NHS Pension Scheme

Most NHS employees in England and Wales are enrolled in the NHS Pension Scheme, administered by NHS Pensions at the NHS Business Services Authority (NHSBSA). New members join the 2015 Scheme, which NHSBSA describes as a Career Average Revalued Earnings (CARE) scheme, a form of defined benefit pension. Each scheme year, a slice of pension is built up based on your actual pensionable pay that year, and that amount is increased every year until you retire or leave. NHSBSA says the revaluation rate is set by HM Treasury and is currently the Consumer Prices Index plus 1.5%.

Scotland has its own NHS pension scheme with its own contribution tiers.

NHSBSA says that if you are eligible when you start work, your employer enrols you, and eligibility covers employees aged 16 to 75. It also says people on a work visa can join while working for the NHS or another employer that offers the Scheme. That includes nurses, doctors and allied health professionals on a Health and Care Worker visa. If you opt out, you also give up the employer contribution described below.

NHSBSA adds that people working under a contract for services, such as GPs, general dental practitioners and ophthalmic medical practitioners, can also be eligible, and that the maximum age for joining or rejoining is 75.

NHS Employers sets out these member rates from 1 April 2026, based on your actual annual pensionable pay:

• up to £13,259: 5.2%
• £13,260 to £28,854: 6.5%
• £28,855 to £35,155: 8.3%
• £35,156 to £52,778: 9.8%
• £52,779 to £67,668: 10.7%
• £67,669 and above: 12.5%

Employers pay 23.7% of pensionable pay on top. The high cost area supplement is pensionable under the NHS terms and conditions. Our NHS take-home pay calculator includes the pension deduction.

Why did the tiers not move with the 2026/27 pay rise? NHS Employers explains that the pay thresholds were increased by CPI of 3.8% on 1 April 2026, and because the Agenda for Change award of 3.3% was lower, there will be no further change to the thresholds in 2026/27.

NHS Pensions' refund form (RF12) says you can have a refund of your contributions if your total membership is less than two years, counting all sections of the Scheme. Income tax at 20% is deducted on refunds up to £20,000, and refunds can be paid to an overseas bank. You cannot claim while you continue pensionable NHS work, including bank shifts, without a break of at least 24 hours. With two years or more, a refund is not available, so ask NHS Pensions about your options before you leave.

• Opting out to boost take-home pay and losing the 23.7% employer contribution.
• Expecting a refund after two years' membership. The refund rule applies only below two years.
• Not checking your tier after a pay rise or extra hours.

See our NHS doctor salary guide and nurse salary comparison.