NHS Mileage Rates
NHS mileage rates reimburse staff who use their own car, motorcycle or bicycle for business journeys under Section 17 of the NHS Terms and Conditions of Service Handbook. The standard car rate is 59p per mile for the first 3,500 business miles each year and 24p per mile after that, with a 30p reserve rate and separate rates for motorcycles and pedal cycles.
This guide sets out the current rates, how they are calculated and reviewed, how they compare with the HMRC 45p rate, how mileage is taxed and shows on your payslip, and how to make a claim.
What Are NHS Mileage Rates?
NHS mileage rates are the pence-per-mile figures in Section 17 of the NHS Terms and Conditions of Service Handbook that reimburse NHS staff for using their own vehicles on business journeys. The rates cover travel between NHS sites, visits to patients' homes, attendance at training events, and other work-related trips, but exclude the ordinary commute between home and the usual place of work. Patient travel costs are governed separately through the Healthcare Travel Costs Scheme.
The headline figures are a standard car rate of 59 pence per mile for the first 3,500 business miles each payroll year, dropping to 24 pence per mile above that threshold, under NHS Employers' current Section 17 rate schedule. The reserve rate is 30 pence per mile for all mileage where the standard rate does not apply. Motorcycles and pedal cycles have their own fixed rates, and a 3 pence per mile supplement is available for carrying heavy or bulky equipment. The rate mechanism uses Office for National Statistics motoring cost data under the Consumer Prices Index and runs biannual reviews, with any adjustment applied from 1 July or 1 January when motoring costs move by more than a penny a mile.
The Scope of Section 17
Section 17 covers business journeys made in a staff member's own car, motorcycle, or pedal cycle while on NHS duty. The scope includes travel between NHS sites, journeys from a base to a patient's home or community location, attendance at mandatory training courses, and meetings away from the usual place of work. Section 17 does not cover the ordinary commute between home and the usual workplace, which is treated as personal travel.
The provisions apply to NHS staff on Agenda for Change contracts across England, with equivalent arrangements in the devolved administrations under their own handbooks. Doctors and dentists outside Agenda for Change (consultants, GPs, specialty doctors on separate national terms) have their own mileage provisions in the medical and dental pay circulars rather than under Section 17.
What Are the Current NHS Mileage Rates?
NHS mileage rates run across six categories under Section 17, with the standard car rate split by annual mileage threshold. The current rates are listed below:
| Vehicle Type | Rate Per Mile | Threshold |
|---|---|---|
| Car (standard rate) | 59p | Up to 3,500 miles per payroll year |
| Car (above threshold) | 24p | Over 3,500 miles per payroll year |
| Reserve rate (car) | 30p | All mileage |
| Motorcycle | 29p | All mileage |
| Pedal cycle | 20p | All mileage |
| Heavy or bulky equipment supplement | 3p | Added per eligible mile |
Rates are set by the NHS Staff Council using ONS motoring cost data under the Consumer Prices Index. The mechanism replaced the previous AA motoring cost reference in 2023, after a decade in which rates had drifted away from real motoring costs between formal reviews.
The Standard Rate and the Annual Mileage Threshold
The standard car rate pays 59 pence per mile for the first 3,500 business miles in each NHS payroll year, which runs from 1 April to 31 March. The 59p rate is designed to cover the full running cost of a privately-owned car in NHS business use, including fuel, depreciation, insurance, servicing, and road tax. Once a staff member crosses the 3,500-mile threshold in a payroll year, the rate drops to 24 pence per mile for the remainder of the year, reflecting that the fixed costs of car ownership have already been covered by the first 3,500 miles.
The threshold resets on 1 April each year, so community-based staff with long patient travel rounds typically hit the threshold around November or December and spend the first quarter of the calendar year on the lower 24p rate. Trusts track the counter against the staff member's electronic expenses record, which carries the running mileage total across the full payroll year.
The Reserve Rate
The reserve rate is 30 pence per mile for all mileage where the standard rate does not apply. The rate is used in three specific situations under Section 17: when a staff member declines an offered lease car from the trust, when the trust requires overtime travel outside the pattern of normal duties, and when an employee returns to work from leave at an unscheduled time to cover service pressure. Reserve-rate journeys do not count toward the 3,500-mile standard-rate threshold, since they already sit under a lower reimbursement regime.
Motorcycle and Pedal Cycle Rates
NHS staff using motorcycles or pedal cycles for business travel receive dedicated per-mile rates under Section 17. The rates are listed below:
- Motorcycle Rate: NHS staff receive 29 pence per mile for all business miles travelled by motorcycle, with no annual threshold or step-down.
- Pedal Cycle Rate: NHS staff receive 20 pence per mile for all business miles travelled by pedal cycle, again with no threshold.
