# NHS Salary & Health and Care Worker Visa Guide 2026/27 — International Healthcare Recruits

> Authoritative guidance for overseas nurses, doctors, and allied health professionals joining the UK NHS: Pre-OSCE (Band 4) vs Post-OSCE (Band 5) take-home pay, IHS exemption savings, and monthly remittance benchmarks.

Canonical: https://netpayscale.uk/international/
Last updated: 2026-10-26

## 1. Pre-OSCE (Band 4) vs Post-OSCE (Band 5) Pay Progression

| Stage | Agenda for Change Band | Gross Annual Salary | Gross Monthly Pay | NHS Pension Deduction | Monthly Take-Home Net |
| :--- | :--- | :--- | :--- | :--- | :--- |
| **Arrival & Pre-OSCE** | Band 4 Entry | £28,392 | £2,366.00 | -£153.79 (6.5%) | **~£1,889.63 / mo** |
| **Post-OSCE NMC PIN** | Band 5 Entry | £32,073 | £2,672.75 | -£221.84 (8.3%) | **~£2,080.39 / mo** |
| **Band 5 with Nights** | Band 5 + 1 Night/Wk | ~£35,665 | ~£2,972.08 | -£246.68 (8.3%) | **~£2,280.00 / mo** |

*Immediate OSCE Pass Pay Gain:* Passing your OSCE awards an extra **+£190.76/month net cash** (+£2,289/year clean take-home).

## 2. Monthly Remittance Benchmarks to Philippines, India & Overseas

| Country & Currency | Monthly Remittance (£ GBP) | Local Currency Equivalent | Typical Usage |
| :--- | :--- | :--- | :--- |
| **Philippines (PHP)** | £600 – £1,000 / mo | ₱43,500 – ₱72,500 PHP | Family upkeep, home mortgage, savings |
| **India (INR)** | £600 – £1,200 / mo | ₹64,000 – ₹128,000 INR | Education loans, family investments |
| **Spain / Eurozone (EUR)** | £500 – £900 / mo | €580 – €1,050 EUR | Eurozone savings, property payments |
| **Nigeria (NGN)** | £500 – £1,000 / mo | ₦950,000 – ₦1,900,000 NGN | Family upkeep, real estate construction |

## 3. Crucial Visa & Payroll Rules for Overseas Staff

1. **100% IHS Surcharge Exemption:** Health and Care Worker Visa holders are completely exempt from the £1,035/year Immigration Health Surcharge.
2. **Do NOT Opt Out of the NHS Pension:** The NHS 2015 CARE Pension builds an inflation-protected guaranteed income for life (1/54th annual accrual). The Trust contributes 23.7% on your behalf plus £64,000+ life assurance cover.
3. **UK Tax Code 1257L:** Verify your first ESR payslip shows tax code 1257L (standard £12,570 personal allowance).

## Related
- [NHS International Recruits Guide (Interactive HTML)](https://netpayscale.uk/international/)
- [NHS Salary & Take-Home Calculator](https://netpayscale.uk/)
- [NHS Band Promotion & Pension Trap Calculator](https://netpayscale.uk/promotion-calculator/)