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How the NHS will calculate your salary

  • November 07, 2022

As a doctor, there are several factors that will determine how the NHS will calculate your salary. Your contract will tell you which pay scale the NHS have given and this is the framework to start calculating from. Your years of NHS experience or grade as a doctor in the NHS will then determine your basic salary. Finally, your rota and out of hours work will determine your uplifts, enhacements, banding or additional programmed activities (PAs) to give you a total salary package.

Each NHS pay scale is slightly differently so even if you have the same qualifications and the same amount of experience as a doctor working at a different NHS hospital, your salary, pay scale and pay enhancements may vary. That said, a higher salary is not always better in the NHS and you should consider the hours you’ll be required to work for your total salary package. In this blog post we explore the different factors that impact your salary, payscales and how the NHS calculate your total take-home salary for each different contract.

2016 NHS Junior Doctor Pay Scale  

Basic Salary

It’s important to note that 2016 Junior Doctor pay scale uses your grade as a doctor (assigned as a nodal point) rather than your years of experience as a doctor to calculate your basic salary. The increments between salaries on this pay scale are much larger but less frequent. For that reason, if you have lots of experience as a doctor this might put you at a disadvantage on basic salary, however don’t forget your uplifts…

+ Pay for Additional Hours

If you work more than 40 hours per week in your NHS Trust, you’ll be paid accordingly at 1/40th of your basic salary per additional hour worked

+ Pay for Enhanced Hours

Any hours you work between 21:00 and 07:00 on weekdays will be paid at 37% above your hourly basic NHS salary pay (i.e. 37% more than 1/40th of your total basic salary)

+ Pay for Weekend Allowance

If you work shifts that start on Saturdays or Sundays on 1 in 8 weekends or more at your NHS Trust then you’ll be awarded an uplift in pay between 3% and 15% depending on frequency. You can find your exact percentage here

+ On Call Allowance

Finally, if your NHS rota includes an on-call commitment of any frequency, you’ll receive a set uplift above your basic salary determined by your grade and nodal point. You can find your on-call uplift here

Total Salary = Basic Salary + Additional Hours + Enhanced Hours + Weekend Allowance + On Call Allowance

As you can see, one of the key advantages for NHS doctors on this pay scale is that it is fair and your total salary package is paid according to the hours that you work and the type of hours. Whilst this might not favour those doctors who wish to have many years of NHS or non-NHS experience to be recognised, it does ensure you are paid equitably for the hours you work. This is also the main pay scale for NHS Junior Doctors since 2016 and we see less and less use of the previous NHS Junior Doctors pay scale from 2002 as the years go on.


2002 NHS Junior Doctor Pay Scale

Basic Salary

Within this pay scale, your basic salary will be calculated based on your years of experience at the grade on offer. The NHS are likely to only consider experience relevant to the grade of post on offer (e.g. they won’t recognize internship or foundation level doctor (FY1 / FY2) experience for a registrar level post (ST3+ or senior clinical fellow for example)) and will want to see references or experience certificates to back this up.

+ Banding

A standard working week in the UK consists of 40 hours so you’ll be rewarded for working beyond that number. There are a number of ‘bands’ available however UK employment law guides a maximum 48 hour working week so the commonly used bands are 1A (40-48 hours, most antisocial) or 1B (40-48 hours, moderately antisocial). For 1A you’ll receive a 50% uplift on your basic salary and for 1B it will be a 40% uplift above your basic salary.

Total Salary = Basic Salary + (% banding supplement x Basic Bay)


2021 NHS Speciality Doctor Pay Scale

Basic Salary

The 2021 NHS Speciality Doctor Pay Scale is a wide ranging pay scale as it covers all equivalent grades from ST3 level through to Consultant with a possible 18 annual increments along the way to maximum basic salary. Correspondingly, your basic salary will be calculated based on years of experience as a doctor at an equivalent grade. The NHS 2021 Speciality Doctor pay scale does not acknowledge internship, foundation or core training level work so, whilst some Trusts may consider it, you should expect your first four years experience as a doctor to be excluded from calculations (FY1, FY2, CT1, CT2, ST1, ST2).

+ Additional PA’s

A programmed activity (PA) is a 4 hour section of work so a normal week (40 hours) contains 10 PAs on the NHS Speciality Doctor pay scale and each additional PA carries a 10% uplift on basic salary (e.g. 48 hours would be denoted as 12 PAs therefore 20% on top of your basic salary)

Total Salary = Basic Salary + Additional PA’s

2021 NHS Specialist Doctor Pay Scale

Basic Salary

Since the 2021 NHS Specialist Doctor pay scale is a new pay scale, most new entrants will start at the beginning of the pay scale and work their way through. That said, the pay scale does recognise years of experience in calculating basic salary. The 2021 NHS Specialist Doctor pay scale is open to very senior speciality doctors you will be expected to evidence a similar level of experience from a non-NHS setting if you wish to start higher than the start of the pay scale

+ Additional PA’s

As with the 2021 NHS Speciality Doctor pay scale, a programmed activity (PA) is a 4 hour section of work so a normal week (40 hours) contains 10 PAs for your basic salary on the pay scale and each additional PA carries a 10% uplift on basic salary (e.g. 48 hours would be denoted as 12 PAs therefore 20% on top of your basic salary)

+ On Call Allowance

Should your rota include an on-call element at your NHS Trust then this will also attract a percentage supplement between 1% and 8% on top of your basic salary which is determined by two things – the frequency and the type (physical onsite attendance or telephone based)

Total Salary = Basic Salary + Additional PA’s + On Call Allowance


NHS Consultant Pay Scale

Basic Salary

In exactly the same way as the 2021 NHS Speciality Doctor pay scale and 2021 Specialist Doctor pay scale, Consultant pay scales are also calculated based on your years of experience as a doctor. That said, the Consultant pay scale only acknowledges years of experience held as a Consultant level doctor and you’ll be expected to evidence that experience, particularly if you’re coming from a non-NHS setting.

Additional PA’s

Again, additional PA’s (each PA being worth 4 hours) are used to calculate any additional hours on your Consultant pay scale and therefore any uplift on basic salary. A 10 PA contract is basic salary alone and each additional PA carries a 10% uplift on basic salary (e.g. 48 hours would be denoted at 12 PAs therefore 20% on top of basic salary)

Total Salary = Basic Salary + Additional PA’s 


Summary

We hope this article has helped you to figure out how your NHS salary is calculated. In conclusion, here are the things to look out for:

  • Which NHS pay scale are you being offered or working on?
  • Do you need to think about your grade as a doctor or years of experience as a doctor when calculating basic salary?
  • What additional hours are your NHS Trust asking you to work and how will these be reflected in your salary according to the pay scale?
  • How does all of the above add up to give you your total salary?

Has this been helpful?

Thanks so much for reading and if you’d like to ask us a question or get in touch then we’re always available on email via [email protected] or on any of our social channels. If you enjoyed this article, then you might like to learn more about NHS Payscales Explained and How much tax do Doctors pay in the UK?

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