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

An NHS Band 8c on the top step has a basic salary of £91,609. After the Tier 6 · 12.5% NHS pension contribution (£11,451), £19,495 PAYE income tax and £3,843 Class 1 National Insurance, the net take-home is £56,820 per year — £4,735.00 per month.

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

On top of the £91,609 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 £5,103 (Inner) and £4,993 (Outer) respectively — though a larger HCAS can push pensionable pay into a higher cliff-edge pension tier.

Which NHS pension tier applies to Band 8c Top?

At a pensionable gross of £91,609, an NHS Band 8c Top falls in Tier 6 · 12.5%. 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 8c top step.

Penny-accurate take-home for an NHS Band 8c on the top step — basic pay of £91,609, the cliff-edge Tier 6 · 12.5% 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): £91,609
Net monthly: £4,735
Effective rate: 38.0%

National

No HCAS supplement

Monthly take-home

£4,735

Annual take-home: £56,820
Pensionable gross: £91,609
HCAS supplement: —

Outer London

15% HCAS · floor / cap clamped

Monthly take-home

£4,993

Annual take-home: £59,919
Pensionable gross: £97,746
HCAS supplement: +£6,137

Inner London

20% HCAS · floor / cap clamped

Monthly take-home

£5,103

Annual take-home: £61,237
Pensionable gross: £100,355
HCAS supplement: +£8,746

Deduction stack · NHS Band 8c 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	£91,609	£97,746	£100,355
HCAS supplement	£0	£6,137	£8,746
NHS pension	£11,451	£12,218	£12,544
Income tax (PAYE)	£19,495	£21,643	£22,556
National Insurance	£3,843	£3,966	£4,018
Annual take-home	£56,820	£59,919	£61,237
Monthly take-home	£4,735	£4,993	£5,103

Reference · 2026/27 FROZEN

The Tier 6 · 12.5% NHS pension and HMRC thresholds driving the national column above.

Basic salary £91,609
NHS pension tier Tier 6 · 12.5%
Pension contribution £11,451
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.