NHS Mileage Tax Relief Explained

If you drive your own car for work as part of an NHS role — visiting patients in the community, covering more than one site as a locum or bank worker, travelling to mandatory training, or any of the dozens of other reasons NHS staff end up behind the wheel for work — this is genuinely one of the more valuable and more overlooked pieces of tax relief available to you, and the rate change taking effect from April 2026 makes it more valuable than it's been in over a decade. This guide isn't tax advice and isn't affiliated with HMRC or the NHS; it explains the general mechanics so you can work out whether you're likely to have a claim, and how to take it further.

What's actually changed, and why it's a bigger deal than it sounds

HMRC sets Approved Mileage Allowance Payment (AMAP) rates — the amount that can be paid to an employee per business mile, tax-free, without needing to be reported as a benefit. These rates are meant to reflect the real cost of running a car for work: fuel, insurance, servicing, depreciation, and so on. For cars and vans, the rate had been fixed at 45p per mile for the first 10,000 business miles in a tax year (and 25p for everything after that) since 2011.

Fifteen years is a long time for a cost-of-motoring figure to stay frozen. Fuel prices, insurance premiums and general running costs have moved considerably since 2011, and for years commentators, unions and professional bodies representing NHS staff who rely on their own car for work — community nurses, health visitors, therapists, some doctors and many others — have argued that 45p no longer reflected the real cost of business motoring. From 6 April 2026, that changes:

The 25p rate for mileage beyond the first 10,000 in a tax year is untouched by this change — only the headline rate for the first 10,000 miles has moved. If you regularly drive more than 10,000 business miles a year, most of your mileage relief calculation will still use that lower, unchanged figure once you cross the threshold, so it's worth keeping the two bands separate when you work out your own numbers rather than assuming 55p applies to everything.

What actually counts as "business mileage" for NHS staff

This is the part that's genuinely important to get right, because getting it wrong in either direction causes problems — either under-claiming relief you're entitled to, or claiming for journeys that don't qualify. The core distinction HMRC draws is between ordinary commuting and business travel.

• ✓ Ordinary commuting — the journey between your home and your normal, permanent workplace. This is never eligible business mileage, no matter how far the journey is or how much it costs you personally.
• ✓ Travel between work locations — a community nurse or health visitor driving between patients' homes during a shift, a therapist covering multiple clinics, an ambulance or other staff member moving between sites as part of the job.
• ✓ Travel to a genuinely temporary workplace — for example a one-off or short-term training venue, a placement expected to last a limited period, or covering a different site on an occasional or short-term basis as a locum or bank worker.
• ✓ Travel from home directly to a temporary workplace can also generally qualify as business travel, rather than being treated as commuting, provided that workplace genuinely is temporary rather than becoming your new normal base.

The distinction that trips people up most often is this: driving from your home to your normal, permanent base is commuting, full stop — it doesn't become business travel just because you're commuting to do NHS work, and it doesn't matter whether you have one fixed base or are simply based at a particular hospital or office most of the time. What changes the answer is travel from that base, or between sites, or to a location that's genuinely temporary rather than your regular workplace.

How Mileage Allowance Relief actually works

This is the mechanism at the heart of this whole guide, and it's simpler than it first sounds once you see it laid out. Every NHS trust sets its own internal mileage reimbursement rate, which may sit below, at, or above the current AMAP rate — there's genuine variation across different trusts, different vehicle categories (some trusts pay a different rate depending on your car's engine size or whether you're a regular or occasional user), and different parts of the UK, so there's no single "typical NHS mileage rate" that applies everywhere. Because of that, the right approach is to check your own trust's current published mileage rate — usually in your trust's travel and expenses policy — rather than assume it matches any figure you've seen quoted elsewhere.

Once you know what your trust actually pays you per business mile, compare it to the AMAP rate for the same mileage band:

• ✓ If your trust pays you less than the AMAP rate for your business mileage, you can generally claim tax relief on the shortfall — the gap between what HMRC's benchmark allows tax-free and what you were actually paid.
• ✓ If your trust pays you at or above the AMAP rate, there's no further relief to claim — you've already received the full tax-free benchmark amount (or more) through your normal mileage payments.
• ✓ If your trust pays you significantly above the AMAP rate, the excess above the benchmark can potentially be treated as a taxable benefit rather than a tax-free payment — a narrower, less common situation worth checking with your payroll team if it applies to you, rather than something most staff need to worry about.

Crucially, the relief isn't paid to you as extra mileage money from your trust — it's a reduction in your taxable income, claimed from HMRC, which then translates into an actual cash saving depending on your marginal rate of Income Tax. That's the same basic mechanism used for other job-expense reliefs, such as the uniform laundering allowance covered elsewhere on this site.

Worked example, using the new rates

Take a community-based NHS worker who drove 10,000 business miles in a year visiting patients across a caseload, and who is paid the national Agenda for Change car rates: 59p a mile for the first 4,500 miles and 36p after (NHS Employers, from 1 June and 1 July 2026). For simplicity this ignores the timing of the 2026 rate and threshold changes and when the NHS mileage counter resets, so a real payslip will differ slightly.

