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 has widened twice over. NHS rates were cut in January 2026, and then in April 2026 the HMRC approved rate rose from 45p to 55p per mile, its first increase since 2011. That shortfall is money you can claim back, and it is now considerably larger than it was a year ago.
This guide explains the current NHS mileage rates, the January 2026 cut, the April 2026 HMRC rate rise, what is coming next, 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 entirely separate tax-free mileage rate, called the Approved Mileage Allowance Payment (AMAP). This is not an NHS rate and has nothing to do with Agenda for Change — it is the national rate for anyone using their own car for work:
- 55p per mile for the first 10,000 business miles per year
- 25p per mile above 10,000 miles
The 55p figure is new. AMAP sat at 45p from 2011 until 5 April 2026, and the increase to 55p took effect from 6 April 2026 for the 2026/27 tax year — the first rise in 14 years. The rate above 10,000 miles is unchanged at 25p. The current rates are published by HMRC on the travel — mileage and fuel rates and allowances page.
The AMAP rise matters enormously for NHS staff, because AfC rates went the other way in January 2026. The two moved in opposite directions, and the gap between them widened on both sides of the AfC threshold.
The NHS AfC rate of 56p per mile still exceeds AMAP for the first 3,500 miles, but only just — by 1p per mile, where it used to beat the old 45p rate by 11p. There is no shortfall to claim on those early miles. (If your total annual business mileage is under roughly 3,500 miles, your trust is technically paying you slightly more than the tax-free amount, and the small excess is taxable. On 3,000 miles that excess is now only £30, down from £330 under the 45p rate.)
The picture reverses sharply once you pass the 3,500-mile threshold. The AfC rate drops to just 21p per mile, while HMRC allows 55p per mile until you reach 10,000 miles. That creates a 34p-per-mile gap on every business mile between 3,500 and 10,000 — up from a 24p gap before the AMAP increase.
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. MAR is worked out on your annual totals, not band by band — you compare the whole AMAP entitlement against everything your trust actually paid.
Here is a worked example for a community nurse who drives 8,000 business miles in the 2026/27 tax year, on the AfC rates in force since January 2026:
Step 1 — Work out the HMRC-approved total:
- 8,000 miles at 55p = £4,400
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:
- £4,400 minus £2,905 = £1,495 MAR claim
Step 4 — Calculate the tax saving:
- Basic-rate taxpayer (20%): £1,495 x 20% = £299 refund
- Higher-rate taxpayer (40%): £1,495 x 40% = £598 refund
How much of that is down to the rate rise? On exactly the same mileage and the same AfC reimbursement in 2025/26, the AMAP total was 8,000 x 45p = £3,600, the shortfall was £695, and the refund was £139 at basic rate or £278 at higher rate. The move to 55p more than doubles the claim: £800 more shortfall, worth an extra £160 a year at basic rate and £320 at higher rate. Nothing about the nurse’s driving changed — only the approved rate did.
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. Work each year out separately at the approved rate that applied then — 55p for 2026/27, and 45p for 2025/26 and earlier. Your AfC reimbursement rates also changed part-way through 2025/26, so check the rate your trust actually paid in each period.
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 approved rate (55p per mile for 2026/27)
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) — these are Agenda for Change rates, separate from HMRC’s
- The HMRC approved (AMAP) rate rose from 45p to 55p on 6 April 2026, its first increase since 2011, so the shortfall you can claim grew by 10p on every mile
- Once you exceed 3,500 miles, your trust pays just 21p versus the HMRC-approved 55p — a 34p gap you claim 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
