Most NHS clinical staff who trained in England since 2012 are repaying a Plan 2 student loan; those who started university from September 2023 are on Plan 5. Repayments come straight off your payslip through PAYE, alongside tax and National Insurance.
The plans at a glance (2026/27)
Plan 1 (pre-2012 England/Wales, and Northern Ireland): 9% of pay above £26,900. Plan 2 (England/Wales 2012–2023): 9% above £29,385. Plan 4 (Scotland): 9% above £33,795. Plan 5 (England from 2023): 9% above £25,000. Postgraduate loans: 6% above £21,000.
Repayments are calculated on gross pay — NHS Pension contributions do not reduce them. A Band 5 nurse on £34,592 with a Plan 2 loan repays 9% of (£34,592 − £29,385) ≈ £469 a year, about £39 a month.
What the pay rise means
Because repayments are only taken on pay above the threshold, a 3.3% pay rise increases your repayment by 9% of the increase — for most staff a few pounds a month. Plan 2 and Plan 1 thresholds also rose in April 2026, which partly offsets this; Plan 5 and postgraduate thresholds are frozen.
Nurses, midwives and allied health students who received the NHS Learning Support Fund grant still repay their main tuition/maintenance loan in the normal way — the grant itself is not repayable.
Should you overpay?
Plan 2 balances are written off 30 years after graduation, and many NHS staff will never repay in full, so voluntary overpayments are often poor value. Plan 1 borrowers close to clearing their balance are the main group who may benefit. This is general information rather than financial advice — check your own balance and interest rate on your Student Loans Company account.