What is the NHS High Cost Area Supplement (HCAS)?
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.
| Area | HCAS Value (2025/26) |
| Inner London | 20% of basic salary, with a minimum payment of £5,415 and a maximum payment of £8,465 |
| Outer London | 15% of basic salary, with a minimum payment of £4,552 and a maximum payment of £5,941 |
| Fringe | 5% of basic salary, with a minimum payment of £1,258 and a maximum payment of £2,197 |
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
Is HCAS changing?
Reforms to the High Cost Area Supplement have been rumoured as part of the annual NHS pay rise for several years. Based on recommendations from the NHS Pay Review Body, it is expected that significant changes could take place during the 2026/27 pay review process, which could mean a difference in HCAS from April 2026.
While the detail of these changes is unclear, one possibility is widening HCAS to cover more high-cost areas of England, such as major cities outside London.
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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?
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?
It is to be included as part of your basic salary when filling in skilled worker visa form.
What makes you say that? The HCAS is an additional allowance and is not considered part of the basic pay unless it is contributes towards tax, NI and pension.
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.
My Trust refuse me to Sponsorship, reason they provide me that they can’t count HCAS to salary so I am not eligible for the sponsorship.
What about Buckinghamshire? We seem to have been forgotten, we are very much surrounded by areas included in the pay.