Senior NHS Consultant Salary 2026/27
Consultant is the senior career grade after CCT. Basic pay in England under the 2003 contract runs from £113,565 at appointment to £150,569 at the top, across five thresholds reached over 14 years as a consultant. The scale carries the 3.5% DDRB award accepted from 1 April 2026.
Typical pay & take-home
- Median gross
- £123,672
- Typical range
- £113,565–£150,569
- Take-home at median
- £77,553 England, no pension applied — use the salary calculator for your scheme.
At the median for this profession, you earn about 217% above the UK full-time median (£39,039), placing you in the top 5% of UK earners.
See exact take-home for £123,672 →
Nodal points, SAS scales, the five consultant thresholds and the salaried GP range, each with take-home after the banded NHS pension: Doctors' pay scales 2026/27, every grade →
What influences senior nhs consultant pay
Basic pay progresses by threshold rather than annually: £113,565 for the first three years, £120,249 at threshold 2a, £123,672 at 2b, £135,645 at threshold 3 from eight years, and £150,569 at threshold 4 from fourteen years. Scotland, Wales and Northern Ireland set their own consultant scales.
Private practice alongside an NHS contract is self-employment income. It goes on Self Assessment, carries Class 4 National Insurance at 6% between £12,570 and £50,270 and 2% above, and allowable expenses such as indemnity and equipment can be deducted.
Two different award schemes get conflated here. National Clinical Impact Awards are open - the 2026 round ran from 1 April to 20 May - and their values were increased to align with the 2025 DDRB recommendation, backdated to 1 April 2025. It is the older local Clinical Excellence Awards and their predecessors that are closed to new applicants and frozen in cash terms.
Career progression
- Consultant appointment (threshold 1): £113,565.
- Threshold 2a, after 3 years: £120,249.
- Threshold 2b, after 4 years: £123,672.
- Threshold 3, after 8 years: £135,645.
- Threshold 4, after 14 years: £150,569.
Frequently asked questions
- Does the 60% effective marginal rate hit consultants?
- Not immediately on appointment. The NHS pension is a net pay arrangement, so the 12.5% contribution comes off before adjusted net income is measured: £113,565 gross leaves about £99,369, just under the £100,000 point where the personal allowance starts tapering. From threshold 2a upwards the taper does bite, and between £100,000 and £125,140 the effective marginal rate is 62% once the 2% National Insurance band is included.
- 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.