NHS Band 4 Salary and Take-Home Pay 2026/27
An NHS Band 4 employee in England earns between £28,392 and £31,157 a year in 2026/27, and takes home roughly £1,870 to £1,990 a month after income tax, National Insurance and the NHS pension. Band 4 covers nursing associates, assistant practitioners, pharmacy technicians and senior support roles. These are the confirmed 2026/27 Agenda for Change rates, which include the 3.3 percent pay award that took effect on 1 April 2026.
Figures verified against NHS Employers AfC pay scales on .
Written by James HartleyCIMA
Band 4 at a glance, England 2026/27:
- Starting salary: £28,392 a year
- Top of band: £31,157 a year (after about 3 years)
- Hourly rate: about £14.50 to £15.93 an hour
- Take-home pay: about £1,870 a month at entry, rising to about £1,990 at the top
- Pension tier: 6.5 percent at entry, rising to 8.3 percent near the top
- Pay points: 2
What is the Band 4 take-home pay each month?
A Band 4 employee on the £28,392 starting salary takes home about £1,870 a month in England, once income tax, National Insurance and the 6.5 percent pension contribution are deducted. At the top of the band, £31,157, take-home rises to about £1,990 a month, though the pension rate increases to 8.3 percent at that level. All of Band 4 is taxed at the basic 20 percent rate, well below the higher rate threshold. These figures assume a standard tax code, no student loan and full-time hours. If you have a student loan, work part time, or receive London weighting, use the NHS pay calculator for an exact figure.
Why does my pension rate increase as I move up Band 4?
Your NHS pension contribution rises from 6.5 percent to 8.3 percent as you progress through Band 4, because the band crosses a pension tier threshold. The 6.5 percent tier covers pensionable pay from £13,260 to £28,854, and the 8.3 percent tier covers £28,855 to £35,155. The entry salary of £28,392 sits just inside the 6.5 percent tier, but the top of the band at £31,157, and even a pay award that lifts you past £28,855, moves you into the 8.3 percent tier, where the higher rate applies to your whole salary. This is why your take-home rises only a little as you reach the top of the band. The contribution is taken before income tax, so you receive tax relief on it, and your employer adds 23.7 percent on top.
Band 4 pay points and progression
Band 4 has two pay points in 2026/27: £28,392 at entry and £31,157 at the top. You move up to the top point on your work anniversary after the set period, subject to a satisfactory appraisal, reaching it after about three years. After that, pay only rises through the annual national pay award, or by moving up to Band 5, which for many Band 4 staff means qualifying as a registered professional.
What is the Band 4 hourly rate?
The Band 4 hourly rate in 2026/27 is about £14.50 an hour at entry and about £15.93 an hour at the top of the band, based on the standard NHS full-time week of 37.5 hours. The hourly rate is worked out by dividing the annual salary by 1,957.5, which is 52.143 weeks multiplied by 37.5 hours. Band 4 sits comfortably above the National Minimum Wage, unlike Bands 2 and 3 which sit much closer to it. Band 4 clinical staff who work shifts also receive unsocial hours enhancements on top of basic pay.
What is the difference between Band 3 and Band 4?
Band 4 is the step up from Band 3 into more skilled and more autonomous support roles. Band 3 ranges from £25,760 to £27,476, and Band 4 from £28,392 to £31,157, so moving from the top of Band 3 to the entry of Band 4 is an increase of about £916 a year. The bigger difference is the role itself: Band 4 includes nursing associates and assistant practitioners who carry more clinical responsibility and often need a foundation degree or equivalent qualification, whereas Band 3 covers clinical support workers and senior assistants.
How much is Band 4 pay in London?
A Band 4 employee in inner London receives a High Cost Area Supplement of 20 percent of basic salary, capped at a minimum of £5,794 and a maximum of £8,746. On the £28,392 starting salary the 20 percent figure is £5,678, which is below the minimum, so the £5,794 floor applies, taking pay to about £34,186 before deductions. Outer London pays 15 percent and the fringe pays 5 percent, each with their own caps. London weighting is pensionable and taxable, and the calculator accounts for it when you select a London zone.
Who works at Band 4?
Band 4 is the bridge between support roles and registered professionals. Typical Band 4 roles include nursing associates, assistant practitioners, pharmacy technicians, bed managers, senior healthcare assistants, theatre support workers, occupational therapy assistant practitioners and senior administrative staff. Many Band 4 staff are working towards registration, with the nursing associate role in particular acting as a stepping stone towards becoming a Band 5 registered nurse.
How do I move from Band 4 to Band 5, and how much more is it?
Moving from Band 4 to Band 5 usually means gaining a professional registration and applying for a registered post, because Band 5 is the entry grade for qualified nurses and allied health professionals. The top of Band 4 is £31,157 and the entry of Band 5 is £32,073, an increase of about £916 a year to start. The real gain is the higher ceiling and the career pathway: Band 5 rises to £39,043, and opens the route to Band 6 and beyond.
Is Band 4 pay the same across the UK?
Band 4 pay is similar but not identical across the four nations in 2026/27. England, Wales and Northern Ireland follow the same Pay Review Body figure, so their cash scales are close. Scotland has a separate, higher multi-year deal and a 36-hour week, so the salary and hourly rate differ, and Scottish income tax bands change the take-home. Select your nation in the NHS pay calculator for the exact figure.
Frequently asked questions
A Band 4 employee on the £28,392 starting salary takes home about £1,870 a month in England after income tax, National Insurance and the 6.5 percent pension contribution. At the top of the band, £31,157, take-home rises to about £1,990 a month, assuming a standard tax code, full-time hours and no student loan.
The starting salary for Band 4 in England is £28,392 a year in 2026/27, including the 3.3 percent pay award applied on 1 April 2026. The top of the band is £31,157, reached after about three years.
Band 4 crosses a pension tier threshold at £28,855, so your contribution rises from 6.5 percent to 8.3 percent as you progress. The entry salary of £28,392 sits in the 6.5 percent tier, but the top of the band at £31,157 falls into the 8.3 percent tier, and the higher rate then applies to your whole salary.
Band 4 pays more and carries more responsibility than Band 3. Band 3 ranges from £25,760 to £27,476 and covers clinical support workers and senior assistants, while Band 4 ranges from £28,392 to £31,157 and covers nursing associates and assistant practitioners, who often need a foundation degree and work with more autonomy.
It takes about three years to reach the top of Band 4. The band has two pay points, and you move from £28,392 to £31,157 on your work anniversary after the set period, subject to a satisfactory appraisal.
The Band 4 hourly rate is about £14.50 an hour at entry and about £15.93 an hour at the top of the band in 2026/27, based on a 37.5 hour week. The rate is calculated by dividing the annual salary by 1,957.5 hours, and sits above the National Minimum Wage.
Band 4 roles include nursing associates, assistant practitioners, pharmacy technicians, bed managers, senior healthcare assistants, theatre support workers and senior administrative staff. The nursing associate role is a common stepping stone towards becoming a Band 5 registered nurse.
Moving from Band 4 to Band 5 usually means gaining a professional registration, such as qualifying as a registered nurse, and applying for a registered post. The entry salary for Band 5 is £32,073, about £916 more than the top of Band 4, and Band 5 rises to £39,043.