NHS Doctor Salary & Pay Scales 2026/27: Junior to Consultant

If you've read our overview of doctors' careers and pay, you'll already know the broad shape of the ladder from FY1 to consultant. This page goes further into the mechanics: exactly how nodal points and the extra elements of resident doctor pay combine into a real number, worked examples at different grades, how the 2002 contract banding in Scotland, Wales and Northern Ireland differs, and what higher pay can do to your tax position. This is genuinely one of the most-searched and least-understood corners of NHS pay — two doctors quoting their "salary" can mean two very different things depending on whether they're talking about basic pay or their actual gross pay including allowances.

Nodal points: basic pay only

Resident doctors — the current term covering FY1 through ST6+, previously "junior doctors" — aren't paid on Agenda for Change bands. Instead, each stage of training sits on its own nodal point, a single basic-pay figure that applies regardless of specialty:

These figures are basic pay only — before any weekend allowance, night work, additional hours, on-call payments, or High Cost Area Supplement. These are the figures for England. Moving up a nodal point happens when you progress to the next stage of training (e.g. from ST1-2 to ST3-5), not automatically with time served within a stage.

Consultant pay: a genuinely different structure

Consultant pay isn't banded in the same way at all, which is a common source of confusion when people compare a senior registrar's payslip to a consultant's. Consultants enter the scale at £113,565 and progress through 4 pay thresholds over 14 years of service to reach £150,569 at the top of the scale — progression that happens through a small number of large steps, not annual increments and not a banding percentage. On top of that basic scale, consultants are typically contracted for a fixed number of weekly Programmed Activities (PAs), with any additional PAs, genuine on-call availability supplements, or (for some) Clinical Excellence Awards calculated and added separately — see our dedicated guide for what's changed in that scheme since 2024. The mechanism is different from resident doctor allowances, but the underlying logic is similar: basic pay reflects a standard working pattern, and anything beyond that standard pattern is paid on top of it, not folded into a single higher basic rate.

Weekend, night and on-call pay: how it adds to basic pay in England

Resident doctors in England are on the 2016 contract, which has no pay banding. Instead, basic pay (the nodal point) is topped up by separately defined elements, per the BMA's payslip guide and the 2016 terms and conditions:

• Weekend allowance: a percentage of basic salary for working 1 in 8 or more frequent weekends, from 3% at 1 in 8 up to 15% at 1 in 2.
• Night work: hours worked in the night period (9pm to 7am, plus some other defined periods) are paid at the basic hourly rate plus 37%.
• On-call availability allowance: 8% of basic salary for non-resident on-call availability, regardless of how often you are on call.
• Additional rostered hours: contracted hours above 40 a week, up to 48 (or 56 if you opt out).
• Flexible pay premia for certain specialties (the BMA lists general practice, psychiatry, emergency medicine, histopathology, academia and oral and maxillofacial surgery) and a £1,000 a year allowance for less-than-full-time training.

The weekend and on-call elements are percentages of basic pay, so a simple illustration is basic pay × (1 + percentages that apply to your rota). Night work is paid per hour worked, so it depends on your rota and is not included in the examples below.

Worked example 1: ST3-5 registrar, 1 in 2 weekends and on-call

An ST3-5 doctor (NP4) on basic pay of £67,325, working 1 in 2 weekends (+15%) and receiving the on-call allowance (+8%):

£67,325 × 1.23 = roughly £82,810 before night work, additional hours, tax and pension.

Worked example 2: FY2 doctor, on-call allowance only

An FY2 doctor (NP2) on basic pay of £47,610 with the 8% on-call allowance:

£47,610 × 1.08 = roughly £51,419.

Worked example 3: ST6+ registrar, on-call allowance only

An ST6+ doctor (NP5) on basic pay of £76,582 with no weekend allowance and the 8% on-call allowance:

£76,582 × 1.08 = roughly £82,709.

These are illustrations of how the percentages combine, not typical payslips: your own rota, night hours, additional hours and any flexible pay premium decide the real figure, so check your work schedule and payslip.

Banding in Scotland, Wales and Northern Ireland (2002 contract)

Pay banding still exists for resident doctors on the 2002 contract in Scotland, Wales and Northern Ireland. It does not apply in England. According to the BMA's pay banding guide, a full-time trainee's supplement is a percentage of basic pay set by the average hours worked, the amount of that time actually spent working and the overall pattern of hours:

Flexible (less-than-full-time) trainees use bands FA (50%), FB (40%) and FC (20%) and others set by hours of actual work. The nodal points on this page are England's, so do not apply these percentages to them: Scotland, Wales and Northern Ireland have their own basic pay scales, and the BMA notes that Wales is moving new residents onto new terms from August 2026, so check the BMA pay pages for your nation. Banding is assessed rota by rota, can change when you rotate to a new post, and is monitored locally, with disputes handled through the trust or health board and BMA representatives.

Tax implications: what higher pay does to your marginal rate

Resident doctors' allowances are taxed through PAYE like basic pay. UK income tax bands have been frozen in cash terms for several years and remain unchanged for 2026/27: the personal allowance is £12,570, the higher rate (40%) applies from £50,270, and the additional rate (45%) applies above £125,140. Crucially, the personal allowance itself is tapered away by £1 for every £2 earned between £100,000 and £125,140 — creating an effective marginal rate of around 60% across that band, regardless of your job title.

Resident doctors in England on basic pay plus allowances will often sit below that zone, as the examples above show, but heavy additional hours or night work can move some towards it. Consultants start even closer to (or inside) it: entry-level consultant pay of £113,565 sits within the taper band already, and anyone progressing toward the top of the consultant scale, taking on additional PAs, or receiving a Clinical Excellence Award can cross into additional-rate territory above £125,140 without a dramatic jump in headline pay. Doctors in this position are also the group most likely to run into NHS Pension annual allowance tax charges, given typically high pensionable pay — see our NHS Pension for doctors and consultants guide for why that exposure is so much higher for doctors specifically, or our annual allowance tax charge explained guide for how the underlying mechanism works. To estimate your own position, use our annual allowance calculator.

None of this is a reason to avoid extra sessions or additional hours if they suit you — but it's a genuine reason to check your actual take-home increase before assuming a bigger gross number automatically means a proportionally bigger net one.

Why you can rely on the figures on this page

• ✓ Nodal point and consultant pay figures are drawn from the most recently confirmed values at time of writing, not projected or estimated
• ✓ We flag exactly what changed in the June 2026 resident doctors' pay deal — the backdating date, the September 2026 implementation, and the five-to-ten nodal point restructure — rather than leaving the page describing a dispute that's since been resolved
• ✓ Every worked example shows the full calculation (basic pay × the percentages that apply) so you can check the method, not just trust a final figure
• ✓ We link directly to bma.org.uk and gov.uk for readers who need to verify the current position before relying on a number for something like a mortgage application

Related NHS pay guides & tools

Where to go next

For the full career ladder — Foundation training through specialty training to consultant, SAS doctors, GPs and how registration works for UK and international graduates — see our doctors' careers and pay overview. And if you want a quick estimate of your own take-home pay, the NHS Pay Calculator is useful as a general reference — but it currently models Agenda for Change bands, not doctors' nodal points and allowances directly, so treat any result it gives a doctor as a rough figure rather than an exact one for your grade and rota. We'd rather be upfront about that limitation than let the tool imply a precision it doesn't have.