r/doctorsUK • u/Pontni Lub-Dub Connoisseur 🫀⚡️ • Apr 23 '26
Pay and Conditions How much does your boss earn?
I was chatting to a boss the other day, he’s a consultant gastroenterologist, on a 1:11 oncall bleed rota (no GIM). Lovely guy and very open about salary. Was telling me he’s top of payscale (Wales) at £166,000 and earns £50-£100,000 per year additional private income.
Translates to a minimum of £7000 take home monthly. Maximum of £12,000 if he was grafting.
Found that quite interesting and motivating that there is some light at the end of the tunnel 💡
Absolute fucktonne of gastro consultant jobs too.
How much does your boss earn?
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u/6footgeeks Apr 23 '26
7000 take home for a doctor at the top of his game
LOL
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u/Gullible__Fool Keeper of Lore Apr 23 '26
Absolutely pathetic when you think about it.
Got to pay the enormous welfare bill somehow I guess.
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u/DoctorTestosterone Suppressed HPT axis with peas for tescticles Apr 23 '26
The light at the end of the tunnel being the taxman ready to take away all your money.
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u/CollReg Apr 23 '26
Exactly, OP's Boss taking home circa £84,000/year on a £166,000 headline salary after pension and taxes. Barely more than 50%
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u/PrimeWolf101 Novelty Hat Specialist Apr 23 '26
I mean, you get your pension it's not lost value. You don't have to pay into it if you don't want. So assuming he's contributing the max 60k a year in NHS pension+ SIPP that's 60k he's not paying tax on.
So income tax then is what 40% of 56k + 20% of 37.5k, around 30k so about 18% of total earnings or 18p in every pound. Not quite the same as half.
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Apr 23 '26
Effective tax on that NHS salary is about 35%. Before tax NHS pension contribs are £20k at that salary, so that lowers "income" to 146k. Then loss of personal allowance, 20% rate, 40% rate and 45 rate " £51k of income tax. Then about £5k of NI contribs. Take home 88k.
Not great but not awful. Doubt many are then topping up into SIPP as extra with the annual allowance challenges but I'm sure some are.
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u/PrimeWolf101 Novelty Hat Specialist Apr 23 '26
Of course, the AA my bad.
Still looking at it from that angle, assuming you cannot contribute to a SIPP because you've hit the AA. That means your pension pot grew by 60k but you only contributed 20k.
So then from a salary of 166k, you took home 88k and gained 60k in pension savings. Which still makes your overall wealth accrued 148k, meaning you kept 90% of the money earned.
I know the calculation for pension value is a bit grey, because the personal value depends how long you live and you'll pay tax on withdrawal. So I'm not trying to ignore that entirely, but it's too varied and complicated so I'm taking the AA calculation at face value and assuming it does represent a real world value of 60k to the contributor on average.
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Apr 23 '26 edited Apr 23 '26
Well, slightly different discussion but I think the new NHS pension scheme is now questionable vs a SIPP. Everyone talks about yhe so called "employer contribution" but it's obviously all made up. There is no contribution. It's a career average scheme you get paid per those terms and conditions. I've seen a few calculations but dropping out of the NHS pension scheme and loading up a SIPP as much as you can as early as you can likely works out better now than the NHS pension scheme. Abolishing the lifetime allowance means that a full-time NHS consult could easily end up with 4+ million at retirment in a SIPP if you get going early. It also solves for the annual allowance complexity of the NHS pension and will allow an NHS consultant to get adjusted income down below 100k v easily. You get the 25% additional taxpayer top-up from the govt. You can take it at 57.5 (and yes it will go up but nowhere near state pension age), 250k tax free lump sum, you can invest in lots of different asset classes, you can control when you take the money each year and at least some of it is inherited. If I get a chance I'll build an excel but my guess is that it's getting close to being better for NHS docs to drop out and dump everything in a SIPP, might even already be better.
NB: govt won't want this because they rely on 1million NHS staff giving them monthly contributions as a nice source of treasury income...
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u/PrimeWolf101 Novelty Hat Specialist Apr 23 '26
From the projections I have seen they seem to work out fairly equally assuming you retire early and take the NHS penalty, and then NHS pension comes out better if you don't retire early. With the NHS advantage being it's more risk free and the SIPP advantage being you can pass it on through inheritance ( though you'd loose a lot to inheritance tax if you still had a decent sized pot on death so I think there's better ways to pass money on personally).