Both rates run flat regardless of annual mileage, reflecting the lower depreciation and running costs of two-wheeled transport. The pedal cycle rate also supports sustainable travel for short cross-site journeys within a city or hospital campus.
The Heavy or Bulky Equipment Supplement
NHS staff carrying heavy or bulky equipment as part of a business journey receive an additional 3 pence per mile on top of the standard or reserve rate. The supplement applies where the equipment either exceeds a weight that one person can comfortably move by hand, or is bulky enough to displace passenger seating in the vehicle. The transport of equipment must be a specific job requirement authorised by the trust, with a risk assessment confirming safe stowage, before the supplement can be claimed.
The supplement runs on every eligible mile of the journey, not only the loaded leg, so a return trip with equipment carried in one direction can be claimed at the enhanced rate for the whole mileage.
How Are NHS Mileage Rates Calculated?
NHS mileage rates are calculated by the NHS Staff Council using motoring cost data from the Office for National Statistics under the Consumer Prices Index. The mechanism was introduced on 1 June 2023, replacing the previous system based on AA motoring cost guides that had ended in 2014 and left rates frozen for several years. The calculation applies the ONS motoring cost index retrospectively to a baseline anchored at HMRC's Approved Mileage Allowance Payments and the historic Section 17 rates to produce the current pence-per-mile figures.
The mechanism holds the standard and reserve rates in a defined ratio to each other, so when the standard rate moves on the biannual review, the reserve rate moves in step. The dual-rate structure above and below the 3,500-mile threshold is also preserved by the mechanism, since the two tiers approximate the full running cost (below threshold) and the marginal fuel-plus-wear cost (above threshold) of a privately-owned car.
The Review Cycle for the Rates
NHS mileage rates are reviewed twice a year under the Staff Council mechanism. The first review draws on ONS motoring cost data published in March and sets any adjustment from 1 July; the second draws on September data and sets any adjustment from 1 January. A review changes the published rates only when motoring costs have moved by more than one penny a mile since the previous rate was set, which prevents constant small adjustments to payroll and expense systems while keeping the rates responsive to real cost pressure.
The threshold-based reviews mean that NHS rates can lag HMRC's static AMAP rate when motoring costs move sharply, since HMRC changes its rate only when government legislation revises it. The 59p rate that applies in 2026 therefore reflects a specific moment of elevated motoring costs in 2023-2024 rather than a current snapshot of ONS data.
What Is the Difference Between the Standard and Reserve Rate?
The standard rate reimburses full car ownership costs at 59 pence per mile below the 3,500-mile threshold and 24 pence per mile above it, while the reserve rate reimburses marginal travel costs only at 30 pence per mile for all mileage. The standard rate applies to staff using their own car for business journeys as a routine part of their job, where NHS Employers assumes the employee bears the full fixed cost of car ownership and operation. The reserve rate applies in three narrower cases: declined lease cars, overtime-driven travel, and unscheduled recall journeys, where the employee's standard travel pattern has already been covered elsewhere.
The practical consequence is that a community nurse who uses her own car every day will spend most of her business miles on the 59p standard rate (dropping to 24p after 3,500 miles), while a hospital-based clinician called in off-shift for an emergency receives only the 30p reserve rate on the extra journeys. The two rates share the same tax treatment, with the margin above HMRC's 45p AMAP taxable in both cases.
How Do NHS Mileage Rates Compare With the HMRC Rate?
NHS mileage rates sit above HMRC's Approved Mileage Allowance Payments rate for the first 3,500 miles and fall below it beyond that threshold. HMRC's AMAP rate is 45 pence per mile for the first 10,000 business miles in a tax year and 25 pence per mile beyond 10,000 miles, under HMRC's Employment Income Manual (EIM31240). The NHS standard rate of 59 pence per mile therefore exceeds HMRC's 45p figure by 14 pence per mile for the first 3,500 miles, with the excess counted as taxable income for the employee.
Above the Section 17 threshold of 3,500 miles, the NHS pays 24 pence per mile against the HMRC rate of 45 pence per mile (still below the 10,000-mile HMRC threshold), which creates a 21-pence-per-mile shortfall. The employee can claim Mileage Allowance Relief on the shortfall through a Self Assessment return or HMRC form P87, recovering the income tax relief on the gap between what the NHS paid and what HMRC's rate would have paid. The relief does not refund the whole 21p — only the income tax that would have been due on it (20%, 40%, or 45% depending on the employee's marginal rate).
Do NHS Lease Car Users Get a Different Mileage Rate?
