The NHS is the fifth largest employer in the world and employs roughly 1.5 million people in the UK. Medical practitioners are also in the top five highest paid professions within the UK.
The NHS is at the heart of the UK and thus their doctors are rewarded for their hard work with an extremely competitive wage. Here is what you can expect to earn at various stages of your career:
Doctors salary range
Pay for almost all directly-employed NHS staff is subject to annual analysis and recommendation by one of three pay review bodies. These recommendations are laid before Parliament, but the Government will always make the final decision on pay arrangements.
There have been significant contractual changes for NHS employees in recent years and in this article, we are going to explore the NHS pay scales for each stage of your career.
Junior Doctor Contract
From August 2016, the Department of Health re-wrote the employment contracts for all new doctors starting in England. The new contract applies to all doctors below consultant level. So, although it is referred to as the “junior doctor” contract, this is misleading because the changes will affect experienced and senior doctors too, such as registrars.
The Banding System
Since December 2000, junior doctors in the UK are employed under a contract based on pay bands. This contract was designed to reduce the previously excessive number of hours that junior doctors worked in the NHS.
Full-time junior doctors’ pay consists of a basic salary for the standard 40 hours worked in a week, plus a variable supplement to reflect how many more hours are being worked on average, the type of working pattern, the frequency of extra duty and the antisocial nature of the working arrangements. This is also known as on-call or uplifts.
Your contracted hours will be set out in your job description attached to the contract agreed in advance between yourself and your Trust. The basic salary for each grade is set on incremental scale and under normal circumstances you will be paid at the minimum incremental point on appointment to a new grade.
The bands can be summarised as such:
Salary supplement as a percentage of basic salary
For those working more than 56 hours per week on average or not achieving the required rest
For those working between 48 to 56 hours per week on average, most antisocially
For those working between 48 and 56 hours per week on average, least antisocially
For those working 40 to 48 hours per week on average, most antisocially
For those working between 40 and 48 hours per week on average, moderately antisocially
For those working between 40 to 48 hours per week on average, least antisocially
For those working no more than 40 hours per week on average, between 7am and 7pm
Speciality Doctors and Consultants
A speciality doctor and Consultant doctors contract is based upon a full-time work commitment of 10 Programmed Activities (Pas) per week.
One PA has the value of four hours of work. Unless it has been mutually agreed between the Consultant or speciality doctor and the Trust to undertake the work in premium time, in which case each PA equates to 3 hours. Premium time is classified as any time that falls outside the hours of 7am to 7pm Monday to Friday and any time at the weekend or on a public holiday.
Please note that depending on your speciality, as a Speciality Doctor, you will be expected to take up extra PAs. Typically, this is an additional two so you will end up working 48 hours a week instead of your contracted 40. This however, is advantageous as the extra hours will be reflected in your salary.
Additional Programmed Activities (APAs) / On-call
Extra programmed activities are referred to as Additional Programmed Activities (APAs) and these may be either academic or clinical.
To calculate the value of an additional programmed activity will depend on:
Your pay threshold, and,
Whether you hold discretionary points, a distinction award or a clinical excellence award
If you do NOT hold a discretionary point, distinction award or clinical excellence award, perform the following calculation:
Take the value of your basic full-time pay (no other payments should be added) and divide this payment by 10.
E.g. Basic salary of £69,991 per annum / 10 = APA allowance of £6,999 per annum (per APA undertaken)
Click here for access to the NHS Pay Circular which informs NHS employers of changes to the Terms and Conditions for doctors.
Understanding UK tax
Each UK citizen has a “personal allowance” which denotes the amount we can earn without paying any income tax. If you earn more than your personal allowance, then you pay tax at the applicable rate on all earnings above the personal allowance, but the allowance remains untaxed.
What is my personal allowance?
£100,000 to £123,700
Decreased from £11,850 by £1 for every £2 you earn, until it reaches £0
What income tax band am I in?
Once you know your personal allowance, anything extra earned will be subject to income tax. For 2018/19 tax year, if you live in England, Wales or Northern Ireland, there are three marginal income tax bands – at the 20% basic rate, the 40% higher rate and the 45% additional rate bracket (remember your personal allowance starts to shrink once earnings hit £100,000).
If you live in Scotland, there are five marginal income tax bands from the 2018/19 tax year - the starter rate of 19%, the 20% basic rate, the 21% intermediate rate, the 41% higher rate, and the 46% additional rate.
Earnings (England, Wales or NI)
Under your personal allowance
For most, £11,850
No income tax payable
Between PA and PA+£34,500 (basic rate)
For most, £11,850 to £46,350
Between PA+£34,500 and £150,000 (higher rate)
For most, £46,350 to £150,000
Over £150,000 (additional rate)
Example monthly take home for a doctor’s salary
Salary after tax
Monthly take home
To work out your monthly take home for your specific salary please visit this site.
You should also note that there is a further opportunity to increase your salary either through Bank Staff work or agency Locum work. Please visit our article on this matter for further information.
If you are an IMG who is interested in relocating to the UK and working within the NHS send your CV to firstname.lastname@example.org and we will be happy to help you.
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