We run courses in London and Manchester, which means we have watched delegates build careers in both and have no axe to grind about which is better. The differences are real, but not always the ones people expect.
Earnings versus cost
London pays more on paper. Glassdoor put the London average around 42,900 pounds against a national figure near 35,700 in 2026. But the premium is partly swallowed by room rents, competition and the cost of standing out. Manchester and the wider North West offer lower overheads and, in places, less crowded high streets, which can leave a comparable margin at the end of the month.
Competition and differentiation
London’s market is deep and demanding. There is more work, and more people chasing it, so a clear clinical position matters more. Outside the capital you may be one of few genuinely medically trained injectors in your area, which is its own advantage. Neither is easier. They are hard in different directions.
The practical bit: where you actually train
For most people the deciding factor is simply travel and time, because a course you can reach without an overnight is a course you will actually attend and repeat. We publish live dates for both venues, and the local hubs go into detail on each, from training in London to training in Manchester.
The takeaway
Do not pick a city on prestige. Pick it on where you will practise, what your overheads will be, and which venue you can get to often enough to build real skill. The course dates page shows what is running where.