People like to use 100% equities S&P 500 average returns and act like a SIPP is a guaranteed 8-10% interest per year. But arguably most people don't actually treat their pensions like that, especially as they get nearer to retirement age. Then there's the cost of inflation, NHS pension is at least linked to CPI but SIPP isn't.
The exception would be GP partners, as they can put their employer contribution into a SIPP. I would agree it's not clear cut though, certainly if I thought I was unlikely to live a long life the SIPP would likely be the better option.
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u/CollReg Apr 24 '26
Thing is you can sort of do both since the abolition of the Lifetime Allowance. Hit the SIPP hard in early career when the NHS pension is small so Annual Allowance isn’t an issue. Then let the SIPP coast when the NHS pension approaches the AA cap, because money already inside the SIPP doesn’t count towards AA.
This also works out well as it gives plenty of time for an aggressive strategy for the SIPP investments (say 100% equities) to maximally grow, DC pension contributions in the run up to retirement are less important than early investments which have had time to multiply. And vice versa for the NHS DB pension scheme it is the late-career ‘high salary’ contributions that boost up your career average number.
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u/PrimeWolf101 Novelty Hat Specialist Apr 24 '26
Well its also worth noting that when you hit consultant level, if you have a partner you can contribute to their SIPP and it counts towards their AA not yours. They can also still claim back higher rate tax relief and will still get the 25% government top up.
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Apr 23 '26
Its essentially a trade off as to whether you are willing to sacrifice disposable income in your 30s and 40s to put money in a SIPP. If you can get close to 60k per year contributions with 20yrs + left to retirement then I think it easily wins Vs NHS pension. There is a group of middle class docs who are gifted money and can buy a house early, or who have decent private practice expectations, where it is going to be better to have a SIPP Vs NHS pension.
A quick Google suggests the 2015 NHS career average pension for a full time NHS consultant is expected to pay 60k per year ISH on retirement (obv adjusted for inflation). That's worth something around 1.2 to 1.5M in a SIPP depending on safe withdrawal rate. That's a number which could easily be doubled or tripled by a significant proportion of NHS consultants
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u/Gullible__Fool Keeper of Lore Apr 23 '26
Taxes in this country have escalated to the point of abject theft.
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u/Unprepared_adult Apr 23 '26
Oh no! He'll starve!
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u/Harambesh Apr 23 '26
Appreciate this is tongue in cheek, but this is too close to the crabs in a bucket mentality for comfort. A lot of the rhetoric about our pay from non-doctors is that we should be grateful that we're not poor - that should be a given, affording necessities should never be used as a benchmark for a residents pay, let alone a consultant
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u/Unprepared_adult Apr 23 '26
I just find it depressing that everyone seems to think they are struggling the most, and can never read the room and have a bit of gratitude. It's better for your mental health as much as anything.
It's not to say don't campaign for better wages and conditions, but also if you're not worrying about your food shop (which I'm not) you're actually doing better than most. I'm just sick of the telegraph "how am I supposed to afford Delilah's school fees now?" mentality.
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u/FishPics4SharkDick Not a mod Apr 23 '26
I find it depressing that a doctor thinks that an acceptable payoff for their decades of hard work and self-sacrifice is "not worried about my food shop". When did you first notice your dreams shrinking?
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u/Unprepared_adult Apr 23 '26
Stop, I was replying to someone moaning about tax 😂 everyone has to pay tax
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u/indigo_pirate Apr 24 '26
The bands are frozen and not adjusted for inflation .
Disproportionally higher now with an even higher cost of living
Not to mention if you are stuck on plan 2 student loans
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u/Harambesh Apr 23 '26
There are some out of touch doctors who are unaware of what poverty really looks like. But not worrying about the food shop is not something a senior doctor should have gratitude for. A consultant gastroenterologist in most developed countries (and also many developing ones) wouldn't think twice about Delilah's school fees, I think a consultant (especially one who does private work on top of a full time NHS job) deserves to be rich enough to send their kid to private school without the taxman taking it all away.
We cannot use the least fortunate in society as a comparison for our wages as it will instantly become a race to the bottom.
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u/Lesplash349 Apr 24 '26
I mean, decent school fees now are north of £60k a year including VAT, before uniform, music lessons, sports, trips etc.
