NHS Payslip Explained 2026/27: Codes, Deductions and Examples

Last reviewed: 12 August 2026

An NHS payslip can look complicated because it combines employment details, hours, allowances, tax, National Insurance, pension contributions and year-to-date figures on one page. This guide explains the standard ESR payslip from top to bottom, including AfC Absence, WTD Pay, Wkd/Earned, Paid/Due, arrears and common doctor pay lines.

If you only want to estimate what should reach your bank account, use the NHS take-home pay calculator. Use this guide when you need to understand why a particular figure or abbreviation appears.

How to View Your NHS Payslip Online

Many NHS employees in England and Wales view payslips through ESR Employee Self Service, although access arrangements vary by employer. Use the portal or app link supplied by your trust or health board. If you have not registered, cannot complete multifactor authentication or cannot see a current payslip, contact the local ESR, HR or payroll team.

Do not assume that every organisation releases payslips on the same date or uses the same login details. Scotland and Northern Ireland may use different local or national systems. Download your payslips and P60s regularly because the amount of online history available varies by employer.

NHS Payslip Layout at a Glance

A standard NHS payslip has five main areas: employee and assignment details; pay and allowances; deductions; year-to-date balances; and the summary showing total payments, deductions and net pay. The official ESR payslip guide uses the same structure.

Example 1: Header, Tax Details and Earnings

Figure 1. Annotated historical NHS doctor payslip showing the header and earnings areas. Figures are illustrative and are not current 2026/27 rates.

1. Assignment number. This identifies a specific job or assignment. ESR guidance says additional posts may use suffixes such as -2 or -3. Quote the complete assignment number when contacting payroll.
2. Tax office reference. This is the employer PAYE reference used by HMRC. It is not the same as the employee’s personal tax code.
3. Pay and allowances. Each row shows a type of earnings. In this doctor example, the rows include Basic Pay, Addn Roster Hours NP, Night Duty 37% and a weekend allowance.
4. Tax code. The example shows 1257L NONCUM. NONCUM means the code is being operated on a non-cumulative basis, so payroll does not consider earlier pay and tax in the tax year when calculating that period.
5. Sal/Wage. This normally shows the annual full-time salary attached to the grade. A separate part-time salary field may appear where applicable. The £40,257 figure in the image is historical, not a current salary.

Example 2: Deductions, Year-to-Date Figures and Net Pay

Figure 2. Annotated historical NHS doctor payslip showing earnings, deductions, year-to-date balances, period summary and net pay.

1. Payments. The payment rows add together to produce Total Payments. A minus amount in this area can represent a reversal or correction.
2. Year-to-date balances. These figures accumulate during the tax year and include gross pay, taxable pay, tax, National Insurance and pension contributions. They are not additional payments due this month.
3. This-period summary. This shows the pay frequency, period end date, pay date and payment method, as well as the current period totals.
4. Deductions. The sample includes PAYE, employee National Insurance, NHS pension contributions and a student-loan line. A zero means that no amount was deducted in that period.
5. Net pay. This is the amount due to the employee after deductions. In the example, £4,029.20 total payments minus £1,304.90 total deductions gives £2,724.30 net pay.

Employee and Assignment Details

The top section tells you which employment record has been paid. Check it carefully when you have changed roles, employers, hours or pay points.

What Do VPD and SD Reference Mean?

Some ESR payslips show VPD or SD Reference fields. VPD is an internal ESR database or organisation reference used by payroll administration. An SD Reference may also appear in the year-to-date area. These fields do not normally change the amount paid, but payroll may ask you to quote them when tracing a record.

Do not rely on a universal expansion for every SD or locally configured reference. If the field matters to a query, give payroll the exact label and number displayed on the payslip.

What Does Inc. Date Mean?

Inc. Date usually means increment date or pay-step date. It identifies when you may become eligible to move to the next pay point, or when you reached the top of the scale. It does not mean every employee receives an automatic annual increase.

Agenda for Change bands have different pay-step intervals, and progression can require the relevant standards and employer process to be completed. If the date has passed without an expected change, compare the assignment’s band and pay point, then read the NHS pay progression guide before contacting HR.

How to Read Wkd/Earned, Paid/Due, Rate and Amount

These are calculation columns, not four different types of pay. “Paid/Due” is therefore not a back-pay code.

