NHS London weighting (high cost area supplement)

NHS staff on Agenda for Change who work in London and the surrounding area get a High Cost Area Supplement on top of basic pay. For 2026/27 it is 20% of basic pay in Inner London, 15% in Outer London and 5% in the fringe, but each zone has a minimum and a maximum payment. Low earners therefore get more than the percentage, and higher earners get a flat capped amount.

The 2026/27 rates

Zone	Percentage of basic pay	Minimum a year	Maximum a year
Inner London	20%	£5,794	£8,746
Outer London	15%	£4,870	£6,137
Fringe	5%	£1,346	£2,270

These are the figures NHS Employers published alongside the 2026/27 pay scales, after the 3.3% award from 1 April 2026. They are annual amounts for full-time staff.

How to work out your supplement

Take your basic annual pay and apply your zone’s percentage. If the result is below the minimum, you get the minimum. If it is above the maximum, you get the maximum. Otherwise you get the percentage.

That gives these break points for 2026/27, worked out from the rates above:

• Inner London: the minimum applies on basic pay below about £28,970, and the cap applies above about £43,730.
• Outer London: the minimum applies below about £32,467, and the cap applies above about £40,913.
• Fringe: the minimum applies below about £26,920, and the cap applies above £45,400.

A hypothetical example: say you are a band 5 nurse at the entry point of £32,073 in Inner London. Twenty per cent of that is £6,414.60, which is between the minimum and the cap, so your total is £38,488. In Outer London, 15% would be £4,810.95, which is below the £4,870 minimum, so you get the minimum and a total of £36,943. In the fringe, 5% comes to £1,603.65, giving £33,677. Those totals match the NHS Employers figures for band 5.

What it means band by band

At band 2 (£25,272) every zone pays the minimum. At band 6 and above, the cap starts to apply: in Outer London from the middle of band 6, and in all three zones from the top of band 6. Every point from band 7 upwards gets the full cap in every zone. A band 7 ward manager in Inner London receives £8,746 on top of basic pay, and so does a band 9 director.

The supplement is worth a much larger share of pay at the bottom of the scale than at the top. A band 2 worker in Inner London receives around 23% extra, and a band 9 manager less than 8%. The individual band guides show the totals, for example band 2, band 5 and band 7.

Which zone you are in

The NHS Terms and Conditions of Service Handbook defines the zones by the location of your workplace, not where you live. Inner London covers the central boroughs, Outer London the rest of Greater London, and the fringe a ring of named areas just outside it. Trusts with sites in more than one zone pay according to where you are based. The job advert usually states the supplement. If it does not, ask the recruiting manager or HR before you accept, because it changes the offer by thousands of pounds.

How other public sector jobs handle London

London pay works differently across the public sector. Teachers get no separate supplement. Instead there are four pay ranges, for the rest of England, the fringe, Outer London and Inner London. From September 2026, M1 is £34,069 outside London and £41,729 in Inner London, so the London element is built into the scale.

Council and school support staff on the NJC pay spine usually receive a London allowance set by their employer. Police officers have a London weighting that rose by 3.5% in 2026 along with pay. Civil Service departments set their own pay ranges, including for London.

The NHS approach is the most transparent of these: a published percentage with a floor and a ceiling, the same in every trust in the same zone. That makes it easy to compare offers from different NHS employers in London, as long as you know which zone each site falls in.

Part-time staff and other pay

If you work part time, the supplement is paid pro rata to your hours, in the same way as basic pay. It is listed separately on your payslip and paid every month along with your salary.

The supplement is separate from unsocial hours enhancements and from any recruitment and retention premium a trust may add for hard-to-fill posts.

For take-home pay, include the supplement in your gross figure in the take-home pay calculator. It is taxed in the same way as the rest of your salary. To compare NHS London pay with schools, councils or the Civil Service, the London weighting guide sets the different systems side by side, and public sector jobs in London lists the main employers.