NHS Doctor Salary 2025/26: Pay Scales by Grade

NHS doctors in the UK earn between £38,831 and £145,478 in basic salary for 2025/26, depending on their grade and years of experience. But basic salary only tells part of the story. Once you add pay for extra hours, night shifts, weekend work and on-call duties, total earnings are roughly 27% higher on average. That means a first-year foundation doctor actually takes home around £45,900 in total NHS earnings, while a senior consultant averages about £161,600.

These rates took effect from 1 April 2025, after the government accepted the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) recommendations. Resident doctors received a 4% uplift plus a consolidated £750 payment, working out to an average 5.4% increase. Consultants, specialty doctors, specialists and salaried GPs all received a straight 4% rise.

This guide covers every doctor grade in the NHS — from FY1 to consultant, GP, surgeon and SAS doctor — with basic pay, estimated total earnings, monthly and hourly breakdowns, and take-home pay after tax.

NHS Doctor Salary at a Glance

Here is a quick-reference table showing what NHS doctors earn in England for 2025/26:

Total earnings include non-basic pay such as additional hours, night enhancements and weekend allowances. Per-hour figures are based on a 48-hour working week, which is the maximum under the European Working Time Directive. These are England figures — Scotland, Wales and Northern Ireland are covered further below.

NHS Doctor Grades Explained

NHS doctors follow a structured career pathway from medical school through to consultant or GP level. Understanding the different grades helps make sense of the pay scales.

What Is a Junior Doctor (Resident Doctor)?

A junior doctor — now officially called a resident doctor — is a qualified medical practitioner working in postgraduate training. They have already completed a five-year medical degree and hold provisional or full registration with the General Medical Council (GMC).

The term covers everyone from a brand-new FY1 in their first week on the wards right through to an ST8 who is months away from becoming a consultant. Resident doctors make up about half of all hospital doctors in the NHS.

What Is a Registrar?

A registrar (formally called a specialty registrar or StR) is a doctor in the later years of specialty training. They have already finished their foundation years and core training, and are now working towards their Certificate of Completion of Training (CCT).

Registrars work at ST3 level and above. In some specialties with “run-through” training — such as neurosurgery or paediatrics — doctors go straight from ST1 without a separate core training stage. The older title “specialist registrar” (SpR) is still used informally in many hospitals.

What Is an SHO?

SHO stands for Senior House Officer. It is a legacy term for doctors at the CT1–CT2 level (core training). The title was officially replaced years ago, but you will still hear it used on hospital wards across the UK. An SHO typically has two to four years of postgraduate experience.

Doctor Hierarchy in the UK

Here is a simple breakdown of how NHS doctor grades work, from most junior to most senior:

Specialty doctors and specialist doctors (collectively known as SAS doctors) sit outside the traditional training pathway. They are experienced clinicians who choose not to pursue the consultant route but still provide senior-level care.

Junior Doctor Salary (Resident Doctor Pay 2025/26)

The 2025/26 pay deal gave resident doctors in England a 4% increase plus a consolidated £750 payment on top. This brought the average uplift to about 5.4%, and follows two years of above-inflation deals. Taken together, resident doctors have seen nearly a 30% rise in basic pay since 2022/23.

Pay works differently depending on where you work. England uses the 2016 contract with “nodal points” — your salary jumps at key stages of training rather than going up each year. Scotland, Wales and Northern Ireland still use the older 2002 contract, where pay rises in small annual increments within each grade.

Foundation Year Doctor Salary (FY1 and FY2)

Foundation year 1 is your first job after finishing medical school. Foundation year 2 follows twelve months later. Here is what foundation doctors earn in basic pay across the UK:

England figures from the 2016 contract. Scotland, Wales and Northern Ireland figures based on the 2002 contract minimum entry points, uplifted for 2025/26.

Basic pay is only the starting point. On top of this, FY1 doctors receive pay for any hours worked beyond a standard 40-hour week, a 37% enhancement for night shifts between 9pm and 7am, a weekend allowance, and an on-call availability payment. The Nuffield Trust estimates that total NHS earnings for an FY1 doctor — including all these extras — come to around £45,900 per year.

