What is the take-home pay for an NHS Band 6 Top in 2026/27?

An NHS Band 6 on the top step has a basic salary of £48,117. After the Tier 4 · 9.8% NHS pension contribution (£4,715), £6,166 PAYE income tax and £2,844 Class 1 National Insurance, the net take-home is £34,391 per year — £2,865.96 per month.

How much more does Band 6 earn with London weighting?

On top of the £48,117 basic, Inner London adds a £8,746 HCAS supplement (20%, clamped to the statutory floor/cap) and Outer London adds £6,137 (15%). That lifts the monthly take-home to £3,324 (Inner) and £3,181 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 6 Top?

At a pensionable gross of £48,117, an NHS Band 6 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 6 top step.

Penny-accurate take-home for an NHS Band 6 on the top step — basic pay of £48,117, 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): £48,117
Net monthly: £2,866
Effective rate: 28.5%

National

No HCAS supplement

Monthly take-home

£2,866

Annual take-home: £34,391
Pensionable gross: £48,117
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£3,181

Annual take-home: £38,177
Pensionable gross: £54,254
HCAS supplement: +£6,137

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£3,324

Annual take-home: £39,887
Pensionable gross: £56,863
HCAS supplement: +£8,746

Deduction stack · NHS Band 6 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	£48,117	£54,254	£56,863
HCAS supplement	£0	£6,137	£8,746
NHS pension	£4,715	£5,805	£6,084
Income tax (PAYE)	£6,166	£7,176	£7,743
National Insurance	£2,844	£3,096	£3,148
Annual take-home	£34,391	£38,177	£39,887
Monthly take-home	£2,866	£3,181	£3,324

Reference · 2026/27 FROZEN

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

Basic salary £48,117
NHS pension tier Tier 4 · 9.8%
Pension contribution £4,715
Inner London HCAS £8,746
Outer London HCAS £6,137
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.