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Tax guides

The NHS Pension Scheme Explained: A Complete 2026/27 Guide

The NHS Pension is a defined benefit scheme: you build a guaranteed pension based on your pay, not on investment returns. This guide explains the 1995, 2008 and 2015 sections, what you and your employer pay, how tax relief and the annual allowance work, and your retirement options.

How does the NHS Pension Scheme work?

The NHS Pension Scheme is a defined benefit pension. Since 1 October 2023, all active members build benefits in the 2015 Scheme, a career average scheme: each year you earn a slice of pension based on your pensionable pay, which is revalued every year. You pay a tiered contribution and your employer pays 23.7% of pensionable pay.

Fixed fees, specialist healthcare accountants, and every HMRC and NHS Pensions deadline handled.

  • Fixed monthly fee — no surprises
  • Specialist in NHS pension and healthcare tax
  • Onboarding within 48 hours
Get my fixed-fee quoteBook a free 15-min tax review
  • ICAEW & ACCA regulated
  • 5,000+ clients served by ACCOTAX
  • Specialist healthcare accountants

Reviewed by Waqas Sagar ACA FCCA FMAAT, Founder of ACCOTAX, 18+ years' experience · Last reviewed: 8 October 2026 · Updated for the 2026/27 tax year

Medical.Accountants by ACCOTAX, ICAEW/ACCA-regulated chartered accountants, London, serving clients across the UK. Over 5,000 clients served.

Key takeaways

  • Member contributions for 2026/27 range from 5.2% to 12.5% of pensionable pay.
  • Employers pay 23.7% of pensionable pay.
  • Contributions get tax relief at your highest rate of income tax.
  • Pension growth above the £60,000 annual allowance can create a tax charge.
NHS Pension sections compared
SectionTypeNormal pension age
1995 SectionFinal salary60 (55 for some special classes)
2008 SectionFinal salary65
2015 SchemeCareer average (CARE)Your State Pension age, or 65 if later

How to check your NHS Pension statement

  1. Log in to Total Reward Statements or My NHS Pension through NHSBSA.
  2. Check your membership dates, section and pensionable pay for each year.
  3. Compare the pension input amount with the £60,000 annual allowance.
  4. Report any mistakes to your employer or NHS Pensions, and send the figures to your accountant.

Free guide: The Doctor's Tax & NHS Pension Handbook 2026/27

Get the free guide

Which accountancy support fits your income?

Start with how you are paid. Different income sources can need different accounts, returns and expense checks.

How you workWhat we checkSupport to explore
Employed or umbrella (PAYE)Tax codes, eligible employment expenses and whether a tax return is needed.Healthcare tax refund support
Genuinely self-employedBusiness income and expenses, Self Assessment and MTD eligibility.Healthcare Self Assessment service
Your own limited companyCompany accounts, Corporation Tax, director income and off-payroll status where relevant.Healthcare limited company accounts
PartnershipPractice accounts, allocated profit and each partner’s personal tax position.Healthcare partnership accounts

Sound familiar?

Problems we fix for self-employed healthcare professionals

  • "My tax return is late and I'm worried about HMRC penalties."
  • "I got a tax bill I didn't expect and don't know why."
  • "HMRC has opened an enquiry and I don't know what to send."
  • "My mortgage lender wants SA302s and tax year overviews."
  • "My current accountant doesn't understand the NHS."
  • "I have a buy-to-let alongside my clinical income."

What it's costing you

Leaving it unfixed is rarely free

Overpaid tax
Unclaimed expenses and wrong tax codes mean paying more than you owe, year after year.
HMRC penalties and interest
Late returns attract automatic penalties, plus interest on tax paid late.
Lost evenings
Hours spent on forms, invoices and spreadsheets after a long shift.

General examples — your position depends on your own figures.

How we solve it

What we actually do for you

Urgent catch-up

We bring overdue returns up to date and talk to HMRC on your behalf.

Tax reserve plan

We tell you what to set aside each month so January holds no surprises.

Enquiry support

We handle HMRC correspondence and prepare the records they ask for.

Simple switching

We contact your old accountant and move your records for you.

How we help

01

Annual allowance checks

We calculate your pension input amount and any annual allowance charge each year.

02

Scheme Pays support

Where a charge arises, we explain whether to pay it yourself or ask the scheme to pay it.

03

Pension forms

Locum and practitioner pension forms kept consistent with your accounts.

04

Retirement tax planning

Tax planning around retirement, retire and return, and partial retirement, alongside your financial adviser.