Core Training and Specialty Registrar Salary (CT1 to ST8)

As doctors progress through core training and into specialty registrar posts, their pay rises at each nodal point:

Under the 2002 contract used in Scotland, Wales and Northern Ireland, pay increases yearly within each grade rather than jumping at nodal points. For example, a doctor in Scotland who starts specialty training at ST1 on around £47,324 will see their pay climb each year through to ST8.

Across all specialty registrars, the Nuffield Trust estimates average total NHS earnings of about £80,500 for full-time staff. That puts registrars above roughly nine in ten workers in the wider UK economy.

Junior Doctor Salary Per Month and Per Hour

Many people want to know what a junior doctor actually earns each month. Here is a breakdown based on basic salary alone:

These figures are for basic salary only. Once you include the 27% average non-basic pay (nights, weekends, on-call and extra hours), total monthly earnings for an FY1 rise to roughly £3,825, and for an average specialty registrar to around £6,708.

The hourly rate varies depending on whether you use a 40-hour standard working week or a 48-hour maximum week. Most resident doctors actually work 40 to 48 hours per week, so their real hourly rate sits somewhere in between.

Junior Doctor Take-Home Pay After Tax

What actually lands in your bank account is quite different from the headline salary. After Income Tax, National Insurance, NHS Pension contributions and student loan repayments, the figures look like this:

These estimates are based on basic salary only, using 2025/26 tax rates (personal allowance of £12,570, basic rate 20%, higher rate 40%), employee National Insurance at 8% between £12,570 and £50,270 then 2% above, and NHS Pension contribution tiers from April 2025. Student loan assumes Plan 2 (threshold £27,295, 9% above).

In reality, your take-home will be higher than this because the additional earnings from nights, weekends and extra hours are not included here. But it does show that an FY1 doctor earning £38,831 on paper actually takes home about £2,220 a month from their basic pay.

Consultant Salary in the NHS (2025/26)

Consultants are the most senior hospital doctors in the NHS. They have completed all their postgraduate training and hold a CCT. For 2025/26, consultant basic salaries in England range from £109,725 for a newly appointed consultant to £145,478 for one with 14 or more years at that grade.

Average total NHS earnings for full-time consultants — including all non-basic pay — come to roughly £161,600 per year. That places them between the 98th and 99th percentile of all UK earners, meaning they earn more than about 98% of the workforce.

Consultant Pay Scale by UK Nation

Consultant pay progresses through four main thresholds in England, based on years of completed service:

England figures from the 2003 contract, uplifted by 4% for 2025/26. Devolved nation figures based on equivalent contracts.

A few things to note. The 2003 consultant contract in England is based on ten programmed activities (PAs) per week, with each PA lasting four hours. If a consultant takes on an extra PA, they receive an additional 10% of their basic salary. Wales has notably faster pay progression in the early consultant years compared to the other UK nations.

Clinical Excellence and Impact Awards

On top of basic salary and other supplements, consultants can apply for additional awards that recognise outstanding contributions to patient care:

National Clinical Impact Awards (NCIAs) replaced the older National Clinical Excellence Awards (NCEAs) in 2022. Up to 600 new awards are granted each year in England. Applicants need to show evidence of impact across five domains, including delivering high-quality service, leadership, education, innovation and research.

The scheme varies by UK nation. In Scotland, distinction awards have been frozen since 2010 with no new awards, though discretionary points are still available. In Northern Ireland, the clinical excellence award scheme was suspended to new entrants in 2011.

Consultant Total Earnings and Take-Home Pay

Here is what consultant pay looks like after deductions:

Level	Basic Salary	Income Tax	National Insurance	NHS Pension (12.5%)	Take-Home	Monthly
Starting (Year 0)	£109,725	£33,267	£4,205	£13,716	£51,118	£4,260
Top (Year 14+)	£145,478	£51,668	£4,920	£18,185	£60,069	£5,006

These figures are based on basic salary alone and do not include a student loan (most consultants will have paid theirs off). In reality, average total NHS earnings of £161,600 mean that a typical consultant takes home considerably more once additional hours, on-call payments and other supplements are included.