The sample doctor payslip makes the distinction clear. Basic Pay uses 162.60 hours in both Wkd/Earned and Paid/Due. The Night Duty 37% row shows 67.07 hours worked but 24.82 paid units because 37% of 67.07 is approximately 24.82. Those units are then multiplied by the hourly rate.

Common NHS Payslip Codes and Abbreviations

The exact description can vary because payroll elements may be configured locally. The following meanings are the most useful starting points.

What Does AfC Absence Mean on an NHS Payslip?

AfC Absence is commonly an average-pay adjustment connected with qualifying annual leave or another eligible absence under Agenda for Change. It can reflect eligible regular additional earnings, such as enhancements or overtime, when average pay is calculated for the absence period. It does not simply mean that you were receiving sick pay.

The eligible earnings, reference period and timing depend on the applicable rules and employer process. The amount may appear after the leave because roster or absence data must first reach payroll. If it seems wrong, check that the leave was recorded accurately and ask payroll which earnings and dates were used.

Seeing AfC Absence and SSP on the same payslip does not by itself prove that occupational sick-pay entitlement has ended. For a separate explanation of full pay, half pay and SSP, use the NHS sick-pay calculator and guide.

What Does WTD Pay Mean?

WTD usually labels a holiday-pay element connected with working-time and paid-leave rules. It is most often seen on bank, irregular-hours or similar worker payslips. Depending on the arrangement, holiday pay may be shown separately from ordinary shift pay.

WTD Pay is not payment for missed statutory rest. Do not assume that every employer uses the same percentage or that substantive employees should always see this line. Check the bank-worker agreement or ask payroll how the figure was calculated. The NHS annual-leave calculator should be used for contractual leave entitlement rather than treating a WTD line as the leave balance.

Enhancement and Unsocial-Hours Pay

For employees covered by the standard Agenda for Change Section 2 arrangement, qualifying unsocial hours include weekday hours after 8pm and before 6am, all Saturday hours, and all hours on Sundays and public holidays. Rates vary by pay band.

These are standard Section 2 rates. Different arrangements can apply to ambulance staff, employees retained on other systems and locally contracted bank workers. The doctor payslip shown above is also governed by a different contract. Use the NHS overtime and unsocial-hours calculator for a separate estimate, but always compare the result with the contract applying to the assignment.

High Cost Area Supplement: Inner, Outer and Fringe

For Agenda for Change employees in qualifying English locations, the 2026/27 High Cost Area Supplement limits are:

HCAS is normally taxable, subject to National Insurance and pensionable. The exact zone depends on the contractual work base rather than a general assumption that every London-area employee receives the same rate.

Doctor and Dentist Payslip Codes

The sample image is a doctor payslip and therefore contains several medical-contract payment lines:

• Basic Pay: pay attached to the applicable nodal point and contracted basic hours.
• Addn Roster Hours NP: additional rostered hours above the basic 40-hour week. NP indicates that the payment is non-pensionable.
• Night Duty 37%: a 37% enhancement for qualifying night hours under the England 2016 training contract.
• Weekend allowance: a percentage of full-time basic salary based on how frequently the doctor is rostered for weekend work across the rota.
• On-call availability: a separate allowance where the work schedule includes qualifying non-resident on-call duties.
• Flexible Pay Premia: additional payments for eligible training programmes or specialties.
• LTFT allowance: an allowance that may apply to eligible less-than-full-time trainees.

Weekend Allowance for Doctors in Training in England

The percentage table explains the type of label visible in the example, but the annual cash value depends on current basic pay and the individual work schedule. Check the latest England doctor and dentist training terms and the most recent medical pay circular before publishing a cash example.

NHS Payslip Deductions Explained

The deductions area contains statutory deductions required by law and voluntary or contractual deductions linked to choices, benefits or money owed.

PAYE Income Tax and Tax Codes

PAYE is income tax deducted through payroll. The amount depends on taxable pay, the tax code supplied by HMRC and whether the code is cumulative or non-cumulative. The standard Personal Allowance for 2026/27 is £12,570, but an individual tax code may provide a different allowance.

