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NHS TAX PLANNING GUIDE

The 60% Tax Trap

If you earn between £100,000 and £125,140, you could be paying a hidden
60% income tax rate — more than someone earning £150,000. Here is
everything you need to know, and how to avoid it.

View our Guide

60%

Hidden tax rate

38p

Kept per £1 earned

1.95m

Taxpayers affected (2025/26)

What Exactly is the 60% Tax Trap?

Everyone in the UK receives a £12,570 tax-free Personal Allowance. But once your income exceeds £100,000, HMRC withdraws that allowance at a rate of £1 for every £2 you earn above the threshold. By the time you reach £125,140 your entire allowance has been removed.

This withdrawal is not labelled as a tax rate, but mathematically it creates an effective 60% income tax charge on every pound earned inside that band. Add 2% National Insurance and you keep just 38 pence from each additional pound — less than a higher-rate taxpayer at £90,000 or an additional-rate taxpayer at £150,000.

HMRC data confirms that almost 725,000 workers now fall squarely within this band in 2025/26, with 1.95 million losing some or all of their Personal Allowance. That figure is projected to reach 2.29 million by 2028/29.

38p
is all you keep from every £1 earned
in the trap zone
(£100k – £125,140)
Source: HMRC income tax thresholds 2025/26
SECTION 02

How the Trap Works

Your tax-free allowance evaporates as income crosses £100,000

£100,000
£112,570
£125,140
Personal Allowance: £12,570

For every £2 you earn above £100,000, you lose £1 of your Personal Allowance. At £125,140 the entire £12,570 allowance has been withdrawn, resulting in an effective 60% marginal tax rate across the entire band.

SECTION 03

The Hidden Costs at £100,000

It is not just the 60% rate. Crossing £100k triggers a cascade of additional losses.

👶
£4,000 – £7,500
Funded Childcare — Lost

In England, 30 funded hours from age 9 months. In Wales, up to 30 hours for 3-4 year-olds only. Both are lost entirely at £100k — no taper, a cliff edge.

💵
£2,000
Tax-Free Childcare — Gone

Per child, per year. Earn £100,001 and the entire entitlement is removed for your family — with no gradual reduction.

📉
62%
True Marginal Tax Rate

60% income tax plus 2% National Insurance — before student loan repayments are taken into account, which push it higher still.

SECTION 04

Real Example: How It Hits an NHS Doctor

A consultant with a £100,000 base salary takes on £10,000 in extra locum work.

What They Expect

Extra income £10,000
Tax at 40% + 2% NI -£4,200
Expected take-home £5,800

What Actually Happens

Extra income £10,000
Income tax at 40% -£4,000
Lost PA: £5k x 40% -£2,000
National Insurance at 2% -£200
Actual take-home £3,800
58p
Kept per £1 at £90k
(40% rate)
38p
Kept per £1 at £110k
(60% trap)
53p
Kept per £1 at £150k
(45% rate)

You keep less at £110,000 than someone earning £150,000. That is the trap.

SECTION 05

Fiscal Drag: Why More People Fall In Every Year

Tax thresholds have been frozen since 2021 and will remain so until at least April 2031.
Meanwhile, salaries keep rising.

1.22m
2021/22
1.80m
2024/25
1.95m
2025/26
2.29m
2028/29

Taxpayers losing some or all of their Personal Allowance (Source: HMRC via Rathbones FOI, Nov 2025)

SECTION 06

7 Strategies to Beat the 60% Trap

Practical, HMRC-compliant ways to reduce your Adjusted Net Income below £100,000.

1

Claim All Professional Expenses

Royal College fees, GMC registration, MDU/MPS subscriptions, and exam costs all reduce your taxable income directly.

2

Top Up via Additional Voluntary Contributions

Standard NHS pension contributions are fixed by tier, but AVCs or Additional Pension purchases reduce your Adjusted Net Income.

3

Private Pension Top-Up

Additional contributions to a personal pension attract 60% effective tax relief inside the trap zone — the highest rate in the UK tax system.

4

Gift Aid Donations

Charitable donations reduce your income pound-for-pound and benefit your community at the same time.

5

Salary Sacrifice

Exchange salary for a car lease, cycle-to-work scheme, or other benefits to lower gross pay. Note: not available for NHS pension contributions.

6

Equalise Income with Your Partner

Restructure savings and investment income so neither partner crosses the £100,000 threshold unnecessarily.

7

Think Before Taking Extra Locum Shifts

That additional shift may cost you more in lost allowances and benefits than the gross income it generates.

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Your Most Powerful Tool: The NHS Pension

Your standard NHS pension contributions already reduce your Adjusted Net Income automatically. You can make Additional Voluntary Contributions to push your income below £100,000 and reclaim every penny of your Personal Allowance.

Tax relief at 60% inside the trap zone is the highest available anywhere in the UK tax system. Your pension is also protected from creditors and grows entirely tax-free.

  • Annual pension allowance: £60,000 (carry forward unused years)
  • AVCs can be set up via Standard Life or Prudential through NHS payroll
  • Personal pension top-ups offer the same effective relief
Pension contribution
£25,140
at £125,140 income
Actually costs you
£10,056
after 60% tax relief
You save £15,084 in tax
SECTION 08

Understanding Adjusted Net Income

The number that determines whether you are caught in the trap.

Component Amount
Gross taxable income (salary, locums, CEAs, dividends) £115,000
Less: pension contributions (relief at source) -£10,000
Less: Gift Aid donations (grossed up) -£2,500
Less: allowable professional expenses -£1,200
Adjusted Net Income £101,300
Just £1,300 more in pension contributions would bring this below £100,000 - reclaiming the full £12,570 Personal Allowance.

Do Not Let the Trap Cost You Thousands

Our specialist advisers help NHS professionals restructure their income and maximise their pension to legally and efficiently avoid the 60% tax trap.