Many consultants also do private practice work alongside their NHS role. In high-earning specialties, this can add tens of thousands of pounds per year, potentially pushing total income above £200,000.

GP Salary in the UK (2025/26)

General practitioners (GPs) have a completely different pay structure from hospital doctors. They work in primary care and are either salaried GPs employed by a practice, or self-employed GP partners who draw income from practice profits.

Salaried GP Pay Scale

Salaried GPs are employed on a BMA-negotiated pay range. For 2025/26, the ranges across the UK are:

Nation	Minimum	Maximum
England	£76,038	£114,743
Scotland	£77,160	£115,167
Wales	£79,123	£119,394
Northern Ireland	£77,140	£116,405

Wales offers the highest salaried GP pay of any UK nation. Salaried GPs benefit from NHS employment terms including sick pay, annual leave, maternity/paternity pay and NHS Pension membership.

GP Partner Earnings

GP partners are self-employed. Their income comes from practice profits after expenses. According to the latest available figures from NHS Digital (2022/23), average GP partner earnings were:

England: £140,200 (all working patterns)
Scotland: £120,000 (14% less than England)
Wales: £115,300 (18% less)
Northern Ireland: £108,300 (23% less)

When adjusted for full-time equivalent working, GP partner earnings may reach around £163,500 to £168,000. However, partners carry business risks and responsibilities that salaried GPs do not. They cover their own sick pay, arrange their own pension contributions, and are responsible for practice overheads like rent, staffing and equipment.

GP Trainee Salary (GPST1–ST3)

GP trainees (also called GP registrars) are paid on the standard resident doctor pay scale. A GPST1 in England starts at nodal point 3, which is £52,656 basic. On top of this, GP trainees receive a flexible pay premium of £10,691 for being in a hard-to-fill specialty. This makes the GP training package one of the most attractive of any specialty training programme.

Surgeon Salary in the UK

There is no separate “surgeon pay scale” in the NHS. Surgeons earn exactly the same basic salary as any other doctor at their grade — a surgical registrar is paid the same as a medical registrar, and a consultant surgeon earns the same basic as a consultant physician.

NHS Surgeon Pay by Grade

Here is the surgical career pathway with salary at each stage:

Stage	Grade	Basic Salary (England 2025/26)
Core Surgical Training	CT1–CT2	£52,656
Higher Surgical Training	ST3–ST8	£65,048–£73,992
Consultant Surgeon	Year 0–14+	£109,725–£145,478

Surgical specialties include general surgery, orthopaedic surgery, neurosurgery, cardiothoracic surgery, plastic surgery, vascular surgery, ENT, urology and paediatric surgery. The basic NHS salary is the same across all of them.

Where surgeon earnings really diverge is through private practice. Consultant surgeons in specialties like orthopaedics, neurosurgery, ophthalmology and plastic surgery can earn substantial private income on top of their NHS salary. Some consultant surgeons with a strong private practice earn well over £200,000 in total. Clinical Impact Awards (up to £40,000 a year) can add further to this.

Specialty and SAS Doctor Salary (2025/26)

Specialty doctors and specialist doctors (collectively known as SAS doctors) are experienced clinicians who work outside the traditional training pathway. They provide ongoing clinical care and often hold significant responsibilities, but they are not on a training rotation to become a consultant.

Specialty Doctor Pay Scale

Specialty doctors on the 2021 contract in England start at £61,542 and can reach £99,216 over a 17-point pay scale. Here are the key thresholds:

Scale Point	England	Scotland (2022 contract)
Minimum	£61,542	£64,158
Point 3	£70,901	£78,617
Point 6	£79,038	£81,223
Point 9	£87,486	£90,600
Point 12–17	£99,216	£99,974

SAS doctors received a 4% uplift for 2025/26.

