Can I afford to leave the NHS?
Compare your NHS package, pension included, against private practice at the caseload you'd actually build.
Stay
£69,909
your total NHS package
- Salary
- £56,515
- Employer pension (23.7%)
- £13,394
Plus paid annual leave and occupational sick pay, which self-employment does not replace.
Hybrid
£57,271
NHS fraction plus a mature private caseload
- NHS package at 0.6 WTE
- £41,945
- Private profit, 8 sessions
- £15,326
Year one, while the private side ramps: about £49,301.
Leave
£30,541
mature-year private profit, pre-tax
- Mature year
- £30,541
- Year one, with the ramp
- £15,598
No pension, leave or sick pay unless you fund them from this figure.
To match your NHS package of £69,909, you would need about 33.1 sessions a week at £70, every working week of the year.
The private figures are pre-tax, pre-National Insurance profit; the NHS figures are salary plus pension value. For what the private side becomes after tax, use the take-home pay calculator. Private income assumes 44 working weeks, so unpaid holiday is already priced in. None of this is financial or pension advice.
The honest version
The pension is the single biggest number people forget, so this calculator refuses to let you forget it. The NHS employer contribution is 23.7% of pensionable pay (2026/27): on a Band 7 salary, that is over £12,000 a year of retirement value that a payslip comparison silently drops. For anyone within sight of retirement, that line alone can settle the question, and the calculator is built so it argues its case in full view rather than in a footnote.
Year one is a ramp, not a cliff-edge into a full diary. Referrals arrive at the speed of relationships, not of ambition, and the year-one figure the calculator shows, with your caseload building over the months you choose, is the number people most underestimate. Budgeting on the mature-year figure from month one is the classic error of the leap.
Hybrid is how most people actually do it, which is why it sits in the middle at equal billing rather than as a footnote. Dropping to 0.6, keeping partial pension accrual and salary while the private day builds, de-risks the referral-building year almost entirely: if the private side stalls, you have lost nothing but some evenings, and if it fills, the next decision makes itself with real data behind it.
Two more honest lines. Unpaid time now comes out of the fee, which is why the private side is priced on 44 working weeks: holiday, sickness and CPD are already deducted, where the NHS figure includes them as paid. And nothing here leans on the scales: whether to leave is a life question this page has no opinion on. The startup cost calculator and take-home pay calculator fill in the two numbers this one deliberately leaves out.
Frequently asked questions
Whichever column you choose, the private day comes with admin the NHS used to do for you. That part, the diary, notes, agreements and payment chasing, is what Bloom exists to shrink.