What to know before you decide

Annual allowance in 2 minutes

The annual allowance is £60,000 for most people. It tapers down, to a minimum of £10,000, where threshold income is over £200,000 and adjusted income is over £260,000. For a defined benefit scheme the test uses growth in your pension, not what you pay in. Read our NHS pension annual allowance guide for the detail.

NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

When to speak to an accountant vs a financial adviser

An accountant works out the tax: annual allowance charges, Scheme Pays and your tax return. Decisions about opting out, retiring early or transferring benefits are regulated financial advice; speak to an FCA-authorised independent financial adviser.

Your questions answered

How does the NHS Pension Scheme work?

The NHS Pension Scheme is a defined benefit scheme. Since 1 October 2023 all active members build pension in the 2015 Scheme, which adds a slice of pension each year based on your pensionable pay and revalues it every year.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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What is the difference between the 1995, 2008 and 2015 sections?

The 1995 and 2008 sections are final salary schemes with normal pension ages of 60 and 65. The 2015 Scheme is a career average scheme with a normal pension age equal to your State Pension age. Benefits already built in older sections are kept.

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How much do I pay into the NHS Pension?

From 1 April 2026 you pay between 5.2% and 12.5% of your pensionable pay, depending on which tier your actual annual pensionable pay falls in. See our NHS pension contribution rates guide for the full tier table.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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How much does the NHS contribute to my pension?

The employer contribution rate is 23.7% of members' pensionable pay, according to NHS Employers.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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How does NHS pension tax relief work?

Your contributions are taken from pay before income tax, so you get relief at your highest rate. For example, a higher-rate taxpayer paying £1,000 in contributions saves £400 of income tax, so the net cost is £600.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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What is the NHS Pension annual allowance?

The annual allowance is the most your pension can grow each year with tax relief: £60,000 for most people, tapering to a minimum of £10,000 for high earners. Growth above it can create a tax charge, which you may be able to pay through Scheme Pays.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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What is the McCloud remedy?

The McCloud remedy corrects age discrimination in the 2015 reforms. Members who were in the scheme between 1 April 2015 and 31 March 2022 have that service moved back to their legacy section and choose, at retirement, whether to take legacy or 2015 benefits for it.

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Can locums and GPs pay into the NHS Pension?

Yes. GP partners are Type 1 practitioners and salaried and locum GPs are Type 2. Locum GPs submit locum forms for pensionable work. Locum doctors in trusts are usually pensionable through the trust's payroll.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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When can I take my NHS Pension, and what is partial retirement?

You can take benefits at your normal pension age, or earlier with a reduction. Partial retirement lets eligible members take part of their pension while continuing to work, provided pensionable pay is reduced as the scheme rules require. Check the NHSBSA rules before deciding.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

Help with this question: Payroll & Pensions for Doctors & Healthcare Professionals

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Is the NHS Pension subject to inheritance tax from April 2027?

The government has legislated for most unused pension funds and death benefits to be included in a person's estate for inheritance tax from 6 April 2027. Death-in-service benefits from registered schemes are excluded. Ask us how this affects your estate.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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Should I opt out of the NHS Pension?

Opting out gives up employer contributions worth 23.7% of pay and guaranteed benefits, so it is rarely sensible just to avoid a tax charge. This is regulated financial advice; speak to an FCA-authorised independent financial adviser before deciding.

Check the official guidance · www.gov.uk

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

Want us to check this for you? Get a free review →

What is carry forward?

Carry forward allows you to use unused pension annual allowance from the three previous tax years. This can increase your current year contribution limit beyond the standard £60,000 allowance. You must have been a member of a registered pension scheme during those prior years. It is a vital tool for clinicians managing their NHS pension growth.

Check the official guidance · www.gov.ukWant us to check this for you? Get a free review →

Can I reduce future charges?

Future tax charges can often be managed through proactive planning and utilising available allowances. This might involve reviewing your pension contributions or business structure. The NHS annual allowance is currently £60,000, though this tapers for high earners. We help you understand how these legislative limits apply to your projected healthcare income.

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What is the McCloud remedy and how does it affect me?

The McCloud remedy addresses age discrimination in public service pension schemes, including the NHS pension. It allows eligible members to choose between different scheme benefits for the remedy period. This choice can impact your tax position and annual allowance calculations. We recommend reviewing your pension statements annually to monitor for potential tax charges.

Help with this question: NHS Pension Tax & Annual Allowance for Doctors & Healthcare Professionals

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Quick quote

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Three fields. No obligation. A specialist replies, not a sales team.

Packages for your working life

Accountancy packages for healthcare professionals

Self-employed income, a limited company, PAYE or a mixture: start with the support that matches how you actually work. We check your status and agree the scope and fee before starting.