Specialist Doctor Pay Scale

The specialist doctor grade was introduced in 2021 for experienced SAS doctors with at least eight years of postgraduate experience. In England, pay ranges from £100,870 to £111,441. This grade bridges the gap between the old specialty doctor and consultant levels, giving career-grade doctors better recognition and pay.

How NHS Doctor Pay Works

NHS doctor pay is more complicated than a single salary figure. Basic pay typically makes up only about 73% of what a doctor actually earns, with the rest coming from various supplements and allowances.

Basic Salary and Nodal Points

In England, the 2016 resident doctor contract uses a system of five “nodal points”. Your salary jumps when you move up a grade — for example, from FY2 to core training, or from core training to higher specialty training. Between nodal points, your basic pay stays the same regardless of how many years you spend at that level.

This is different from the 2002 contract still used in Scotland, Wales and Northern Ireland, where pay rises in small annual increments within each grade. Under the 2002 system, if it takes you an extra year to complete a grade, your salary still goes up. If you then move to the next grade, you are placed on the next most favourable pay point so you never take a pay cut.

Additional Hours, Night Pay and Weekend Allowances

On top of basic salary, resident doctors in England receive several additional payments:

Additional hours: Any hours worked beyond 40 per week are paid at 1/40th of your basic weekly pay per hour.
Night enhancement: A 37% uplift on your hourly rate for hours worked between 9pm and 7am.
Weekend allowance: Between 3% and 15% of your basic salary, depending on how often you work weekends (from 1 in 8 weekends up to 1 in 2 weekends).
On-call allowance: A flat-rate payment based on your nodal point, ranging from £2,930 (FY1) to £5,634 (ST6–ST8).

In the devolved nations, the 2002 contract uses a “banding” system instead. Your total pay is calculated by multiplying your basic salary by a banding multiplier — ranging from 1.2 for the lightest on-call commitment up to 2.0 for the heaviest and most antisocial rotas. This means some doctors in Scotland, Wales or Northern Ireland with demanding rotas can earn nearly double their basic salary.

An exception reporting system allows doctors in England to flag when they are working beyond their agreed hours, making sure they are paid fairly.

Flexible Pay Premia for Hard-to-Fill Specialties

Doctors training in certain specialties that struggle to recruit receive an extra annual payment called a flexible pay premium:

Specialty	Annual Premium
General Practice (GP training)	£10,691
Emergency Medicine (ST4+)	£8,693
Histopathology	£5,216
Psychiatry (core training)	£4,347
Psychiatry (higher training)	£3,260
Oral & Maxillofacial Surgery	£3,260–£6,520

Doctors training less than full time (LTFT) also receive an annual allowance of £1,000, or £1,500 under older transitional arrangements.

London Weighting and Regional Allowances

NHS staff working in London and surrounding areas receive a High Cost Area Supplement (HCAS), commonly known as London weighting:

Zone	Amount (2025/26)
Inner London	20% of basic salary (min £5,609, max £8,466)
Outer London	15% of basic salary (min £4,714, max £5,941)
Fringe	5% of basic salary (min £1,303, max £2,198)

Note: these are the Agenda for Change rates. Doctors on medical and dental contracts may receive different geographical allowances. For resident doctors in England, UCL reports allowances of around £5,197 for those at nodal points 1–3 and £4,678 from nodal point 4 onwards.

London weighting does not apply in Scotland, Wales or Northern Ireland.

NHS Pension for Doctors

One of the most valuable parts of an NHS doctor’s package is the NHS Pension Scheme. Employee contribution rates for 2025/26 are tiered based on your salary:

Pensionable Pay	Contribution Rate
Up to £13,259	5.2%
£13,260–£27,797	6.5%
£27,798–£33,868	8.3%
£33,869–£50,845	9.8%
£50,846–£65,190	10.7%
£65,191 and above	12.5%

What many doctors do not realise is that their employer contributes a further 23.2% on top. This employer contribution does not come out of your salary — it is paid separately by the NHS. When you factor this in, the pension is worth an estimated 20% or more in additional “hidden” compensation beyond your take-home pay.