A code such as 1257L is common, while W1, M1, X or a NONCUM label indicates a non-cumulative basis. A K code, BR, D0 or D1 can materially change the deduction. Payroll normally cannot choose a different tax code without an HMRC instruction. If the code looks wrong, follow the NHS tax-code correction steps and check your HMRC Personal Tax Account.

National Insurance

NI A is the standard employee category for many workers. For 2026/27, a Category A employee normally pays 8% on monthly earnings between £1,048 and £4,189, then 2% above £4,189. National Insurance is calculated for each pay period rather than through the same cumulative method used for most PAYE calculations.

NHS Pension or Superannuation

The pension or superannuation line is the employee contribution to the NHS Pension Scheme. For England and Wales, the 2026/27 rate is based on actual annual pensionable pay.

The selected percentage is generally applied to pensionable earnings, not every item in gross pay. Basic pay, paid sick leave, qualifying additional hours for part-time staff and HCAS can be pensionable, while one-off payments, expenses and hours above standard whole-time hours may be excluded. Scotland and Northern Ireland have separate contribution tables.

For scheme benefits and contribution estimates, use the NHS pension calculator. Before sending readers there, update that page to the rates shown above.

Student Loan and Postgraduate Loan

Loan deductions are based on the plan held by HMRC and the employee’s earnings in that pay period. The 2026/27 thresholds are:

A student-loan line can appear with a zero amount when the plan is recorded but earnings for that pay period did not produce a deduction. An unexpectedly high deduction can occur in a month containing arrears or other additional earnings.

Other Possible Deductions

• Union subscription: for example UNISON, RCN, BMA or Unite membership.
• Salary sacrifice: for example a car, cycle or other approved arrangement. Check the separate NHS salary-sacrifice calculator.
• Parking, accommodation or facilities: local employer deductions.
• Payroll giving: charitable giving arranged through payroll.
• Attachment of earnings or court order: a legally required deduction.
• Overpayment recovery: repayment of wages previously paid in error.

Gross Pay, Taxable Pay, NI Pay and Pensionable Pay

These totals can be different without the payslip being wrong:

• Gross pay: the total value of payment lines before deductions.
• Taxable pay: earnings subject to PAYE after relevant pre-tax adjustments and exclusions.
• NI pay: earnings used to calculate employee National Insurance for the period.
• Pensionable pay: earnings on which the NHS pension contribution is calculated.
• Non-taxable pay: payments not subject to income tax, where applicable.
• Net pay: the amount remaining after all deductions.

Taxable pay is not always simply gross pay minus pension. Salary sacrifice, expenses, refunds, non-taxable payments and other payroll adjustments can affect the totals.

This Period Summary and Year-to-Date Balances

The current-period summary answers one question: what happened in this payroll run? It normally contains total payments, total deductions, taxable and pensionable pay, the pay date, payment method and net pay.

Year-to-date balances cover the tax year from 6 April to the current pay period. They are useful when comparing the payslip with HMRC records or the year-end P60. They may include gross pay, taxable pay, tax paid, NI pay and contributions, pensionable pay and pension contributions.

Arrears, Adjustments, Refunds and Negative Lines

ARRS or Arrs means that a payment or deduction relates to an earlier period. Common causes include a pay award, late enhancement data, a corrected pay point, changed hours or a retrospective pension correction.

A large arrears payment can increase PAYE, National Insurance, pension and student-loan deductions in that month. PAYE may later rebalance when a cumulative code applies, but National Insurance and student-loan calculations follow their own pay-period rules. Use the NHS back-pay calculator to estimate the gross arrears separately rather than turning this page into another back-pay guide.

A minus payment can reverse an earlier payment. In the deductions area, “R” can identify a refund. Always compare the description, amount and total rather than assuming that every minus sign is money newly taken from pay.

Sick Pay, Maternity Pay and Leave Lines

Absence-related payslips can contain several lines because occupational and statutory payments may operate together. The key labels include OSP, SSP, OMP, SMP, ShPL and AfC Absence.

Sick Pay

OSP is occupational sick pay under the applicable NHS terms. SSP is the statutory payment. From April 2026, the standard weekly SSP limit is £123.25 or 80% of average weekly earnings if lower, subject to the statutory rules. The payslip may show both occupational and statutory elements because payroll offsets or combines them when calculating the total entitlement.

