NHS Pay Meter

High cost area supplement

HCAS is described as a percentage of basic salary, but for most staff it is not one — a minimum and a maximum payment sit either side of it, and on the current scale one of those two governs far more often than the percentage does.

Updated for 2026/27Pay circular effective 1 April 2026 - 31 March 2027

The three zones

Staff working in and around London receive a high cost area supplement on top of basic salary. There are three zones, and each is described as a percentage of basic salary with a minimum and a maximum payment.

High cost area supplement percentage, minimum and maximum by zone
ZonePercentage of basicMinimum paymentMaximum payment
Inner London20%£5,794£8,746
Outer London15%£4,870£6,137
Fringe5%£1,346£2,270

Figures above from: NHS Employers / NHS Staff Council pay circular for 2026/27 (England), HCAS tables. Effective from 2026-04-01. This site is not affiliated with the NHS, NHS Employers or the NHS Business Services Authority.

Why the percentage usually is not what you get

The minimum and maximum are not edge cases. Across the 31 pay points and three zones — 93 combinations in total — the percentage actually governs in only 17 of them. The minimum payment governs 18 and the maximum governs 58.

The reason is arithmetic. At the bottom of the scale the percentage of a £25,272 salary is less than the zone minimum, so the minimum is paid instead. At the top, the percentage of a £129,783 salary exceeds the zone maximum, so the maximum caps it. Only the middle of the scale sits between the two.

What each zone pays a given salary

Worked for a Band 1 salary of £25,272:

High cost area supplement payable on £25,272 basic salary, by zone
ZoneSupplementTotal with basicSet by
Inner London£5,794£31,066the minimum payment
Outer London£4,870£30,142the minimum payment
Fringe£1,346£26,618the minimum payment

And for a Band 9 salary of £129,783:

High cost area supplement payable on £129,783 basic salary, by zone
ZoneSupplementTotal with basicSet by
Inner London£8,746£138,529the maximum payment
Outer London£6,137£135,920the maximum payment
Fringe£2,270£132,053the maximum payment

Where HCAS does and does not count

HCAS is part of your taxable pay, so it is taxed and it raises the pay your pension tier is assessed on. It is not part of the base used to work out unsocial hours payments — Section 2.8 excludes it by name. Those two facts are easy to conflate, and conflating them produces an unsocial-hours figure that is too high for every member of staff in a high cost area.

Part-time staff receive a pro-rated supplement: the minimum and maximum are full-time figures.