The current scheme (2015 NHS Pension Scheme) is a career-average revalued earnings (CARE) scheme, meaning your pension is based on the average of your earnings throughout your career, not just your final salary.

NHS Doctor Salary by UK Nation

Pay for NHS doctors differs across the four UK nations because of separate contracts, devolved health policy and independent pay negotiations.

Doctor Salary in England

England uses the 2016 contract for resident doctors with nodal points and the 2003 contract for consultants. Basic pay is generally the highest in England for FY1 and registrar grades. However, non-basic pay as a proportion of total earnings is lower in England than in the devolved nations.

Doctor Salary in Scotland

Scotland still uses the 2002 contract for resident doctors and the 2004 contract for consultants. The standout difference is that non-basic pay in Scotland averages a remarkable 84% on top of basic salary for resident doctors. This means that while basic salaries may appear lower, total earnings in Scotland are often significantly higher. In 2023/24, average total earnings for resident doctors in Scotland reached £80,322.

Doctor Salary in Wales

Wales also uses the 2002 contract and offers non-basic pay worth 32–44% of total earnings for resident doctors. Consultant pay progression in Wales is notably faster in the early years than in any other UK nation. Wales also has the highest salaried GP pay range, with a maximum of £119,394.

Doctor Salary in Northern Ireland

Northern Ireland uses the 2002 contract with non-basic pay making up 47–62% of total resident doctor earnings. GP partner earnings in Northern Ireland are the lowest of the four nations, coming in about 23% below England.

Comparing basic salaries alone can be misleading. Because the devolved nations have different contractual terms for additional hours, on-call and antisocial hours pay, total earnings can be quite different from what the basic pay tables suggest.

How NHS Doctor Pay Compares

NHS Doctor Salary vs UK Average Wage

The UK median full-time salary is about £34,963. Here is where NHS doctors sit on the earnings scale:

FY1 doctors earn above the median but below the mean average wage.
Specialty registrars earn more than roughly 89–90% of all UK workers.
GP partners and consultants sit between the 98th and 99th percentile — earning more than about 98 in every 100 workers.

However, these figures need context. Doctors train for a minimum of ten years after school (five years of medical school plus at least five years of postgraduate training). Many accumulate student debt of £100,000 or more. Graduate outcome data shows that medical and dentistry graduates have the highest earnings of any subject group one year after graduation, with a median of £39,100.

Has Doctor Pay Kept Up With Inflation?

Despite the recent pay rises, the Nuffield Trust estimates that real-terms earnings for resident doctors in 2025/26 are still between 4% and 10% below 2010/11 levels, after adjusting for inflation using the Consumer Price Index (CPI).

That said, the picture has improved markedly since 2023/24. The 30% cumulative increase in basic pay since 2022/23 has begun to close the gap. Looking further back to the 1990s and early 2000s, the long-term trend shows alternating periods of real-terms growth followed by sustained real-terms erosion.

It is worth noting that the majority of current resident doctors started their medical degrees after 2012, so the 2010/11 baseline predates their careers.

Highest-Paid Doctor Specialties in the UK

All NHS consultants earn the same basic salary regardless of their specialty. The difference in total income comes from three main factors: private practice, clinical impact awards and additional programmed activities.

The specialties with the highest overall earning potential tend to be:

• Neurosurgery — limited supply of specialists, high private demand

• Cardiology — significant private practice opportunity

• Orthopaedic surgery — one of the largest private practice markets

• Ophthalmology — high volume of private cataract and laser eye surgery

• Radiology — growing demand and locum premium rates

• Dermatology — strong private practice with cosmetic work

Some consultants in these specialties earn well above £200,000 per year when private practice income is included. Locum consultant rates can also be significantly higher than standard NHS pay for short-term work.

