What is the take-home pay for an NHS Band 5 Top in 2026/27?

An NHS Band 5 on the top step has a basic salary of £39,043. After the Tier 4 · 9.8% NHS pension contribution (£3,826), £4,529 PAYE income tax and £2,118 Class 1 National Insurance, the net take-home is £28,570 per year — £2,380.80 per month.

How much more does Band 5 earn with London weighting?

On top of the £39,043 basic, Inner London adds a £7,809 HCAS supplement (20%, clamped to the statutory floor/cap) and Outer London adds £5,856 (15%). That lifts the monthly take-home to £2,798 (Inner) and £2,694 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 5 Top?

At a pensionable gross of £39,043, an NHS Band 5 Top falls in Tier 4 · 9.8%. 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 5 top step.

Penny-accurate take-home for an NHS Band 5 on the top step — basic pay of £39,043, the cliff-edge Tier 4 · 9.8% 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): £39,043
Net monthly: £2,381
Effective rate: 26.8%

National

No HCAS supplement

Monthly take-home

£2,381

Annual take-home: £28,570
Pensionable gross: £39,043
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£2,694

Annual take-home: £32,327
Pensionable gross: £44,899
HCAS supplement: +£5,856

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£2,798

Annual take-home: £33,580
Pensionable gross: £46,852
HCAS supplement: +£7,809

Deduction stack · NHS Band 5 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	£39,043	£44,899	£46,852
HCAS supplement	£0	£5,856	£7,809
NHS pension	£3,826	£4,400	£4,591
Income tax (PAYE)	£4,529	£5,586	£5,938
National Insurance	£2,118	£2,586	£2,743
Annual take-home	£28,570	£32,327	£33,580
Monthly take-home	£2,381	£2,694	£2,798

Reference · 2026/27 FROZEN

The Tier 4 · 9.8% NHS pension and HMRC thresholds driving the national column above.

Basic salary £39,043
NHS pension tier Tier 4 · 9.8%
Pension contribution £3,826
Inner London HCAS £7,809
Outer London HCAS £5,856
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.