What is the NHS High Cost Area Supplement (HCAS)?

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The NHS High Cost Area Supplement (HCAS) or “London Weighting” is an additional payment for NHS staff on Agenda for Change contracts who work in London and the surrounding areas. The payment is a percentage of salary, subject to minimum and maximum values.

Can you get High Cost Area Supplements (HCAS) outside of London?

HCAS only applies to jobs in London and the immediately surrounding areas. However, a small number of jobs outside London (particularly in areas with high cost of living or remote areas) do receive additional Recruitment and Retention Premia (RRPs).

How much extra money will I get from the High Cost Area Supplement?

The value of the High Cost Area Supplement depends on your location.

AreaHCAS Value (2023/24)
Inner London20% of basic salary, with a minimum payment of £5,132 and a maximum payment of £7,745
Outer London15% of basic salary, with a minimum payment of £4,313 and a maximum payment of £5,436
Fringe
5% of basic salary, with a minimum payment of £1,192 and a maximum payment of £2,011

You can also check out our predictions for how HCAS payments will change in 2024/25.

Where are the High Cost Area Supplement regions?

Areas affected by HCAS are based on historical Primary Care Trust (PCT) regions originally laid out in 2005. These may not correspond to existing geographic boundaries (as PCTs were disestablished in 2013), so it is always worth checking carefully on job descriptions whether a role is eligible for HCAS.

The regions for HCAS are:

Inner London HCAS regions (20% of basic salary)

  • Hammersmith and Fulham
  • Kensington and Chelsea
  • Westminster
  • Camden
  • Islington
  • City and Hackney
  • Tower Hamlets
  • Lambeth
  • Lewisham
  • Southwark
  • Wandsworth

Outer London HCAS regions (15% of basic salary)

  • Brent
  • Ealing
  • Harrow
  • Hillingdon
  • Hounslow
  • Barnet
  • Enfield
  • Haringey
  • Barking and Dagenham
  • Havering
  • Newham
  • Redbridge
  • Waltham Forest
  • Bexley
  • Bromley
  • Greenwich
  • Croydon
  • Kingston
  • Richmond and Twickenham
  • Sutton and Merton

Fringe HCAS regions (5% of basic salary)

  • Dartford, Gravesham and Swanley
  • Basildon
  • Billericay, Brentwood and Wickford
  • Epping Forest
  • Harlow
  • Thurrock
  • Dacorum
  • Hertsmere
  • Royston, Buntingford and Bishop Stordford
  • South East Hertfordshire
  • St. Albans and Harpendon
  • Watford and Three Rivers
  • Welwyn and Hatfield
  • Bracknell Forest
  • Slough
  • Windsor, Ascot and Maidenhead
  • Wokingham
  • East Elmbridge and Mid-Surrey
  • East Surrey
  • Guildford and Waverley
  • North Surrey
  • Surrey Heath and Woking

6 replies on “What is the NHS High Cost Area Supplement (HCAS)?”

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  • Help… during nhs maternity leave and pay do you still get high cost area supplement payment?

  • Should Brighton be included as a high cost of living area?

    Amanda Maunders
  • How does working from home affect HCAS? and what are the thresholds?

  • Is HCAS considered as an allowance under the Skilled Worker Visa rules or is it cosidered as part of salary?

  • Living in Birmingham has become just as expensive as some areas of London yet there is no extra wage for this despite paying city rents and costs . Paying just London staff extra is unjust and unfair on people working in other cities where costs are also inflated.

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