Other NHS Doctor Pay Scales

Medical Academic Salary (Clinical Lecturers)

Medical academics are doctors employed by universities and research organisations. Clinical lecturers on the 2009 contract earn between £45,925 and £85,046 in England for 2025/26, depending on their position on the 12-point scale. Pay varies slightly across the four nations, with Wales generally offering the highest rates for clinical lecturers.

Armed Forces Doctor Salary

Doctors in the Defence Medical Services (DMS) often take home more than their NHS counterparts, particularly at junior levels. This is because armed forces doctors pay no pension contributions and receive “X-factor” payments — a pensionable addition recognising the unique conditions of military service.

Grade	DMS Take-Home	NHS Take-Home
Foundation Doctor (FY1)	£34,807	£27,228
Foundation Doctor (FY2)	£43,782	£31,792
Specialty Trainee (starting)	£44,773	£39,605
Specialty Trainee (max)	£56,587	£47,994
Consultant (starting)	£58,691	£67,174
Consultant (max)	£80,210	£76,530

At the consultant level, NHS pay overtakes the DMS for the starting grade, though the armed forces catch up at the maximum point. The Defence Clinical Impact Awards (DCIA) have replaced the older clinical excellence awards in the military.

Frequently Asked Questions

How much does a junior doctor earn in the UK?

A first-year junior doctor (FY1) in England earns a basic salary of £38,831 for 2025/26. With additional payments for nights, weekends and extra hours, total NHS earnings reach roughly £45,900. By the time you reach ST6–ST8 registrar level, basic pay is £73,992 and total earnings average around £87,400.

What is a GP’s salary in the UK?

Salaried GPs in England earn between £76,038 and £114,743 for 2025/26. GP partners — who are self-employed and draw income from practice profits — earn significantly more. The latest available data (2022/23) put average GP partner earnings at £140,200 across all working patterns, or roughly £163,500 when adjusted for full-time equivalent working.

Can doctors earn £200,000 in the UK?

Yes. A senior NHS consultant earning £145,478 in basic pay, with additional programmed activities, a Clinical Impact Award and private practice income, can comfortably exceed £200,000 in total annual earnings. This is most common in surgical specialties and other fields with strong private practice demand.

What band is a junior doctor?

Doctors are not on the Agenda for Change (AfC) banding system. AfC bands (1 to 9) apply to nurses, allied health professionals and other NHS staff. Doctors have their own separate pay structure based on nodal points (for the 2016 contract) or annual increments (for the 2002 contract). So when someone asks, “What band is a doctor?” the answer is: they are not in any band at all.

Which doctor is the highest paid in the UK?

In terms of NHS basic salary, all consultants earn the same regardless of speciality — from £109,725 to £145,478. However, when you include private practice, the highest earners tend to be consultant neurosurgeons, orthopaedic surgeons, cardiologists, ophthalmologists and dermatologists. Some earn well over £200,000 per year in total.

How much do NHS doctors earn per hour?

Based on basic salary and a 48-hour working week, FY1 doctors earn about £15.56 per hour. For a speciality registrar at ST6–ST8 level, the basic hourly rate is around £29.64. When total earnings (including supplements) are considered, a consultant’s effective hourly rate averages about £64.74 based on a 48-hour week.

Do junior doctors get paid for overtime?

Yes. Under the 2016 contract in England, any hours worked beyond 40 per week are paid at the standard hourly rate (1/40th of your weekly basic pay). Night hours between 9 pm and 7 am receive a 37% enhancement on top. If you feel you are regularly working beyond your scheduled hours, you can use the exception reporting system to ensure fair pay.

How does an NHS doctor’s pay compare to other countries?

UK doctors generally earn less than their counterparts in the United States, where physician salaries are substantially higher. However, UK pay is broadly comparable to that of doctors in other European countries and Australia. The NHS Pension — with its 23.2% employer contribution — partially offsets the gap, as do lower medical school fees compared to the US. Many UK-trained doctors emigrate for higher salaries, which is one factor behind NHS workforce challenges.