Understanding NHS doctor pay scales is essential whether you are a newly qualified foundation doctor, an international medical graduate considering a move to the UK, or an experienced consultant exploring new opportunities. The NHS uses a structured pay system that determines your salary based on your grade, years of experience, and additional responsibilities.
This guide breaks down exactly what doctors earn at every level of the NHS in 2026, including base salary, on-call supplements, London weighting allowances, and pension contributions.
Quick Overview: NHS doctors earn between £36,616 (Foundation Year 1) and £139,882+ (senior consultant). Total earnings including supplements and additional sessions can be significantly higher.
NHS Pay Scales by Grade
Foundation Doctors
Foundation training is a two-year programme that all newly qualified doctors complete. FY1 doctors work under provisional GMC registration, while FY2 doctors hold full registration. Pay increases automatically upon progression to FY2.
Specialty Registrars (Training Grades)
Specialty training typically lasts between three and eight years depending on the specialty. Pay increases are linked to nodal points in the training pathway rather than annual increments.
Specialty Doctors & Specialist (SAS) Grades
SAS doctors are experienced clinicians who work outside the traditional training pathway. The 2021 contract reform created the new Specialist grade, offering higher pay and better progression for senior SAS doctors.
Consultants
Consultants are the most senior doctors in the NHS. Pay progression occurs through annual increments over approximately 17 years. Many consultants earn significantly more through Clinical Excellence Awards, private practice, and additional programmed activities.
Additional Earnings & Supplements
On-Call and Weekend Supplements
Doctors who work unsociable hours receive additional pay. Weekend supplements are calculated based on the frequency of your weekend duties. Typical supplements range from 3% to 15% of base salary for junior doctors. Consultants receive a separate on-call availability supplement of 1% to 8% depending on the rota frequency.
London Weighting
| Zone | Annual Supplement |
|---|---|
| Inner London | £2,162 |
| Outer London | £1,015 |
| London Fringe | £508 |
Locum Rates
Locum (temporary) doctors can earn significantly more per hour than their substantive counterparts. Typical locum rates for junior doctors range from £40 to £70 per hour, while consultant locum rates can exceed £100 to £150 per hour, depending on specialty and urgency.
NHS Pension Scheme
The NHS Pension Scheme is one of the most valuable benefits of working in the NHS. It is a defined benefit scheme, meaning your pension is based on your career average earnings rather than investment performance. As of 2026, the scheme is structured as follows:
- Contribution rates: Between 5.2% and 13.5% of pensionable pay, depending on your earnings tier.
- Employer contribution: The NHS contributes approximately 23.7% of your pensionable pay.
- Accrual rate: 1/54th of your pensionable earnings each year.
- Normal pension age: Linked to your State Pension age (currently 67 for most doctors starting today).
How to Maximise Your NHS Earnings
- Negotiate your starting salary: If you have prior NHS-equivalent experience from overseas, you may be able to start at a higher nodal point.
- Take on additional responsibilities: Clinical lead roles, teaching commitments, and research activities can attract additional pay.
- Consider location carefully: London weighting adds to your salary, but the cost of living is also higher. Regional NHS trusts in less competitive areas often offer more attractive overall packages.
- Explore locum opportunities: Short-term locum work can supplement your income, particularly during career breaks or while between permanent positions.
- Apply for Clinical Excellence Awards: Consultants who demonstrate exceptional contributions can receive annual awards of £3,000 to £77,000 on top of base salary.
Find Your Next NHS Role
Ava Medical helps doctors at all career stages find NHS positions that match their expertise and salary expectations. From foundation year posts to consultant vacancies, we have opportunities across the UK.
Browse NHS JobsInternational Doctors: What to Expect
If you are an international medical graduate moving to the UK, your starting salary will depend on the grade you are appointed to. Most IMGs begin at trust-grade or clinical fellow level (equivalent to ST1-ST3 pay) or as specialty doctors. Your overseas experience is taken into account when determining your starting nodal point, so it is worth providing detailed evidence of your experience during the application process.
Working with a specialist recruitment agency like Ava Medical ensures you receive appropriate salary benchmarking and support during contract negotiations, so you start on the right pay scale for your experience level.