The tight aspect ratios (typically A≈1.4) and low magnetic field of spherical tokamak (ST) plasmas, when combined with densities approaching the Greenwald limit, provide a significant challenge for all currently available auxiliary heating and current drive schemes. NBI heating and current drive are difficult to interpret in sub-megampere machines, as in order to achieve suitable penetration into the plasma core, fast ions have to be highly suprathermal and, as a result of the low magnetic field, can be non-adiabatic (i.e. non-conserving of magnetic moment µ0). The physics of NBI heating in START is discussed. The neutral beam injector deployed on START was clearly successful, having been instrumental in producing a world record tokamak toroidal beta of ≈40%. A fast ion Monte Carlo code (LOCUST) is described that was developed to model non-adiabatic fast ion topologies together with a high level of charge exchange loss and cross-field transport (present in START due to an envelope of high density gas surrounding the plasma). Model predictions compare well with experimental data, collected using a scanning neutral particle analyser, bolometric instruments and equilibrium reconstruction using EFIT. In particular, beta calculations based upon reconstruction of the pressure profile (by combining measurements from Thomson scattering, charge exchange recombination spectroscopy and model predictions for the fast ion distribution function) agree well with beta values calculated using EFIT alone (the routine method for calculation of START beta). These results thus provide increased confidence in the ability of STs to sustain high beta high confinement H mode plasmas and in addition indicate that the injected fast ions in collisional START plasmas evolve mainly due to collisional and charge exchange processes, without driving any significant performance degrading fast particle MHD activity.