Following years of intensive negotiations and industrial action, the 2026/27 financial year marks a pivotal point for doctors’ pay in the United Kingdom.
The Government’s acceptance of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) recommendations has introduced a headline 3.5% pay uplift, backdated to April 1, 2026.
This increase, combined with multi-year reform packages for resident doctors (formerly known as junior doctors), has significantly increased the baseline for hospital-based medical professionals across England, Scotland, Wales, and Northern Ireland.
The 2026 pay scales reflect the first full year of “nodal point reform.” This restructure aims to make pay rises more frequent and fairer as doctors progress through their training.
England Basic Pay Scales (2026/27)
| Grade / Training Level | Annual Basic Salary | Estimated Total Earnings* |
| Foundation Year 1 (FY1) | £41,226 | ~£48,500 |
| Foundation Year 2 (FY2) | £47,610 | ~£56,000 |
| Specialty Registrar (ST1–2) | £52,656 | ~£62,000 |
| Specialty Registrar (ST3–5) | £65,048 | ~£78,000 |
| Specialty Registrar (ST6–8) | £73,992 | ~£89,000 |
*Note on Total Earnings: These estimates include common supplements for “out-of-hours” work, weekend shifts, and the standard 48-hour working week (which adds roughly 20% to the basic 40-hour salary).
Consultants remain the highest-earning hospital doctors. In 2026, the starting salary for a new consultant in England has risen to £109,725.
Consultant Pay Progression (England 2026/27)
Starting Salary: £109,725
After 4 Years: £119,490
After 8 Years: £131,058
Senior (14+ Years): £145,478
Whilst these are basic figures, the average total NHS earnings for a full-time consultant are currently estimated at £161,600.
This includes additional programmed activities (PAs), on-call supplements, and a bonus system called Clinical Excellence Awards (CEAs; now largely transitioned to local performance-based schemes).
Specialist, Associate Specialist, and Specialty (SAS) doctors—those who are highly experienced but not in formal training or consultant roles—have also seen significant adjustments under the 2021 and 2026 contract reforms.
Specialty Doctors: £59,175 – £95,400
Specialists: £96,990 – £111,441
These roles are increasingly popular in 2026 as they offer a more predictable work-life balance compared to the high-intensity demands of consultant or training pathways.
While England often sets the benchmark, the devolved nations have distinct pay scales as of early 2026.
| Nation | FY1 Starting Pay (Basic) | Consultant Starting Pay (Basic) |
| England | £41,226 | £109,725 |
| Scotland | £34,500* | £111,430 |
| Wales | £33,307* | £110,240 |
| Northern Ireland | £29,566* | £106,424 |
*Note: Some devolved nations are still in active negotiations for 2026/27 “catch-up” awards; therefore, these base figures may be subject to backdated uplifts following local election outcomes.
The Locum Market: Demand for locum (temporary) doctors remains high. However, the 2026 “Locum Cap” policies implemented by many Integrated Care Boards (ICBs) have started to stabilise hourly rates, pushing more doctors toward permanent “bank” contracts.
Private Practice: Consultants in specialties like Ophthalmology, Orthopaedics, and Dermatology continue to augment their NHS income significantly—often by £50,000 to £150,000+—through private medical practice.
Pension Reform: Changes to the pension annual and lifetime allowances in previous years have reduced the “tax trap” for senior doctors, encouraging consultants to take on more additional shifts in 2026 than in the early 2020s.
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