Self-employed accountants for healthcare professionals packages

For genuine sole-trader income. We prepare your business accounts and Self Assessment, review allowable expenses and explain payments on account.

  • Sole-trader accounts and personal tax return
  • Allowable business expenses reviewed
  • Tax reserve and payment deadline guidance
  • MTD support scoped separately where required

Fixed fee quoted after a review

Discuss this package

Limited company accountants for healthcare professionals packages

For clinicians working through their own company. Choose Essential/Compliance, Core/Complete or Growth according to your accounts, bookkeeping and payroll needs.

  • Statutory accounts and Corporation Tax return
  • One director return for salary and dividends from the same company
  • Confirmation statement support; filing fee extra
  • Bookkeeping, VAT and payroll according to your chosen plan

Company packages from £45.83 + VAT / month

Compare company packages

Personal tax return packages for healthcare professionals

For employed clinicians, partners and people with mixed income who need a return. We check whether Self Assessment is required and reconcile the relevant income, expenses and pension tax information.

  • Self Assessment requirement checked
  • PAYE and other income reconciled
  • Eligible employment expenses reviewed
  • Pension tax work agreed separately where needed

Fixed fee quoted after a review

Discuss this package

Employment status is determined by the facts, not the package you choose. PAYE, umbrella and partnership arrangements may also apply. A limited company does not override IR35 or off-payroll rules, and not every employed clinician needs a tax return.

Overpaid tax?

Tax refund support for healthcare professionals

We review tax codes, eligible professional expenses and overpaid tax, then prepare a claim where you qualify. A refund is not guaranteed; HMRC decides the claim.

£249 + VAT

For refunds up to £5,000, our fee is £249 plus VAT. For refunds above £5,000, add 5% of only the amount above £5,000 to the £249 fee. VAT applies to the total professional fee.

Example: a £6,000 refund means £249 + £50 = £299 plus VAT.

Professional fee, excluding VAT

£249

Ask about a tax refund

This illustrates the fee only, not whether you qualify or how much HMRC will refund. We agree the claim scope and payment terms before work starts.

What's included

Limited company packages — compare what's included

Essential/Compliance

For locums, salaried GPs and dentists with a limited company

from £45.83 + VAT /month

  • FRS 105 or FRS 102 1A statutory accounts
  • Corporation tax return (CT600) and tax computation
  • Confirmation statement preparation and filing support
  • One director Self Assessment return
  • Deadline reminders ahead of every filing date

Core/Complete

For private practice, consultants and associate dentists

from £62.50 + VAT /month

  • Everything in Essential/Compliance
  • Monthly bookkeeping and bank reconciliation
  • Quarterly Making Tax Digital VAT returns
  • Director payroll with RTI filing and pension submissions
  • Quarterly review call on numbers and tax position

Growth

For clinics, dental practices and growing medical teams

from £75.00 + VAT /month

  • Everything in Core/Complete
  • Payroll for up to five employees

Prices exclude VAT. Making Tax Digital quarterly updates available as an add-on. Compare fees

Why clinicians trust us

Chartered accountants who know the NHS

  • ACCOTAX has served over 5,000 clients.
  • Regulated chartered accountants (ICAEW and ACCA).
  • Founded by Waqas Sagar ACA FCCA FMAAT, with 18+ years' experience.

Reviewed by Waqas Sagar ACA FCCA FMAAT

Chartered accountant and founder of ACCOTAX. Last reviewed October 2026.

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How it works

  1. 01

    Free call

    A 15-minute chat about your income, structure and deadlines.

  2. 02

    Onboarding in 48 hours

    We set up your records, software and HMRC agent access.

  3. 03

    We handle the rest

    HMRC, NHS Pensions and every deadline, with reminders before each one.

Free resource

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Related healthcare expertise

NHS Pension Tax & Annual Allowance for Doctors & Healthcare ProfessionalsPayroll & Pensions for Doctors & Healthcare ProfessionalsNHS pension annual allowance accountantsNHS Pension Annual Allowance ExplainedMcCloud Remedy & NHS Pension ChoiceNHS Pension Scheme Pays Deadlines
Accountants for healthcare professionalsHealthcare tax questions answered

General information for the 2026/27 tax year, prepared from the official guidance linked below. It is not personalised tax or regulated financial advice. Rules and circumstances can change; confirm your position before acting.

Official sources referred to on this page: NHSBSA member hub; NHS Employers: member contributions; GOV.UK: Annual allowance; HMRC Pensions Tax Manual.

Official guidance

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