Consultant Doctor Salary 2026/27
Consultants are not on Agenda for Change — they have their own national pay scale, their own contract, and pay that is built differently: thresholds instead of spine points, programmed activities instead of hours, and an on-call supplement instead of unsocial-hours enhancements. This page uses the official 2026/27 scales for England and Scotland and works out real take-home pay, including the pensionable/non-pensionable split that generic salary calculators get wrong.
Last updated November 2026 · Figures checked against NHS Employers, the Scottish Government and GOV.UK in November 2026. Next scheduled check: the April 2027 pay award.
Calculate a consultant's take-home pay
Worked example — a newly appointed consultant
A consultant starting in England in 2026/27 at Threshold 1 earns £113,565 for a standard 10-PA job plan. In the NHS Pension Scheme they pay the top-tier contribution of 12.5% — £14,195.63 a year — because the tier is set by pensionable pay and every full-time consultant is above the £67,669 top-tier threshold. Income tax is £27,179.75 and National Insurance £4,281.90, leaving £67,907.73 a year, £5,658.98 a month.
One detail generic calculators miss: at £113,565 this consultant is inside the £100,000 personal-allowance taper zone — but because pension contributions are deducted before tax under the net pay arrangement, their adjusted net income falls to £99,369, just under £100,000, so they keep their full £12,570 personal allowance. Opting out of the pension pushes them into the taper: the tax bill alone rises by £8,391.05 a year (to £35,570.80), before counting the lost pension and employer contribution. Untick the pension box in the calculator above and see it happen.
Add a Category A high-frequency on-call rota (8%) and the same consultant's gross rises by £9,085.20 to £122,650.20, with take-home of £5,919.35 a month. Add one additional PA instead and take-home is £6,029.14 a month — the extra PA pays more per pound because it is not pensionable, so no 12.5% contribution comes off it.
Consultant pay scale — England 2026/27
From Pay and Conditions Circular (M&D) 1/2026 (a 3.5% uplift from 1 April 2026). Take-home assumes full time (10 PAs), NHS Pension membership, no on-call, no extra PAs and no student loan.
| Threshold | Years as a consultant | Basic salary | Take-home / month |
|---|---|---|---|
| Threshold 1 | 0–2 years | £113,565 | £5,658.98 |
| Threshold 2a | 3 years | £120,249 | £5,853.33 |
| Threshold 2b | 4–7 years | £123,672 | £5,947.45 |
| Threshold 3 | 8–13 years | £135,645 | £6,276.71 |
| Threshold 4 | 14+ years | £150,569 | £6,769.70 |
Progression is not an annual increment. There are only five pay values across a whole career, reached after 3, 4, 8 and 14 years as a consultant, and each step depends on meeting the Schedule 15 criteria in the consultant Terms and Conditions — satisfactory appraisal and job-plan review, meeting agreed objectives, and keeping up mandatory training. The terms say it will be the norm to progress; a step can be deferred, normally by a year, but never because of an employer's finances or quotas. Starting pay can also be set above Threshold 1 where previous consultant-level experience is approved.
On-call supplement, extra PAs and awards
Three things sit on top of basic pay — and they are taxed and pensioned differently, which is where most salary calculators go wrong.
On-call availability supplement (pensionable)
Paid when your job plan requires you to be on an on-call rota. It is a percentage of your full-time basic salary (including thresholds), set by how often you are on call and whether you must return to site immediately (Category A) or can usually advise by phone first (Category B). Because it follows your rota contribution, a part-time consultant who covers the rota like full-time colleagues receives the percentage of the full-time salary, not of their part-time salary.
| Rota frequency | Category A | Category B |
|---|---|---|
| High — 1 in 1 to 1 in 4 | 8% | 3% |
| Medium — 1 in 5 to 1 in 8 | 5% | 2% |
| Low — 1 in 9 or less often | 3% | 1% |
Additional programmed activities (not pensionable)
A standard full-time job plan is 10 PAs (each PA is nominally four hours; time outside 07:00–19:00 Monday to Friday and at weekends counts as premium time at a three-hour value). Each additional PA you agree pays 10% of your full-time basic salary per year — £11,356.50 at Threshold 1 — and is not pensionable, so no 12.5% contribution is deducted from it.
National Clinical Impact Awards (not pensionable)
The current award values, in force from 1 April 2025, are £21,000 (N1), £31,500 (N2) and £42,000 (N3) a year, held for five years. Be careful with older sources: many pages — and even an out-of-date GOV.UK guide — still quote the pre-2025 values of £20,000 / £30,000 / £40,000. Awards held from the old Clinical Excellence scheme keep their frozen values (£36,192–£77,320). All new awards are non-pensionable.