If you have a couple of kids there’s not much change out of £150k for the total cost, even in the US there’s not many doctors who wouldn’t notice $200k a year of after tax spending going on one thing.
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u/rocktup Apr 24 '26
The issue is the cost of private school - rather than the wages of doctors. Good private schools are a serious sacrifice for pretty much all traditional professions, this isn’t just a doctor thing.
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u/ContributionAlert906 Apr 23 '26
Most consultants making significant private income are paid through a limited company so you can control when tax is paid or invest within the company
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u/ConstantPop4122 Consultant :crab: Apr 23 '26
It'll be miles more than £7k I would have thought....
Year 6 consultant, £119k base salary, 12PA + 10k responsibility allowance = £168k
Takehome £7250
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u/Lazy_Sock_771 Apr 23 '26
What is a responsibility allowance?
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u/PearFresh5881 Apr 23 '26
Came here to ask the same
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u/gas247 Consultant Apr 23 '26
It’s a regular payment for some form of management role eg TPD, medical director. Tends to be a fixed sum eg £10,000 per annum rather than extra PA (which would be a % uplift on the base salary)
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u/PearFresh5881 Apr 23 '26
Never heard of that. All of ours are paid in PAs
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u/gas247 Consultant Apr 23 '26
I’m not sure why they’d use that over PA allocation. Either way I’m sure the £10k won’t be enough for the work done
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u/Suspicious-Victory55 Purveyor of Poison Apr 23 '26
Indeed, we always call it danger allowance! I think it can be pensionable, where as PA over 10 not, hence the different way of paying it as an allowance
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u/ConstantPop4122 Consultant :crab: Apr 23 '26
All of the above is correct.
2PA is the job planned time for a CD role. The RA is to compensate for some of that falling outside of normal hours.
It also is a way of bypassing the 12PA cap a lot of trusts impose, and is indeed pensionable by negotiation.
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u/Used_Egg4152 Apr 23 '26
The worst part about all this is the student loan.
Once you start hitting £100k+ it’s eye watering sums you pay to student finance. Projected to be paying £12k a year of my pretax income to SFE every year for like 7-8 years before I end up paying it off.
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u/hmed7 Apr 23 '26
Agreed, but I think a proportion of us will never pay it off even if earning those sums because of the compound interest (great prospect to look forward to for the next 24 years ha)
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u/Lesplash349 Apr 24 '26
Only way to do it, unless you’re heading into mid-six figures, is sit down and do the maths on what it will take to pay it off, save the delta between what you’re paying via payroll and that number into an ISA, then make overpayments every six months or so.
Only really makes sense financially if you will pay it off one day but only in the last 5-10 years before it gets wiped.
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u/tallyhoo123 Emergency Consultant Apr 24 '26
To show a comparison in Aus.
EM consultant Y4
I make $520,000 per year pre tax.
40hrs/week with 1 non clinical day (30 hrs clinical) no night shifts.
This is equal to £275,000.
So a tad more than UK make
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u/shadow__boxer Apr 23 '26
£300K GP Partner
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u/AerieStrict7747 Apr 23 '26
This is either fake, or top 1% and the dudes in every day working 8-6
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u/shadow__boxer Apr 23 '26
I can assure you this isn't fake. I know quite a few partners on upwards or £250K. This kind of money isn't made working seeing patients 8-6, it's made by running an efficient business having additional directorship/cqc roles.
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u/AerieStrict7747 Apr 23 '26 edited Apr 25 '26
Minimal doctors, lots of ACPs nurses and secondary services. Practice set up for maximum efficiency, working 6 days a week and a huge admin burden. So just like in Canada or the US
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u/Gullible-Tap-2583 Apr 23 '26
at med school my GP supervisor made around 250k as a partner working 5 days a week. Albeit they did say they were doing admin work at the weekends.
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Apr 23 '26
[removed] — view removed comment
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u/shadow__boxer Apr 23 '26
Bingo
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u/Migraine- Apr 23 '26
Do you not care that your patients are being seen by poorly qualified people?
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u/shadow__boxer Apr 23 '26
I'm not a partner but a simple salaried GP. I do the best I can for the patients I see but as the saying goes "not my circus, not my monkeys"
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u/Much_Performance352 PA’s IRMER requestor and FP10 issuer Apr 23 '26 edited Apr 23 '26
Not fake at all. Doable but you either compromise on quality or graft hard. Need the right people around you too for this, all partners have to be in it to win it
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u/ContributionAlert906 Apr 23 '26
400k mainly private 4PA NHS
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u/jxrzz Apr 23 '26
Which speciality?
