Key points
Where reference has been made to “National Minimum Wage”, this includes the National Living Wage and the National Minimum Wage.
This information has been independently reviewed and updated by an external organisation and was confirmed to be accurate as of July 2026.
The National Minimum Wage
Disclaimer: The advice in this guidance is generic only.
Both the National Minimum Wage (and tax) legislation can be complex and will be fact specific where you may need to seek advice from your benefit provider and/or seek independent tax advice.
Paying staff at least the legal minimum is a basic employer responsibility. For most NHS organisations this is manageable, but there are still areas where errors can happen, especially around unpaid extra hours, salary sacrifice, working time, and deductions from pay.
This web page explains the key points in a practical, NHS-focused way.
How to calculate National Minimum Wage
NMW is calculated using an hourly rate and applies to all eligible workers even if they are not paid by the hour. For employers, this means that regardless of how someone is paid, employers need to work out a worker’s equivalent hourly rate to ensure they are being paid at the legal minimum wage in a pay reference period (PRP).
There are a number of steps employers need to take to ensure they are calculating NMW pay correctly. The following diagram sets out the steps to follow.
Further information for each step is highlighted below.
There is also a set of frequently asked questions (FAQs), split into themes, at the end of this guidance which are reflective of the most popular questions asked by employers.
Step 1: Worker category
Confirm the individual is an employee who is working for the NHS. Most people employed by NHS organisations under a contract of employment will count as a worker for minimum wage purposes if they:
- have a written, verbal or implied contract
- are required to do the work personally
- receive something of value in return, such as pay or benefits
- are not genuinely self-employed, which would include individuals engaged through personal service companies who are considered to be outside IR35.
Next, identify the work category. There are four different work types that make up the basis of NMW calculations. It is important for employers to first establish which worker type each staff member is, then to work out their equivalent hourly rate to ensure they are being paid at least the NMW.
Most workers are entitled to the minimum wage, but there are some exemptions.
1. Salaried hours work
This usually applies where a worker:
- is paid an annual salary
- has a contract of employment for a set number of basic hours across the year
- is paid in equal instalments across the year.
Read more about salaried work on the GOV.UK website.
Example: Annual salary of £30,000 paid in monthly equal instalments.
Hours of work are Monday to Friday 9am to 5pm with one-hour unpaid lunch break.
Basic annual hours would be 35 hours per week x 52 weeks (or any other denominator used to calculate annual hours, e.g. 52.14, 52.18).
Risk area: unpaid extra hours.
If additional hours are worked but not paid or offset through time off in lieu (TOIL), this may create a breach.
2. Time work - paid by the hour
This is usually the simplest category. It applies where a worker:
is paid an hourly rate
is paid for all time worked in each pay reference period (PRP) so pay can vary in relation to time worked in each PRP, which can be weekly, monthly etc (see step 2 below).
Read more about time work on the GOV.UK website.
The NMW must be met in each PRP separately. Higher pay or overpayments from one PRP cannot be used to cover a shortfall in another. The only exception is where a payment (or adjustment to pay) in the next PRP relates to work done (or adjustment due) in the previous PRP, for example, overtime worked late in the period that misses the payroll cut-off and is paid in the following PRP, or an adjustment to pay for absence.
Example: Employee is paid £14.50 per hour.
Working hours are 40 hours per week, Monday to Friday.
Weekly pay would be actual time worked in the week x £14.50.
Monthly pay would be actual time worked across the number of days worked in the month x £14.50.
Risk area: additional working time incurred not captured for payment.
3. Output work
This applies where a worker is paid for output, such as the number of tasks completed or items produced (piece work).
This is less common in NHS settings.
Read more about output work on the GOV.UK website.
Risk area: pay falling below NMW rate due to unrealistic piece rate targets.
4. Unmeasured work
This worker type applies where the work does not fit the other three categories and can also apply to work where certain tasks are to be carried out but they vary and are not paid per task performed.
Unmeasured workers must be paid for the actual time worked in a PRP or have a daily average agreement in place at the start of their employment.
Read more about unmeasured work on the GOV.UK website.
Example: £14.50 per hour times actual time worked in the pay period or under a daily average agreement a worker is paid an hourly rate for set hours.
Step 2: Pay reference period (PRP)
The PRP is the period used to check whether the worker has been paid at least minimum wage.
A PRP can be up to one calendar month, but not longer, for example:
- weekly paid (PRP is one week)
- two-weekly paid (PRP is two weeks)
- four-weekly paid (PRP is four weeks)
- monthly paid (PRP is one calendar month).