Maternity Pay

For an eligible Agenda for Change employee receiving the standard NHS occupational maternity package, the usual pattern is:

For 2026/27, SMP is 90% of average weekly earnings for the first six weeks. The remaining statutory weeks are £194.32 per week or 90% of average weekly earnings if lower. Eligibility, return-to-work conditions and locally agreed ways of spreading occupational pay can alter the monthly appearance. Use the NHS maternity-pay calculator for the detailed projection.

Keeping in Touch Days

An employee can normally work up to 10 Keeping in Touch days during maternity leave without ending the leave. The work and payment should be agreed with the employer in advance. A KIT day is not automatically guaranteed at the normal daily rate and may appear as a separate line or an adjustment alongside maternity pay.

How to Check an NHS Payslip in 60 Seconds

1. Confirm the assignment. Check the employee name, full assignment number, employer, job title and contracted hours.
2. Check salary information. Compare the band, pay point or nodal point, annual salary and Inc. Date with the contract and latest pay notice.
3. Compare hours with the rota or timesheet. Look at Wkd/Earned, Paid/Due, the rate and amount for each additional payment.
4. Check tax and NI. Review the tax code, cumulative status and NI category.
5. Check pension and loans. Confirm the pension rate, pensionable pay and student-loan plan.
6. Reconcile the total. Verify that total payments minus total deductions equals net pay.
7. Compare with the previous month. Identify the exact line responsible for an unexplained change.

What to Do If Your NHS Payslip Is Wrong

1. Save the evidence. Download the payslip and keep the relevant contract, work schedule, rota, timesheet, leave record or HMRC notice.
2. Describe one specific discrepancy. State the pay period, assignment number, exact payroll line, expected figure and amount shown. Avoid sending an unstructured message saying only that net pay looks wrong.
3. Send the query to the correct team. Payroll handles calculations, while HR or the line manager may need to correct an assignment, hours, absence or pay-step record before payroll can act.
4. Ask for the calculation and correction date. Request a written explanation of the source data, rate, period and expected payroll run for any correction. Timing depends on the payroll cut-off and employer process.
5. Escalate with support if necessary. If the issue remains unresolved, follow the employer grievance or payroll escalation process and seek help from the relevant trade union.

If You Have Been Overpaid

Tell payroll promptly and do not assume the extra money can be kept. An employer can normally recover an accidental overpayment, but Acas guidance on overpayments says the employer should explain the mistake, notify the worker and discuss how repayment will be made. For a large or long-running overpayment, ask for a written calculation and a fair repayment plan.

Differences Across England, Wales, Scotland and Northern Ireland

The broad ideas – earnings, deductions, year-to-date balances and net pay – are similar, but the system, contract and rates are not identical across the UK. England and Wales widely use ESR. Scottish boards and Northern Ireland employers may use different portals, pension administrators and pay descriptions.

Do not apply England’s HCAS, doctor-contract or pension table to another nation without checking the relevant national guidance. When writing to payroll, use the exact employer, assignment and code shown on the payslip.

Frequently Asked Questions

Sources and Method

This guide was checked against the following primary or authoritative sources on 12 August 2026:

• Electronic Staff Record: Understanding Your Payslip
• NHS Terms and Conditions of Service Handbook
• NHS Employers: Unsocial Hours Payments
• NHSBSA: Cost of Being in the NHS Pension Scheme
• NHSBSA: Which Payments Are Pensionable?
• NHSBSA: High Cost Area Allowance 2026/27
• HMRC: Rates and Thresholds for Employers 2026/27
• HMRC: Tax Codes
• Acas: Handling Overpayments

Disclaimer

This guide provides general information and is not payroll, tax, legal or financial advice. NHS employers can use local payroll descriptions, and entitlements vary by contract, nation and individual circumstances. Confirm disputed figures with the employer’s payroll or HR team and use HMRC for personal tax-code queries.

Daniel Carter

Daniel Carter is a senior NHS Payroll Accountant with over 10 years of experience in Agenda for Change pay structures, tax, and pensions. He created the NHS Pay Calculators platform to help NHS staff easily understand their take-home pay, sick pay, maternity pay, and pension entitlements through simple, accurate online tools.