Yes. NHS lease car users receive the reserve rate of 30 pence per mile under Section 17, which is lower than the standard rate because the lease arrangement already covers the fixed costs of car ownership. A trust-provided lease typically includes insurance, servicing, road tax, breakdown cover, and depreciation inside the monthly lease price, so the employee pays only the marginal cost of fuel and some wear when driving on NHS business. The 30p reserve rate reflects that marginal cost rather than full ownership cost.
Lease car arrangements under NHS Fleet Solutions or Tusker typically pair with the salary sacrifice route into the Scheme Rules, which means pensionable pay and tax treatment also run differently from a privately-owned car. Staff considering a lease should compare the overall position (lease cost plus 30p reserve rate against private ownership plus 59p standard rate) before taking the lease.
Are There Separate NHS Mileage Rates for Electric Cars?
No. Electric cars receive the same Section 17 rates as petrol, diesel, and hybrid vehicles, so an electric private car on NHS business claims 59p per mile up to 3,500 miles and 24p per mile above it. The NHS Staff Council has acknowledged in review minutes that the rate mechanism does not currently distinguish between fuel types, even though electric running costs are substantially lower than petrol or diesel at typical UK energy prices.
Some NHS trusts negotiate local supplements or temporary arrangements for electric vehicles under salary sacrifice schemes, but these sit outside Section 17 and do not change the national rate. HMRC's AMAP rate also treats electric vehicles identically to combustion-engine cars at 45 pence per mile.
Do Doctors Get Different NHS Mileage Rates?
No, when doctors are employed under Agenda for Change terms (nearly all non-training grade non-consultant doctors are not AfC — but AfC-equivalent terms where applicable). AfC doctors receive the same Section 17 rates as any other AfC staff member. Doctors and dentists on separate national terms — consultants, specialty and specialist doctors, GPs under the GMS contract, and dentists under their own contract — follow mileage provisions set in medical and dental pay circulars rather than Section 17.
The non-AfC mileage rates frequently mirror Section 17 in practice, since the circulars draw on the same ONS motoring cost data and the same Staff Council mechanism. Local medical staff committees sometimes negotiate variations for specific travel-heavy roles, so doctors should check their contract or pay circular rather than assume the Section 17 figure applies.
What Is a Year of NHS Mileage Actually Worth?
A year of NHS mileage is worth £2,065 for the first 3,500 miles at the 59p standard rate, with any additional miles paid at 24p a mile under Section 17. A community nurse driving 5,500 business miles a year collects £2,065 for the first 3,500 miles plus £480 for the additional 2,000 miles at 24p, totalling £2,545. A ward-based clinician driving only 500 business miles a year to attend training and cross-site meetings collects £295 at the full 59p rate.
The variation across NHS roles is substantial. Community nurses, district nurses, specialist outreach teams, and some senior management with multi-site responsibilities regularly top 5,000-7,000 miles a year, while most ward-based staff claim only a few hundred pounds. The reimbursement is not pay — it covers business motoring costs the employee incurs — but the net effect on monthly budgets is similar for staff who make substantial regular claims.
Is Mileage Reimbursement Taxed Like Your NHS Pay?
No. Mileage reimbursement is tax-free up to HMRC's Approved Mileage Allowance Payments rate of 45 pence per mile and taxable only on the margin above it. For NHS staff on the 59p standard rate, the first 45p a mile is tax-free and the 14p margin above the HMRC rate is treated as taxable earnings, subject to income tax and employee National Insurance at the staff member's marginal rate. The taxable margin shows on the payslip as a separate line (often "Mileage Benefit" or "Excess Mileage Taxable") or at year-end on form P11D, depending on the trust's payroll setup.
Staff on the reserve rate of 30p or the above-threshold rate of 24p receive their mileage fully tax-free, since both figures sit below HMRC's 45p AMAP rate. Those staff can also claim Mileage Allowance Relief on the gap between the NHS rate and HMRC's rate, which refunds the income tax that would have been due on the shortfall.
How Does Mileage Sit Alongside Your Taxable NHS Pay?
NHS mileage reimbursement sits outside basic salary for both tax and pension purposes, running on its own line of the payslip and following its own HMRC rules. The three structural effects are explained below.
Mileage and Pensionable Pay
Mileage reimbursement is not pensionable pay under NHS Pension Scheme regulations. The reimbursement is treated as reimbursement of business expenses rather than earnings, so neither employee nor employer pension contributions apply to it, and the mileage does not count toward career-average accrual under the 2015 Scheme. A staff member claiming £2,500 of mileage a year sees no pension effect from the claim, whether positive or negative.
