NHS nurses and community healthcare workers regularly drive between hospitals, GP surgeries, clinics, and patient homes. If you use your own car for these journeys, the NHS mileage allowance you receive through Agenda for Change is likely lower than the HMRC approved rate — and the gap widened in January 2026 when NHS rates were cut. That shortfall is money you can claim back.
This guide explains the current NHS mileage rates, the January 2026 changes, what is coming after April 2026, and exactly how to claim every penny you are owed from HMRC.
NHS Agenda for Change Mileage Rates from January 2026
The NHS Staff Council reviews Agenda for Change (AfC) mileage reimbursement rates every six months. Following the November 2025 review, rates decreased from 1 January 2026 due to sustained falls in fuel prices during the 12 months ending October 2025.
The current rates for staff on AfC terms and conditions are:
- 56p per mile for the first 3,500 business miles per year (down from 59p)
- 21p per mile for every mile above 3,500 (down from 24p)
- Motorcycle: 28p per mile (down from 30p)
- Passenger supplement: 5p per mile (unchanged)
These rates apply to all NHS employees whose contracts reference Section 17 of the NHS Terms and Conditions of Service Handbook. That includes the vast majority of nurses, midwives, allied health professionals, and healthcare support workers employed directly by NHS trusts.
The reduction hit community and district nurses hardest because their roles involve the most driving. Industry bodies warned the cut could act as a “tipping point” for staff already struggling with motoring costs, particularly when the NHS is trying to shift more care into the community.
How NHS Rates Compare to the HMRC Approved Rate
HMRC sets its own separate tax-free mileage rate, called the Approved Mileage Allowance Payment (AMAP):
- 45p per mile for the first 10,000 business miles per year
- 25p per mile above 10,000 miles
The NHS AfC rate of 56p per mile actually exceeds the HMRC rate for the first 3,500 miles. That means there is no shortfall to claim for those early miles — you are already receiving more than the tax-free amount.
However, the picture reverses sharply once you pass the 3,500-mile threshold. The AfC rate drops to just 21p per mile, while HMRC still allows 45p per mile until you reach 10,000 miles. That creates a 24p-per-mile gap on every business mile between 3,500 and 10,000.
For a district nurse or community nurse who drives 8,000 business miles per year, the shortfall on those miles above 3,500 is significant — and it is fully claimable from HMRC.
Calculating Your Mileage Allowance Relief (MAR)
Whenever your employer reimburses you at less than the HMRC approved rate, you can claim the difference as Mileage Allowance Relief. Here is a worked example for a community nurse who drives 8,000 business miles in the 2025/26 tax year:
Step 1 — Work out the HMRC-approved total:
- 8,000 miles at 45p = £3,600
Step 2 — Work out what your trust actually paid:
- First 3,500 miles at 56p = £1,960
- Remaining 4,500 miles at 21p = £945
- Total received: £2,905
Step 3 — Find the shortfall:
- £3,600 minus £2,905 = £695 MAR claim
Step 4 — Calculate the tax saving:
- Basic-rate taxpayer (20%): £695 x 20% = £139 refund
- Higher-rate taxpayer (40%): £695 x 40% = £278 refund
You submit this claim to HMRC using either a Self Assessment tax return or a P87 form if you do not file Self Assessment. Claims can be backdated up to four previous tax years, so if you have never claimed before, you could be owed a lump sum covering multiple years.
For a full breakdown of how MAR works, see our guide to Mileage Allowance Relief and Form P87.
What Is Changing After April 2026?
The NHS Staff Council is negotiating a completely new mileage calculation mechanism to replace the current fuel-price-only model. The existing system relied on data from the AA, which is no longer available, and only tracked fuel costs rather than the full cost of motoring.
Key elements of the proposed new mechanism include:
- Higher baseline rates that reflect the real cost of running a car, not just fuel
- A higher threshold — the reduced-rate band would kick in at 4,500 miles instead of the current 3,500
- ONS-linked adjustments using Office for National Statistics data on actual motoring costs
- More responsive reviews — rates would adjust whenever costs move by more than 1p per mile
- Annual reset on 1 April each year
The new mechanism is expected to be written into the NHS Terms and Conditions Handbook by March 2026, with implementation through the Electronic Staff Record (ESR) system as soon as possible after 1 April 2026. The next phase of negotiations will also look at rates for electric and hybrid vehicles.
For high-mileage community staff, the increase from 3,500 to 4,500 miles at the higher rate should provide meaningful financial relief.
Which Journeys Qualify for NHS Mileage?
Not all travel counts as business mileage. Your trust will only reimburse journeys that meet the qualifying criteria, and HMRC applies similar rules for MAR claims.
Journeys that typically qualify:
- Travelling between NHS sites during your working day (e.g. hospital to community clinic)
- Visiting patients at home as a district or community nurse
- Attending mandatory training or courses away from your normal base
- Travelling to a temporary workplace such as a vaccination centre or short-term placement
- Inter-patient journeys during a round of home visits
Journeys that do not qualify:
- Your regular commute from home to your permanent base
- Personal errands during the working day
- Travel already reimbursed at or above the HMRC 45p rate
If you work across multiple sites but none is your permanent base — for example, a bank nurse covering shifts at different hospitals — each location may count as a temporary workplace, making travel from home potentially claimable. The rules here are specific, so check your individual circumstances carefully.
How to Track and Submit Your Mileage
Your trust will have its own mileage claim process, usually a monthly submission through ESR or a local expenses system. For every journey you need to record:
- The date
- Start point and destination
- Business purpose of the trip
- Miles driven
HMRC requires the same information if you later submit a MAR claim. Keeping one accurate, real-time log that serves both purposes is far better than trying to reconstruct months of journeys from memory.
Tripbook records every business journey automatically via GPS, logging the date, route, distance, and purpose as you drive. At the end of each month you can export your trips for your trust’s expenses system, and at tax year end you have a complete HMRC-ready mileage log without any extra effort.
For best practice on what HMRC expects, see our guide to business mileage record keeping.
Download Tripbook from the App Store to start logging your NHS mileage automatically.
Key Takeaways for NHS Nurses
- NHS AfC mileage rates fell in January 2026 to 56p (first 3,500 miles) and 21p (above 3,500 miles)
- Once you exceed 3,500 miles, your trust pays just 21p versus the HMRC-approved 45p — claim the difference as MAR
- A new mileage mechanism after April 2026 should raise baseline rates and increase the threshold to 4,500 miles
- Use a P87 form or Self Assessment to claim your tax relief — and backdate up to four years if you have not claimed before
- Keep a contemporaneous mileage log for both your trust and HMRC — Tripbook handles this automatically
