What is the take-home pay for an NHS Band 7 Top in 2026/27?

An NHS Band 7 on the top step has a basic salary of £56,515. After the Tier 5 · 10.7% NHS pension contribution (£6,047), £7,619 PAYE income tax and £3,141 Class 1 National Insurance, the net take-home is £39,708 per year — £3,308.99 per month.

How much more does Band 7 earn with London weighting?

On top of the £56,515 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 £3,685 (Inner) and £3,573 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 7 Top?

At a pensionable gross of £56,515, an NHS Band 7 Top falls in Tier 5 · 10.7%. 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 7 top step.

Penny-accurate take-home for an NHS Band 7 on the top step — basic pay of £56,515, the cliff-edge Tier 5 · 10.7% 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): £56,515
Net monthly: £3,309
Effective rate: 29.7%

National

No HCAS supplement

Monthly take-home

£3,309

Annual take-home: £39,708
Pensionable gross: £56,515
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£3,573

Annual take-home: £42,873
Pensionable gross: £62,652
HCAS supplement: +£6,137

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£3,685

Annual take-home: £44,219
Pensionable gross: £65,261
HCAS supplement: +£8,746

Deduction stack · NHS Band 7 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	£56,515	£62,652	£65,261
HCAS supplement	£0	£6,137	£8,746
NHS pension	£6,047	£6,704	£6,983
Income tax (PAYE)	£7,619	£9,811	£10,743
National Insurance	£3,141	£3,264	£3,316
Annual take-home	£39,708	£42,873	£44,219
Monthly take-home	£3,309	£3,573	£3,685

Reference · 2026/27 FROZEN

The Tier 5 · 10.7% NHS pension and HMRC thresholds driving the national column above.

Basic salary £56,515
NHS pension tier Tier 5 · 10.7%
Pension contribution £6,047
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.