880/yr (£2,573/mo). Registrar (£58,000 gross): approximately £44,197/yr (£3,683/mo). Newly appointed consultant (£105,000 gross): approximately £70,457/yr (£5,871/mo). Senior consultant / Clinical Director (£155,000 gross): approximately £93,936/yr (£7,828/mo). These figures are after income tax and National Insurance, before pension and student loan deductions.
How much do NHS consultant psychiatrists earn in 2026/27?
NHS consultant psychiatrists start on the consultant pay scale, with a base of approximately £99,532 rising through annual increments, clinical excellence awards and additional programmed activities (APAs) to £140,000-£160,000+. New consultants in their first years typically gross £99,000-£110,000. Section 12 approved status, responsible clinician duties and on-call supplements add to the base salary at many trusts.
What is the NHS pension contribution rate for a psychiatrist earning £105,000?
NHS Pension Scheme (2015 CARE scheme) contributions are tiered. At £105,000 pensionable pay the employee contribution is approximately 12.5% (top tier), costing roughly £13,125/yr. The employer contributes around 23.7%. Contributions attract income tax relief at the higher rate (40%) or additional rate above £125,140, so the net cost to take-home is significantly less than the headline percentage suggests.
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How does the Personal Allowance taper affect psychiatrist take-home above £100,000?
Between £100,000 and £125,140 the £12,570 Personal Allowance is tapered at £1 for every £2 of income above £100,000. Combined with the 40% income tax rate this creates a 60% effective marginal rate (62% when NI is included). A newly appointed consultant psychiatrist earning £105,000-£125,000 sits directly in this zone. Additional NHS pension contributions or salary sacrifice that reduce adjusted income below £100,000 can be highly tax-efficient.
What is the take-home pay for a Specialty Registrar (ST4-ST6) in psychiatry?
Specialty registrar pay in psychiatry follows the NHS medical and dental pay scales, typically £50,000-£62,000 basic depending on training year, plus banding supplements for out-of-hours and on-call work where applicable. After tax and NI (no student loan), take-home at £58,000 is approximately £44,197/yr (£3,683/mo).
Do psychiatrists pay student loans on their NHS salary?
Yes, most psychiatrists have an undergraduate medicine degree plus Foundation and specialty training debt. Plan 2 borrowers (started before August 2023) repay 9% of earnings above £27,295. At £58,000 this deducts approximately £229/mo. At £105,000 it deducts approximately £582/mo. Plan 5 (post-August 2023 starters) has a £25,000 threshold, so repayments start earlier and the amounts are slightly higher at comparable salaries.
Is there a London weighting for psychiatrists working in London hospitals and community mental health trusts?
Yes. NHS staff working in inner London receive a High Cost Area Supplement (HCAS) of 20% of basic salary (capped at £8,176/yr). Outer London attracts 15% (capped at £5,373/yr) and the London fringe 5% (capped at £2,011/yr). For a newly appointed consultant psychiatrist earning £99,532 in inner London this adds approximately £8,176, bringing gross pay to around £107,708 before APAs and on-call.
How does private practice add to a consultant psychiatrist income?
Many consultant psychiatrists, particularly in general adult, forensic and old-age subspecialties, undertake private practice alongside NHS work -- private assessments, medico-legal reports and ongoing therapy or medication management. Private consultation fees typically range from £250-£500 for an initial assessment and £150-£300 for follow-ups. A consultant doing one private clinic session a week can add £15,000-£40,000+ gross annually, though this pushes many consultants into or through the £100,000-£125,140 taper zone and, at higher volumes, into the 45% additional rate band above £125,140.
What are additional programmed activities (APAs) for NHS psychiatrists?
NHS consultant contracts are based on 10 Programmed Activities (PAs) per week, typically split between direct clinical care and supporting professional activities (SPAs) for CPD, audit, teaching and management. Consultants frequently take Additional PAs for extra clinics, on-call cover, medico-legal work or leadership roles, each worth roughly 1/10 of the consultant base pay (around £9,953-£10,500 per APA at entry level). Two or three APAs can add £20,000-£30,000+ to annual gross pay.
How much can a psychiatrist earn as a locum or fully private consultant?
Locum consultant psychiatrist rates through NHS trusts and agencies typically range from £100-£150 per hour, or £900-£1,400 per session, reflecting the acute national shortage of psychiatrists in many subspecialties. Wholly private practitioners, particularly in London, can generate £150,000-£300,000+ gross from a mix of consultations, expert witness work and private hospital sessional fees. Locum agency work is usually taxed as employment income (Class 1 NI) via the agency payroll or PAYE umbrella; genuinely self-employed private practice uses Class 4 NI and Self Assessment.
Disclaimer
All salary and take-home pay figures on this page are estimates for illustrative purposes only, based on 2026/27 England income tax and National Insurance rates. They do not constitute financial, tax or employment advice. Individual tax positions vary and may be affected by pension contributions, student loan plans, benefits in kind, Scottish income tax rates and other factors. Always verify current NHS pay scales at nhsemployers.org and seek advice from a qualified tax adviser or financial planner for your personal circumstances.