A worker must be paid at least the minimum wage for the actual time worked (or deemed time worked) in each PRP.
Step 3: Working time
For minimum wage purposes, working time is generally any time when an employer requires a worker to be somewhere, do something, or remain available for work.
Examples of working time include:
- changing into uniform or personal protective equipment (PPE) at work
- setting up equipment before a shift
- paperwork or admin after a shift
- mandatory training outside normal hours
- handovers or team meetings outside rostered time
- travel between sites or appointments during the working day
- travel time in community roles where travel is part of the job.
What does not usually count includes:
- normal home-to-work travel
- normal travel from home to college or training (unless actually working, e.g. responding to, preparing emails, admin tasks whilst travelling on a train) time spent away overnight when no actual work-related tasks are undertaken.
Example: NHS staff can continue to work beyond their contractual hours, for example, due to urgent care needed.
This additional time would be considered working time and should be factored into the overall calculation of actual time worked in a PRP.
Step 4: Pay that counts for NMW
Not all pay elements count for NMW purposes and some pay elements are treated differently across the different work categories.
Wrongly including an element of pay that doesn't count, for example an overtime premium, can result in it appearing that the minimum wage is being paid when in fact it is not.
Pay that usually counts
The following payments count towards minimum wage pay:
- basic salary or wages
- performance related bonus - for example annual bonus or quarterly bonus
- commission payments (if a salaried worker is entitled to receive commission, they would not be treated as a salaried worker and default to unmeasured) – not relevant to the NHS
- overtime pay at the basic rate (associated time worked must also be factored into the calculation).
Pay that usually doesn’t count
The following payments do not count towards minimum wage pay:
- overtime premium payments (except for unmeasured workers)
- allowances that are not considered consolidated into the overall pay arrangement:
- reimbursement of work-related expenses
- benefits in kind (other than living accommodation)
- payment of a loan under a loan agreement
- advances of wages
- pension payments, e.g. receiving from other employments, State Pension
- lump sums on retirement
- redundancy, payment in lieu of notice (PILON), ex-gratia payments
- other payments received under settlement agreements
- rewards under staff suggestions schemes.
In the NHS it is common practice for employees to be paid premium rates and/or allowances for:
- working in excess of contracted hours
- working unsocial hours at evenings, weekends, bank holidays.
- receiving the high-cost area supplement (HCAS) for working in London and the surrounding areas.
- recruitment and retention premia to address national skills shortages and can be paid short or long term.
Step 5: How deductions and reductions affect NMW pay
Some deductions and payments made in connection with a worker’s employment can reduce the pay used to calculate NMW. NMW legislation does not differentiate between a reduction to gross pay (for example, a salary sacrifice) or a deduction from net pay (for example, to pay for car parking).
NMW compliance always refers to the gross pay before any deductions/reductions such as salary sacrifice are considered. Deductions from pay for NMW purposes can also include costs incurred by employees to pay for items that they need to do their job where the cost is not reimbursed by the employer.
Examples that typically reduce pay.
- Buying required uniform items or a specific type or colour of footwear.
- Car/transport deductions or payments where having the car is a requirement of the role (community worker, district nurse/midwife) - e.g. Fleet Solutions car arrangements.
- Deposits for fobs, passes, keys if there is a requirement for staff to have these.
- Admin charges linked to work arrangements, e.g. fees for processing DBS checks, payment charges for processing attachment of earnings orders or facilitating a payment to a third party.
The table below illustrates how payments from a worker and deductions taken via payroll are treated for NMW compliance purposes using a uniform requirement as an example:
| Deduction by employer | Payment from worker to employer | Payment from worker to third party where the cost is not reimbursed |
All NHS workers are required to wear black trousers and black shoes | Reduces NMW pay | Reduces NMW pay | Reduces NMW pay |
No uniform requirement | Reduces NMW pay (unless paid to a third party - see end column) | Does not reduce NMW pay | Does not reduce NMW pay |
Examples that do not reduce pay.
- Income tax and National Insurance contributions.
- Trade union subscriptions.
- Contractual deductions relating to conduct, e.g. parking fines, speeding tickets, lost locker keys/key fobs, damaged/unreturned work items.
- Repayment of a loan or advance of wages under a formal agreement.
- Recovery of overpaid wages.
- Pension contributions made by the employee.
- Payments not deemed in connection with employment or not for employer own use and benefit.
- Voluntary payments by the worker for the purpose of purchasing goods and or services from the employer (unlikely to be relevant in NHS).
- Accommodation (if less than the offset rate).
This list is not exhaustive but covers a number of the most common scenarios.