What is the take-home pay for an NHS Band 8a Top in 2026/27?

An NHS Band 8a on the top step has a basic salary of £64,750. After the Tier 5 · 10.7% NHS pension contribution (£6,928), £10,561 PAYE income tax and £3,306 Class 1 National Insurance, the net take-home is £43,955 per year — £3,662.95 per month.

How much more does Band 8a earn with London weighting?

On top of the £64,750 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 £3,973 (Inner) and £3,863 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 8a Top?

At a pensionable gross of £64,750, an NHS Band 8a 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 8a top step.

Penny-accurate take-home for an NHS Band 8a on the top step — basic pay of £64,750, 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): £64,750
Net monthly: £3,663
Effective rate: 32.1%

National

No HCAS supplement

Monthly take-home

£3,663

Annual take-home: £43,955
Pensionable gross: £64,750
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£3,863

Annual take-home: £46,355
Pensionable gross: £70,887
HCAS supplement: +£6,137

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£3,973

Annual take-home: £47,673
Pensionable gross: £73,496
HCAS supplement: +£8,746

Deduction stack · NHS Band 8a 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	£64,750	£70,887	£73,496
HCAS supplement	£0	£6,137	£8,746
NHS pension	£6,928	£8,861	£9,187
Income tax (PAYE)	£10,561	£12,242	£13,156
National Insurance	£3,306	£3,428	£3,481
Annual take-home	£43,955	£46,355	£47,673
Monthly take-home	£3,663	£3,863	£3,973

Reference · 2026/27 FROZEN

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

Basic salary £64,750
NHS pension tier Tier 5 · 10.7%
Pension contribution £6,928
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.