Mileage matters because the NHS rate is higher than HMRC's at low mileage. Someone driving only 3,000 business miles is paid 3,000 × 59p = £1,770 against an AMAP amount of 3,000 × 55p = £1,650, so they have no shortfall, and HMRC's rule is that the £120 excess is added to pay and taxed (which is where the June 2026 statement on additional tax relief may apply). Someone driving 12,000 business miles is paid (4,500 × 59p) + (7,500 × 36p) = £5,355 against an AMAP amount of (10,000 × 55p) + (2,000 × 25p) = £6,000, a shortfall of £645, worth £129 back at basic rate or £258 at higher rate. Staff paid a local or lower flat rate will see larger shortfalls. This is exactly the kind of calculation the NHS Mileage Claim Calculator does automatically, and the NHS Tax Relief Calculator can take a rate of your own, rather than working through the bands by hand.

How to actually claim it

Mileage Allowance Relief is normally claimed directly from HMRC. The June 2026 NHS Staff Council statement says employers are able to apply additional tax relief on NHS reimbursement rates backdated to 1 April 2026, so check your payslips and ask payroll what, if anything, your trust has done before you claim, and don't claim the same amount twice. In practice:

• ✓ Keep a mileage log as you go — date, start and end points, purpose of each business journey, and the mileage. This is your evidence if HMRC ever asks, and it's far easier to keep a running log than to reconstruct a year's driving from memory afterwards.
• ✓ Keep records of what you were actually paid per mile by your trust, so you can show the gap between that and the AMAP rate for the relevant tax year.
• ✓ Claim via form P87 for most modest claims — online through your personal tax account, or by post — the same route used for other job expenses such as professional subscriptions and uniform laundering. If you already complete a Self Assessment return, or your total employment expense claims are larger, HMRC may expect the claim through Self Assessment instead.
• ✓ Claim for previous years too if you've never claimed before — generally the current tax year plus the four previous ones, using the mileage rate that applied in each of those years (45p for years before 6 April 2026, 55p from that date onwards).

See our companion guide on how to claim NHS tax relief yourself for a fuller walkthrough of the P87 process, including what other job expenses are commonly claimed alongside mileage on the same form.

If your trust pays the national Agenda for Change rates, which changed on 1 June 2026, our free NHS Mileage Claim Calculator compares them with HMRC's approved amount for your own miles and shows any relief you could claim.

How mileage relief fits alongside your other NHS tax relief claims

Mileage is rarely the only relief worth checking. It's common for the same NHS employee to be eligible for mileage shortfall relief, the uniform laundering flat rate, and relief on a professional subscription such as an NMC, GMC, HCPC or GPhC registration fee, all at the same time — and all three can typically be claimed together on the same form, for the same tax year, rather than needing separate submissions. If you're working through a mileage claim, it's worth pausing to check whether you're also claiming everything else you're entitled to, since the admin overhead of adding another expense type to the same P87 is minimal once you're already filling one in.

It's also worth remembering that mileage relief calculations don't carry over automatically from one tax year to the next in the way a tax code adjustment for a flat-rate allowance sometimes can. Because your business mileage and your trust's reimbursement rate can both change year to year — a new role, a different patch, a trust-wide change to its mileage policy, or simply driving more or fewer miles than the year before — it's worth treating each tax year's mileage shortfall as its own calculation rather than assuming a previous year's figure, or a previous year's approval, still applies. This is one of the reasons a running mileage log kept throughout the year is so much more reliable than trying to reconstruct or estimate a figure at the end of it, or assuming last year's number still holds.

Common mistakes worth avoiding

• ✕ Assuming your trust's mileage rate automatically matches the AMAP rate, or that your trust has not already applied additional tax relief — check your payslips and your trust's actual current figure rather than assuming.
• ✕ Claiming for ordinary commuting between home and your normal, permanent base — this is never eligible, regardless of distance or cost.
• ✕ Using the old 45p rate for mileage driven from 6 April 2026 onwards, or the new 55p rate for mileage driven before that date — each tax year uses the rate that applied at the time.
• ✕ Not keeping a mileage log until after the fact — a log kept as you go is far more reliable evidence than an estimate reconstructed later.
• ✕ Forgetting the two-band structure once you pass 10,000 business miles in a tax year — only the first 10,000 miles use the higher rate.

Why you can rely on this page

• ✓ The 45p-to-55p rate change, its 6 April 2026 effective date, and the fact it's the first change since 2011 are general HMRC rules verified against current guidance and professional/accountancy commentary, not figures we've estimated ourselves
• ✓ We're explicit that AMAP rates are a tax-free ceiling and benchmark, not a rate your trust is obliged to pay you
• ✓ We separate ordinary commuting from business travel clearly, including the less obvious temporary-workplace and 24-month considerations, rather than implying all work-related driving qualifies
• ✓ This guide is not affiliated with HMRC, NHS England or DHSC, and isn't tax advice — for your own exact position, HMRC's current guidance is the authoritative source

This guide is provided for general information only, is not affiliated with HMRC, the NHS or the Department of Health and Social Care, and is not tax advice — for your own exact eligibility and claim, check HMRC's current guidance or contact HMRC directly.

Frequently asked questions