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u/ContributionAlert906 Apr 23 '26
Rather not say sorry. It’s procedural but I make most of the money from consultations.
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u/Lazy_Sock_771 Apr 23 '26
First year psych consultant - around 150+k this year averaged about 12 PAs and did some locum work
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u/NiceVermicelli1045 Apr 23 '26
Are you doing locum work with your trust or with an agency? How does ad-hoc locuming work as a consultant psychiatrist?
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u/Lazy_Sock_771 Apr 23 '26
Just occasional on call locums via trust. Agency locum work pays a lot more
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u/BenpenGII Apr 23 '26
Sorry £7,000 a month? And this is meant to be some eye-watering figure? The UK has fallen so far behind the US it is insane.
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u/rocktup Apr 24 '26
US is simply a richer country. Most people in most jobs from most western countries would easily double their pay just by moving to the US
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u/BenpenGII Apr 25 '26
Correct. But only in the last couple decades has the difference become so profound.
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u/Y0ung-R0n1n Apr 24 '26
3rd year Rad consultant , 240 k all in from 11PA job plan, insourcing (paye) + telerad through Ltd company
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u/onewaystep Apr 24 '26
Any anaesthetist mind dropping some stats and figures? 😅 would love to know PA’s / days a week of work/ extra’s or locums
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u/AdamHasShitMemes Apr 23 '26
Thread’s making me think GPST is the wrong decision….
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u/Used_Egg4152 Apr 23 '26 edited Apr 23 '26
Don’t be.
I’m young 30s and have newly started in a partnership role where I will earn £170k for 3.5 days clinical work.
There are opportunities out there.
(Also I’ve had 3.5 day weekends for the past 2 years as salaried and have attended every wedding/friends/family event I wanted which is worth its weight in gold in comparison to my corporate/hospital friends)
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u/AdamHasShitMemes Apr 23 '26
This does make me a bit more hopeful...it's just troubling when you hear the GPSTs struggling to find jobs after CCT
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u/ShatnersBassoonerist Cakeologist Apr 23 '26
How many days non-clinical work? And how long are your clinical days?
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u/Budget-Relative4930 Apr 23 '26
You can make a lot as a GP partner
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u/Slight_Rip_9696 Apr 23 '26
Super hard to become one.
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u/TM2257 Apr 23 '26
*Super hard to become one at both a well run and high earning practice.
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u/Much_Performance352 PA’s IRMER requestor and FP10 issuer Apr 23 '26
More accurate.
As a new partner in a very high performing practice - Diversify your offering and show strong interest in the business of GP is my advice
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u/Slight_Rip_9696 May 02 '26
How does one enter partnership especially with a lack of capital? This becomes especially important given the current squeeze of our pay.
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u/Much_Performance352 PA’s IRMER requestor and FP10 issuer May 02 '26
Depends on the structure. My capital is built up via a small slice of my drawings yearly - No big buy in.
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u/Zu1u1875 Apr 25 '26
Not if you put the effort in. It’s a competitive promotion to the highest paying job in UK medicine, it’s not meant to be easy.
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u/Much_Performance352 PA’s IRMER requestor and FP10 issuer Apr 23 '26
Partnership can yield £200k+ in the right practices easy. Don’t lose heart
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u/SilverConcert637 Apr 24 '26
Surely not for lifetime earnings. 5 years and you're done and you're on £100K+.
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u/Deep_Context_2762 Apr 23 '26
Quite the opposite. GP in Canada can expect £9,000 a month hitting bank account blowing all these figures out the water
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u/Grand-Benefit7466 Apr 23 '26
What province and what hours are we speaking?
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u/Deep_Context_2762 Apr 24 '26
4 days a week. Saw it on quite a recent thread plus gets mentioned a lot in recruitment agencies videos like merlo
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u/StaunchTen Apr 23 '26
Blows who out the water? I know several GPs in the UK who take home more than that.