The Taxable Margin Above the Approved Rate
The 14 pence per mile that NHS staff receive above HMRC's 45p AMAP on the standard rate is a taxable margin, not tax relief. HMRC treats the margin as taxable earnings under the Employment Income Manual (EIM31335), so it attracts income tax at the employee's marginal rate (20%, 40%, or 45%) and employee National Insurance at 8% below the upper earnings limit (or 2% above it, under the 2026/27 rates). The trust reports the margin to HMRC either through PAYE in real time or on the annual P11D return.
A staff member claiming the full 3,500 miles at 59p generates a taxable margin of £490 a year (3,500 × 14p), on which a basic-rate taxpayer pays about £137 in income tax and NI combined. The net benefit of the 59p rate over the HMRC rate is roughly 10p per mile after tax, not the full 14p headline figure.
Claiming Tax Relief on Reserve-Rate and Lease-Car Journeys
Staff paid at the reserve rate (30p) or the above-threshold rate (24p) can claim Mileage Allowance Relief on the gap up to HMRC's 45p AMAP. The relief is claimed through a Self Assessment return (if one is already filed) or HMRC form P87 (otherwise), which calculates the tax saving against the shortfall. A reserve-rate journey leaves a 15p-per-mile shortfall below the HMRC rate, so 1,000 miles at the reserve rate generates £150 of unused relief, worth £30 in tax saving for a basic-rate taxpayer and £60 for a higher-rate taxpayer.
The relief has to be claimed within four years of the end of the tax year to which it relates, and claims above £2,500 of annual expenses need to run through Self Assessment rather than P87.
How Do You Claim NHS Mileage?
NHS mileage is claimed through the trust's expense system (usually ESR, SBS Expense Manager, or a trust-specific portal), with the claim covering every business journey in the period. The steps are listed below:
- Verify Business-Use Insurance: Confirm with your car insurer that the policy covers "business use class 1" for the journeys claimed, since standard social, domestic, and pleasure cover does not include NHS business travel.
- Log Each Journey: Record the date, start point, destination, purpose, miles driven, vehicle type (car, motorcycle, pedal cycle), and the rate class (standard, reserve, or equipment supplement).
- Deduct Commute Mileage: Where a journey starts from home rather than the usual base, deduct the ordinary home-to-base mileage before claiming, unless the trust's policy allows full home-to-destination claims for community roles.
- Add Parking, Tolls, and Congestion Charges: Attach receipts for parking fees, toll road charges, and congestion zone charges incurred on the journey.
- Submit Within the Deadline: Send the claim through the trust's expense system within the monthly or quarterly deadline, since late claims can be rejected under local policy.
- Keep Records for Four Years: Retain the mileage log, receipts, and claim records for four years in case of HMRC tax relief claim or employer audit.
The approving manager typically reviews the claim before payroll processes it, and reimbursement appears in the next pay cycle after approval.
Business Miles Versus Home-to-Base Miles
Business miles are journeys made for NHS duties outside the ordinary commute, such as travel between NHS sites, patient home visits, cross-site meetings, and attendance at off-site training. Home-to-base miles are the ordinary daily commute to the usual place of work, which is treated as personal travel under Section 17 and HMRC rules and is not claimable. The distinction matters most when a journey starts at home and goes somewhere other than the usual base. Trusts handle this in one of two ways: strict deduction (subtract the normal home-to-base mileage from the claim) or community exemption (allow the full home-to-destination mileage for roles where the base is nominal, such as community nurses).
Other Costs Reclaimable on the Same Journey
Several other travel costs can be reclaimed alongside the mileage on the same journey, provided they are directly related to the business trip. The reclaimable items are listed below:
- Parking Fees: Receipted parking at the destination or any intermediate stop during the journey.
- Toll Road Fees: Toll charges on routes used for the business journey.
- Congestion Charges: Daily congestion zone charges (London Congestion Charge, Clean Air Zone fees) incurred on the journey.
- Public Transport Costs: Bus, train, taxi, or tram fares where part of the journey was made by public transport rather than private vehicle.
Receipts are required for each additional cost and the trust's expense system usually accepts digital images attached to the claim.
What Mileage Rate Applies to Patient Travel?
Patient travel runs under the Healthcare Travel Costs Scheme (HTCS), not Section 17, so staff mileage rates do not apply to patients claiming reimbursement for journeys to NHS treatment. The HTCS reimburses eligible patients for the cost of travelling to NHS treatment appointments, with rates set locally by each NHS provider or integrated care board rather than nationally. A patient claiming under HTCS at one trust may receive 17 pence per mile while a patient at a neighbouring trust claims 23 pence per mile, depending on local scheme design.
Eligibility for HTCS is means-tested against low-income benefits (Income Support, Pension Credit Guarantee, Universal Credit under earnings threshold, Working Tax Credit with disability element). Patients should check with the hospital or trust that is treating them for the applicable rate, the eligibility criteria, and the required supporting documents before making a claim.
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