Understanding health-tech salaries and equity

Pay in the NHS is transparent and predictable. You know your pay point, your progression and your pension. Health-tech is different: salaries vary widely between companies and roles, offers are negotiable, and startup offers often include equity that's hard to value.

This article explains how health-tech pay works so you can compare offers sensibly and negotiate with confidence. It's general information, not financial advice; for decisions about your own finances, speak to a qualified adviser.

Compare the whole package, not just salary

When comparing an industry offer with your NHS role, look at total reward:

• Base salary: the headline number.
• Pension: the NHS Pension Scheme is a defined benefit scheme with a substantial employer contribution. Most private companies offer defined contribution pensions with lower employer contributions. This difference can be significant, so factor it in.
• Bonus: some companies offer performance bonuses; many startups don't.
• Equity: share options or shares, common in startups.
• Benefits: private health cover, learning budgets, flexible working and leave.
• Hours and flexibility: no nights, weekends or on-call can be worth a lot to you, even if it isn't on the payslip.

A salary that looks similar to your NHS pay can be worth more or less once all of this is considered.

Research what's typical

Salaries vary with role, seniority, company size, funding stage and location. To get a realistic range:

• Look at job adverts that publish salary ranges for similar roles.
• Use salary data sites and reports, treating them as a guide rather than a guarantee.
• Ask people in similar roles. Many are willing to share a range privately, especially if you've built a relationship first.
• Talk to specialist recruiters, who see many offers.

Clinical background can be valued, but early in a career move you're also new to the function. Expect to be assessed on your experience in the new role, not just your clinical seniority.

How to negotiate

• Don't accept on the spot. Thank them, ask for the offer in writing and take a day or two.
• Know your range and the reasons behind it.
• Negotiate the package, not just salary. Start date, learning budget, title, equity and flexible working can all move.
• Be positive and specific. "I'm really excited about this role. Based on my research and the clinical safety experience I'd bring, I was hoping for a base nearer X. Is there flexibility?"

Most companies expect some negotiation. Being polite, prepared and reasonable rarely damages an offer.

Understanding equity

Startups often offer equity to share future upside. It can be valuable, but it's also risky: many startups don't reach a point where employee equity pays out.

Share options are the most common form. An option gives you the right to buy shares later at a fixed price, called the exercise or strike price. If the company's value grows, the difference between the strike price and the future share price is your potential gain.

Vesting means you earn your options over time. A common pattern is vesting over four years with a one-year cliff: nothing vests until your first anniversary, then the rest vests gradually.

EMI (Enterprise Management Incentives) is a UK scheme for qualifying companies that can make share options more tax efficient for employees. Many UK startups use it. Ask whether your options are EMI options.

Leaver provisions set out what happens to your options if you leave. Some companies let you keep vested options; others give you a limited window to exercise them.

Questions to ask about an equity offer

• How many options am I being offered, and what percentage of the company is that on a fully diluted basis?
• What's the exercise price, and what was the price per share at the latest funding round?
• What's the vesting schedule, and is there a cliff?
• Are these EMI options?
• What happens to my options if I leave?

A percentage tells you far more than a number of options. If the company won't share basic information, treat the equity cautiously.

Value it conservatively

A sensible approach is to choose an offer based on the salary and package you'd be happy with even if the equity were worth nothing. Treat equity as a potential bonus, not as income.

Next steps

Before you negotiate, research three comparable roles and write down your ideal and minimum package. If you're weighing a move against your NHS career, Exploring health-tech alongside an NHS career covers options that keep a foot in both.

The A–Z HealthTech Career Guide includes a full chapter on salary and equity, with negotiation scripts and the questions to ask. Get the guide before your next offer conversation. See also our Disclaimer.