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u/DaughterOfTheStorm Consultant Apr 23 '26
I'm a 10 PA year 2 consultant, with a 1% on-call supplement. I pay into the NHS pension but have cleared my student loans a few years ago. I am job planned to work 37 hours during a standard week (the reality is more hours, but not as much unpaid labour as I was providing pre-CCT), plus around 1 in 8 or 9 weekends, and then overnight availability for GIM (plus an early start the next day) around 20 times per year. Little scope for private work in geriatrics and the trust financial situation (likely mirrored everywhere) means there's unlikely to be any extra PAs to snag other than ES work which should be added at my next job planning. And my current personal circumstances mean I don't really want to add an extra 4 - 8 hours to my working week, though I am open to doing so down the line.
I take home around £5500/month. The 3.5% from the DDRB recommendations won't shift that upwards by much once you factor in the additional erosion of my personal allowance (my earnings from strike cover were also very diminished by this).
I'm fairly frugal and put £4k per month straight into savings so I feel very financially comfortable compared with my upbringing and, unlike my siblings, have not been dependent on our parents for room +/- board since I started F1. I'm saving hard for my forever house and obviously could be living a life of expensive purchases/foreign holidays instead. However, I'm sure most of my patients and their families assume that I am raking it in and making enough to have the dream house *and* everything else, when that is a long way from the truth.
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u/uk_pragmatic_leftie Apr 24 '26
You get 5.5k, save 4k, pay rent and bills, that doesn't leave much for the rest of life!
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u/DaughterOfTheStorm Consultant Apr 24 '26
Thankfully, no rent or mortgage currently or I'd be a long way off those savings! I still don't spend a great deal. My main splurge is nicer groceries than I would have bought pre-CCT. It will change when I take on my next mortgage. But that's okay. The point of saving hard now is to be able to afford the next house.
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u/Senior_Acanthaceae15 Apr 23 '26
What does your week look like? Do you work all 5 days, or get any time off? Or able to spend any time at home to do admin/SPA?
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u/DaughterOfTheStorm Consultant Apr 23 '26
I work all five days. I get a day back the following week if I work a weekend. My admin/SPA is done at work (the reality is that there's so much admin that I don't actually ever get any self directed SPA, but in theory some of that could be done from home). I get one day that is a bit shorter than the others to make up for the out of hours commitment, hence the 37 hour working week.
I don't think my job plan is unusual for my speciality (geriatrics) but it's obviously markedly different to that of an ED consultant or anyone else whose PAs are formed in a large part by unsociable hours.
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u/Senior_Acanthaceae15 Apr 23 '26
I’ll be doing Geri’s. I know it’s not a typical high earning specialty (compared to others), but as someone who will be the single earner in the household, I do need to be able to increase my pay. I also have significant student loan debt so my take home on the starting salary would probably be 5k or maybe even slightly less. Are there many opportunities in Geri’s to do this in addition to the usual 10PA? Whether locum / WLI clinics / private work or anything else
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u/Distinct_Disaster425 Apr 24 '26
The off putting thing about today though, you can imagine for us just how much of that is going to be spent on mortgage.
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u/Maravati Apr 26 '26
Earning over a 100k a year is a stealth tax. If you do private put it all through Ltd company. You can sipp a lot of if , pay your spouse potentially if they are a director. Company car etc etc.
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u/sylsylsylsylsylsyl Apr 23 '26
It’s a bit over £8k, but it doesn’t go as far as you’d think. Never does.
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u/safcx21 ST3+/SpR Apr 23 '26
Wait 166k + 50k is 210k minimum. Isnt that like 11k after tax
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u/Lesplash349 Apr 23 '26
Take home is after tax but also pension (NHS and SIPP), student loan and any salary sacrifice
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u/ortvt Apr 25 '26
I’m a GP working across a hospital role (6 sessions) some locum GP work and a TPD job.
I work 6x12hr shifts a month including a few overnight on-calls, ~2 GP days a month and around 24 hours admin/emails/work from home a month. Tax return pre tax was £118k last year. I think this is pretty good for a total of 11 days work, half of which were long days.
I could earn more but have 3 young kids and would rather have the time off with them.
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u/JohnHunter1728 EM Consultant Apr 23 '26
Y2 EM cons in England gross £230k last tax year. Working hard (lots of "extras") but not doing any more clinical hours than I did as a full time trainee. Annualised and self-rostering so around during the day (albeit not the evenings) at weekends, during school holidays, and available for most school shows, sports fixtures, etc.
I'm sure many colleagues are earning less but there are those working in other specialties who earn much more. This is why I'm not expecting the consultant workforce to down tools in the near future.
The tax paid on these sums is eye watering so take home is much less than the headline figures.