Profession · 2026/27
Senior NHS Consultant Salary 2026/27
Consultant is the senior career grade post-CCT. NHS England 2024/25 pay range £105,504–£139,882, with progression across 8 thresholds over 19 years. London, private practice and Clinical Excellence Awards add substantially.
Typical pay & take-home
- Median gross
- £120,000
- Typical range
- £105,000–£180,000
- Take-home at median
- £76,157
England, no pension applied — use the salary calculator for your scheme.
At the median for this profession, you earn about 221% above the UK full-time median (£37,430), placing you in the top 5% of UK earners.
What influences senior nhs consultant pay
NHS Consultant basic pay (England 2024/25) sits at £105,504 at appointment, progressing through thresholds every 3–5 years to £139,882 after 19 years. Scotland and Wales have their own slightly different scales.
Many consultants supplement NHS pay with private practice — under an honorary NHS contract with agreed arrangements, this can add £50k to £300k+ for in-demand specialties (orthopaedics, plastics, ophthalmology). This is self-employment income, subject to Class 4 NI and requires Self Assessment.
Clinical Excellence Awards (CEA / local CEA) add £3k–£80k per year at senior consultant level. Abolished for new consultants in England from 2018 onwards but retained at lower rates for existing holders.
Career progression
- Consultant entry: £105,504 England.
- Consultant top: £139,882 (after 19 years progression).
- Associate Medical Director / Clinical Lead: £140-170k with added responsibilities.
- Medical Director / CMO track: £160-230k.
Frequently asked questions
- Does the 60% effective marginal rate hit consultants?
- Yes, and it's a significant issue. Consultants in the £100k–£125,140 PA-taper band face 60% effective marginal rates on top of NHS pension contributions (~14.5% at this salary tier). Many consultants use salary sacrifice into pension AVCs or reduce sessions to manage this.
- How is private practice income taxed?
- Self-employment — you declare it on Self Assessment, pay Income Tax at marginal rate plus Class 4 NI (6% £12,570–£50,270, 2% above). You can deduct allowable business expenses (indemnity, equipment, accounting). Incorporating as Ltd is common for high-volume consultants but requires careful IR35/Ltd company compliance.