NHS Trust Comparison Tool

How much does the trust you choose change your pay?

For most staff, less than people expect. The Agenda for Change band and pay point set your basic pay within each nation, and trusts do not set their own scales. The differences that do exist are the High Cost Area Supplement for London and the surrounding area, the separate Welsh and Scottish pay scales (and Scotland's income tax), and local allowances such as the Scottish Highlands and Islands payments. The table uses the same engine as the tool, for Band 6, middle of the band, full time, in the NHS Pension Scheme with no student loan.

London weighting is not a bonus for the same job. It reflects the higher cost of working in and around London, so more take-home pay there does not mean more spending power. Our guide to London weighting and HCAS explains the terminology and the history.

High Cost Area Supplement for 2026/27

HCAS is a percentage of basic pay, with a minimum and maximum cash amount, paid in addition to Agenda for Change pay in three zones. Low earners get the minimum and high earners are capped at the maximum.

What that is worth after tax depends on your band. Comparing a trust in Inner London with one outside HCAS areas, middle of the band, full time:

Scotland, Wales and Northern Ireland

Scottish boards use the Scottish Agenda for Change scale and Scottish income tax, so a Scottish and an English trust can differ at the same band for reasons that have nothing to do with the employer. Our NHS Scotland pay scales guide has the scale; NHS Scotland's full-time week is 36 hours from 1 April 2026, so check your own contract for hours. Wales publishes its own Agenda for Change scale, which is different from England's, covered in NHS Wales pay 2026/27. Northern Ireland is shown on the England scale until its 2026/27 award is confirmed. The tool flags any comparison that mixes scales.

What this tool deliberately does not show

It will not show a CQC rating, staff numbers, waiting times or claims about culture, because we cannot keep them accurate and a wrong figure would be worse than none. For ratings, use the Care Quality Commission and read our guide to how NHS hospitals are rated. For the structure behind trusts, ICBs and health boards, see how the NHS is structured.

What the AI comparison can and cannot tell you

• ✓ What a trust's stated type and region imply, for example that a large acute trust in a major city usually offers broader rotation options than a small community trust
• ✓ What an HCAS zone means for pay, and that it reflects cost of living rather than a bonus
• ✓ Honest flags where a priority such as work-life balance or management culture cannot be judged from public facts, with concrete ways to find out
• ✓ Never a ranking or a 'pick this one': it lays out what the facts and your priorities suggest and leaves the decision to you

Before you move trusts

Pay is only one part of the decision. Ask about the rota and how unsocial hours are paid, the induction or preceptorship on offer, whether your continuous service and pension carry over, and the real cost and time of the commute. If you are moving between NHS employers, our guides on moving between trusts: pay and pension and what transfers when you move trust cover the rules. Newly qualified staff should also read NHS preceptorship explained.

Sources and how we calculate

• Pay: the 2026/27 Agenda for Change scales and HCAS rules used across FrontlinePay, from NHS Employers pay circulars; see our pay scales guide.
• Take-home: the same income tax, National Insurance and NHS Pension engine as the NHS Pay Calculator, with the Scottish tax bands for Scottish boards.
• Trust facts: the published trust profiles in our trust directory. Read our editorial policy for how we source and update them. Last updated October 2026.