NHS consultant salary 2026/27
Consultant pay in England from April 2026, what each threshold leaves after deductions, and how extra sessions and on-call change it.
Consultant pay thresholds
| Years as consultant | Threshold | Basic (10 PAs) | Take-home a month | With 11 PAs and 3% on-call |
|---|---|---|---|---|
| Years 0 to 2 | Threshold 1 | £113,565 | £5,659 | £6,076 |
| Year 3 | Threshold 2a | £120,249 | £5,853 | £6,283 |
| Years 4 to 7 | Threshold 2b | £123,672 | £5,947 | £6,390 |
| Years 8 to 13 | Threshold 3 | £135,645 | £6,277 | £6,874 |
| Year 14 onwards | Threshold 4 | £150,569 | £6,770 | £7,522 |
England, 2003 contract, NHS Pension member, tax code 1257L. Pay rises at each threshold after the set years of service.
The tax trap
Most consultants with extra sessions earn more than £100,000. Between £100,000 and £125,140 of taxable pay you lose your personal allowance, which works out at 60% tax on that slice. NHS Pension contributions come off first, which helps, and salary sacrifice can help further. Read more about the 60% tax trap.
What a year looks like in practice
A new consultant on £113,565 for 10 PAs takes home about £5,659 a month. Add one extra PA and a 3% on-call supplement and that rises to £6,076. At the top, £150,569 for 10 PAs takes home £6,770 a month, and with extra sessions and on-call £7,522.
The 3.5% award from April 2026 raised every threshold and was paid from June in secondary care. Consultants in England are in dispute with the government, with the BMA describing the award as a crushing blow after years of real terms pay erosion. See the 2026 pay rise for the timeline and specialty doctor salary for the grade below.
What a consultant does
Consultants are the senior doctors who lead a team and take final responsibility for their patients’ care. They train and supervise resident doctors and often lead services, research or teaching.
Job plans and PAs
Consultant work is agreed in a job plan made of programmed activities, each usually four hours. Full time is 10 PAs, typically split between direct clinical care, such as clinics, theatre and ward rounds, and supporting professional activities, such as teaching, audit and appraisal. Extra PAs are each paid at a tenth of basic pay.
On-call
Many consultants are on call from home. The on-call availability supplement is 1% to 8% of basic pay, depending on how often you are on call and how likely you are to be called in.
How to become one
You need a Certificate of Completion of Training and entry on the GMC specialist register, then you apply for consultant posts. Most doctors reach consultant level after around 8 to 10 years of training after medical school, longer if they work part time or take time out.
Common questions
How much does an NHS consultant earn?
£113,565 to £150,569 basic for 10 PAs in England from April 2026, depending on years as a consultant. A new consultant takes home about £5,659 a month on basic pay.
How many consultant pay thresholds are there?
Five on the 2003 contract: after 3, 4, 8 and 14 years as a consultant you move to a higher threshold.