Consultant pay scale — Scotland 2026/27
Scottish consultants are on the separate 2004 contract, paid under circular PCS(DD)2026/02 (also +3.5% from 1 April 2026). The scale is a seniority spine: eight pay points reached over 20 years. Take-home assumes full time, SPPA pension membership and basic pay only — Scottish availability supplements, discretionary points (up to eight, on top of the scale) and distinction awards follow the Scottish contract and are not modelled here.
| Pay point | Seniority | Basic salary | Take-home / month |
|---|---|---|---|
| 1 | Year 1 | £115,331 | £5,431.10 |
| 2 | Year 2 | £117,767 | £5,484.61 |
| 3 | Year 3 | £121,270 | £5,561.60 |
| 4 | Year 4 | £124,778 | £5,638.70 |
| 5 | Years 5–9 | £128,275 | £5,715.54 |
| 6 | Years 10–14 | £136,602 | £5,889.22 |
| 7 | Years 15–19 | £144,927 | £6,072.52 |
| 8 | Year 20 | £153,247 | £6,373.39 |
Scotland starts higher (£115,331 against £113,565) and ends higher (£153,247 against £150,569) — but the climb takes 20 years instead of 14, and Scottish income tax takes a bigger share at these salaries, which is why the take-home column runs lower than England's at a similar gross. Scottish consultants pay the SPPA pension tiers (top rate 12.7%, against 12.5% in England and Wales).
Two tax issues every consultant should know
The £100,000 allowance taper. The whole consultant scale sits inside or above the zone where the personal allowance is withdrawn (£1 of allowance lost per £2 of income over £100,000, gone completely at £125,140), creating an effective 60% income-tax band. Pension contributions reduce adjusted net income, so staying in the scheme is worth more at this level than it looks — see the worked example above.
Pension annual allowance. This calculator does not model annual allowance tax charges, and for senior consultants they are a real and common issue: pension growth in a defined-benefit scheme is valued at broadly 16× the increase in annual pension, so long service, a threshold jump or extra income can breach the £60,000 allowance — or the tapered allowance (which can fall as low as £10,000 where threshold income exceeds £200,000 and adjusted income exceeds £260,000). If you receive a pension savings statement showing growth above your allowance, take advice; do not rely on any take-home calculator, including this one, for that part of the picture.
London. Consultants working in London receive a London Weighting Allowance on top of basic pay, and it is pensionable. The 2026/27 medical and dental rates were not published in a form we could verify against the standard of this site — and the Agenda for Change London amounts used elsewhere on this site are a different allowance that must not be applied to consultants — so the consultant calculator does not offer a London option rather than guess. London consultants should treat the figures as basic-pay-only.
Other NHS roles
Consultant doctor salary — frequently asked questions
How much do NHS consultants earn in 2026/27?
A consultant in England starts on £113,565 a year and reaches £150,569 after 14 or more years, under the 2026/27 scale in Pay and Conditions Circular (M&D) 1/2026. In Scotland the 2004 contract scale runs from £115,331 to £153,247, with the top point reached at 20 years. On top of basic pay, consultants can earn an on-call availability supplement of 1% to 8% of basic pay, 10% of basic pay for each additional programmed activity, and National Clinical Impact Awards worth £21,000, £31,500 or £42,000 a year.
What is a new consultant's take-home pay?
A newly appointed consultant in England on Threshold 1 (£113,565), working full time with no extras and paying into the NHS Pension Scheme, takes home £5,658.98 a month — £67,907.73 a year — after £14,195.63 of pension contributions, £27,179.75 of income tax and £4,281.90 of National Insurance.
Are consultants paid on Agenda for Change bands?
No. Consultants have their own national contract and pay scale — the 2003 consultant contract in England and the 2004 contract in Scotland — separate from Agenda for Change. Pay is organised in thresholds reached after set numbers of years as a consultant, not band spine points, and extra work is paid as additional programmed activities (PAs) rather than hourly overtime.
How does consultant pay progression work?
In England there are five pay values. A consultant moves to Threshold 2a after 3 years, Threshold 2b after 4 years, Threshold 3 after 8 years and Threshold 4 after 14 years. Progression is not automatic: it depends on meeting the criteria in Schedule 15 of the consultant Terms and Conditions, including satisfactory appraisal and job-plan review, though the terms state it will be the norm for consultants to progress.
How much pension does a consultant pay?
Consultants are in the same NHS Pension Scheme as other NHS staff, with the member contribution rate set by total pensionable pay. Every full-time consultant falls into the top tier: 12.5% in England and Wales and 12.7% in Scotland. Contributions are charged on pensionable pay only — basic pay and the on-call supplement — not on additional PAs or Clinical Impact Awards.
Why is Scotland's consultant pay higher?
Scotland negotiates consultant pay separately under its own 2004 contract. Its scale starts higher (£115,331 against £113,565 in England) and ends higher (£153,247 against £150,569), but the climb is slower — the top point takes 20 years of service, against 14 years in England. Scottish consultants also pay Scottish rates of income tax and the Scottish (SPPA) pension contribution tiers.
Sources
England scale, on-call supplement, additional PAs and progression: NHS Employers, Pay and Conditions Circular (M&D) 1/2026 and Terms and Conditions — Consultants (England) 2003, version 16 (Schedules 14–17). Scotland scale: NHS Scotland circular PCS(DD)2026/02 and Scottish Government 2026-27 pay award confirmation. National Clinical Impact Award values: GOV.UK, Clinical Impact Awards 2026 employers' guide (values from 1 April 2025). Pension tiers: NHSBSA (England and Wales) and SPPA (Scotland), 2026/27. Annual allowance parameters: GOV.UK pension scheme rates. Figures checked November 2026. How every figure is calculated: our methodology.
How every figure on this site is calculated and checked: our methodology.