Autumn Budget 2026: NHS Take-Home and Pensions

This page is for NHS staff who want to know what the Autumn Budget could change in their payslip: income tax, National Insurance, salary sacrifice and student loans. The Budget is on 28 October 2026. It has not happened yet, so the page is split into what is already decided, what is only being reported, and what to look for on the day. FrontlinePay is independent. This is the take-home and tax side; for the lump sum, the annual allowance and pension tax relief, see Autumn Budget 2026 and your NHS Pension.

Confirmed, reported, unknown: how this page is labelled

Already decided: tax and National Insurance

These are the rates and thresholds in force for 2026 to 2027, and what has already been decided about later years.

Scotland sets its own income tax rates and bands through the Scottish Budget, so the rates above are for England, Wales and Northern Ireland. The thresholds-until-2031 line comes from the 2025 Budget document, which describes holding income tax and National Insurance thresholds at current levels from April 2028 to April 2031 (they were already held before that).

What the threshold freeze means on an NHS payslip

A freeze does not change a rate. It stops the thresholds rising with pay, so as pay goes up, more of it is taxed at the higher rate and fewer people stay under the lines. The table uses FrontlinePay's pay engine and the 2026/27 Agenda for Change scale for England, with NHS Pension contributions, and no student loan or other deductions.

Two things stand out. First, NHS Pension contributions come off before income tax, so the £50,270 higher-rate line applies to your pay after your pension contribution. The top of Band 7 is only £198 over it, so only that slice is taxed at 40%, while the bottom of Band 7 has £5,723 of room. Second, the last column: the top of Band 7 keeps less of each extra £100 than the bottom of Band 5 because the 40% rate, the 2% National Insurance above £50,270 and a 10.7% pension tier all apply to the next pound. With the thresholds frozen, any pay rise moves pay towards the higher-rate line without the line moving. That is arithmetic, not a forecast of any pay award. For your own band and point use the NHS Pay Calculator; for what a tax code does see how to read your NHS payslip.

Salary sacrifice: what is announced and what it does not touch

From April 2029 only the first £2,000 a year of employee pension contributions made through salary sacrifice will be exempt from National Insurance. Contributions above that attract National Insurance, from the employee and the employer, and income tax relief stays within the usual limits (GOV.UK, published 26 November 2025). Your main NHS Pension contributions are not salary sacrifice, so they are not affected. Extra contributions through a salary sacrifice AVC could be, if you put in more than £2,000 a year. Test your own numbers with the salary sacrifice pension impact calculator. On 28 October the question is whether this is changed or delayed; we found a pensions trade body asking for a softer cap, which is a request, not a plan.

Student loans

The 2026 to 2027 thresholds are Plan 1 £26,900, Plan 2 £29,385, Plan 4 £33,795, Plan 5 £25,000 and postgraduate £21,000, with deductions at 9% (6% for postgraduate loans) of income above the threshold (GOV.UK). The government's student loan forecast methodology says the Plan 2 threshold is held at £29,385 for three years, through 2029 to 2030, after the 2025 Budget, and goes back to rising with RPI from April 2030. The same page says Plan 5 stays at £25,000 until April 2027, and that Plan 1 and Plan 5 rise with RPI from then. We did not find the new April 2027 amounts published, so we do not state them. A held threshold means repayments grow as pay grows. The NHS Pay Calculator includes the student loan plans.

Minimum wage and the lowest NHS pay points

The National Living Wage is £12.71 an hour from April 2026. Bands 1 and 2 start at £25,272 a year, which is about £12.92 an hour on the 37.5-hour week (our conversion: annual pay divided by 37.5 hours and 52.143 weeks), only about 21p above it. The Low Pay Commission has been asked to report by the end of October 2026 on rates from 1 April 2027. In its April 2026 consultation letter it gave an indicative range of £13.02 to £13.34 an hour, central estimate £13.18, and said the figures could change. Those are the Commission's working estimates, not a decision. If the final rate lands anywhere in that range, the lowest Agenda for Change points would need to rise, from the pay award or an interim uplift as in April 2025 (NHS Pay Review Body, 39th report). Whether the rate is announced at the Budget is not something we can confirm; the 2026 rate was in the 2025 Budget document.

Reported, not confirmed

Last year's pattern is a fair warning. Before the November 2025 Budget there was heavy speculation about the tax-free lump sum; the Treasury confirmed it would leave the limit alone (Financial Reporter, 11 November 2025), while the less publicised salary sacrifice cap did arrive. The detail is in our NHS Pension Budget page.

What to watch on the day

Each row says what is already decided and the question the Budget could answer. The right-hand column stays "Not yet announced" until we update it after the statement.

On the day, the primary documents are the Treasury's Budget document and its overview of tax legislation and rates, and the OBR's forecast, all published on gov.uk and the OBR site. The Treasury published a similar overview with the 2025 Budget.

• ✓ Read the Treasury's own summary of tax measures before a news summary
• ✓ Check the start date of each measure: many start in April 2027 or later, which leaves time to act
• ✓ Note whether a measure is announced (a policy) or legislated (in an Act or regulations)
• ✓ Check for transitional protection and for whether Scotland follows
• ✓ Look for the National Living Wage and statutory pay rates for 2027/28
• ✓ Ignore anything in a social media screenshot until you see it on gov.uk

After the Budget

This page is built to be updated, not rewritten. After the statement we change the status date at the top, move the "Outcome" column from "Not yet announced" to the announced position, and retire the "Reported" list. Every row keeps its source. The page you are reading says status as of 19 October 2026; if that is still the date when you read this after 28 October, it has not been updated yet.

Related guides

General information as of 19 October 2026, not tax or financial advice. Speak to HMRC, your payroll team, a union rep or a regulated adviser about your own position. FrontlinePay is independent and not affiliated with HM Treasury, HMRC or the NHS.