What is the take-home pay for an NHS Band 3 Top in 2026/27?

An NHS Band 3 on the top step has a basic salary of £27,476. After the Tier 2 · 6.5% NHS pension contribution (£1,786), £2,624 PAYE income tax and £1,192 Class 1 National Insurance, the net take-home is £21,874 per year — £1,822.80 per month.

How much more does Band 3 earn with London weighting?

On top of the £27,476 basic, Inner London adds a £5,794 HCAS supplement (20%, clamped to the statutory floor/cap) and Outer London adds £4,870 (15%). That lifts the monthly take-home to £2,105 (Inner) and £2,055 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 3 Top?

At a pensionable gross of £27,476, an NHS Band 3 Top falls in Tier 2 · 6.5%. The NHS scheme is a Net Pay Arrangement, so the contribution is deducted before PAYE — granting immediate tax relief — while National Insurance is still charged on the full gross.

NHS · Agenda for Change · FY 2026/27 Calc-engine routed

NHS Band 3 top step.

Penny-accurate take-home for an NHS Band 3 on the top step — basic pay of £27,476, the cliff-edge Tier 2 · 6.5% NHS pension as a Net Pay Arrangement, and Inner / Outer London HCAS side by side.

Engine note · `computeNhsBreakdown()` — HCAS floor/cap clamp, cliff-edge pension on the whole gross, NI on full gross, PAYE on the post-pension base. Integer pence, no float drift.

Basic (national): £27,476
Net monthly: £1,823
Effective rate: 20.4%

National

No HCAS supplement

Monthly take-home

£1,823

Annual take-home: £21,874
Pensionable gross: £27,476
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£2,055

Annual take-home: £24,661
Pensionable gross: £32,346
HCAS supplement: +£4,870

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£2,105

Annual take-home: £25,265
Pensionable gross: £33,270
HCAS supplement: +£5,794

Deduction stack · NHS Band 3 Top

Standard tax code 1257L, no student loan. NHS pension is a Net Pay Arrangement (deducted before PAYE); NI is charged on the full pensionable gross. Layer pension tiers, HCAS and student loans live in the NHS calculator.

Line item	National	Outer London	Inner London
Pensionable gross	£27,476	£32,346	£33,270
HCAS supplement	£0	£4,870	£5,794
NHS pension	£1,786	£2,685	£2,761
Income tax (PAYE)	£2,624	£3,418	£3,588
National Insurance	£1,192	£1,582	£1,656
Annual take-home	£21,874	£24,661	£25,265
Monthly take-home	£1,823	£2,055	£2,105

Reference · 2026/27 FROZEN

The Tier 2 · 6.5% NHS pension and HMRC thresholds driving the national column above.

Basic salary £27,476
NHS pension tier Tier 2 · 6.5%
Pension contribution £1,786
Inner London HCAS £5,794
Outer London HCAS £4,870
Personal Allowance £12,570

Step through the pay grid

Adjacent steps in this band and the same step on neighbouring bands — plus the interactive tool for pension, HCAS and student-loan overlays.