NHS Band 4 salary 2026/27
NHS Band 4 pays £28,392 to £31,157 a year in England from 1 April 2026, about £1,874 a month after tax, National Insurance and pension at entry and £1,990 at the top. That is £14.52 an hour rising to £15.93. Scotland pays £31,537 at entry on a 36-hour week.
Band 4 pay points and take-home
| England 2026/27 | Salary | Take-home a month | Take-home a week | Per hour |
|---|---|---|---|---|
| Entry | £28,392 | £1,874 | £432 | £14.52 |
| After 3 years | £31,157 | £1,990 | £459 | £15.93 |
Full time on 37.5 hours, NHS Pension member, tax code 1257L, no student loan, before shift pay. You move up a step after 3 years in the band, as long as you meet the usual appraisal standards.
Where a Band 4 salary goes
| Band 4 entry, each year | Amount |
|---|---|
| Gross pay | £28,392 |
| NHS Pension (6.5%) | £1,845 |
| Income Tax | £2,795 |
| National Insurance | £1,266 |
| Take-home | £22,485 |
Jobs on Band 4
Agenda for Change bands the job, not the profession, so very different roles share the same pay. Typical Band 4 roles include:
- Nursing associate (registered)
- Assistant practitioner
- Ambulance technician or associate ambulance practitioner
- Pharmacy technician (some trusts)
- Dental nurse
- Medical secretary or team administrator
- Trainee psychological wellbeing practitioner
A bridge between support work and registered roles
Band 4 is where many people sit while they train for a registered profession, such as trainee nursing associates or apprentices on a nursing degree. The top of the band, £31,157, comes after three years. A registered nursing associate at the top of Band 4 earns £916 less than a newly qualified nurse at Band 5 entry, and £7,886 less than a nurse at the top of Band 5, which is what topping up to a nursing degree is worth.
Band 4 pay in England, Scotland, Wales and Northern Ireland
| Nation | Full-time week | Salary range | Take-home a month at entry | Per hour at entry |
|---|---|---|---|---|
| England | 37.5 hours | £28,392 to £31,157 | £1,874 | £14.52 |
| Scotland | 36 hours | £31,537 to £34,303 | £2,042 | £16.80 |
| Wales | 37.5 hours | £28,819 to £31,626 | £1,898 | £14.74 |
| Northern Ireland | 37.5 hours | £27,485 to £30,162 | £1,820 | £14.06 |
Scotland has its own pay scales and a 36-hour week from April 2026, so its hourly rate is the highest. Northern Ireland figures are 2025/26 rates while its 2026/27 award waits for approval. Scottish take-home uses Scottish Income Tax.
Shifts, London weighting and overtime on Band 4
In England, Band 4 gets time plus 30% for nights (8pm to 6am) and Saturdays, and time plus 60% for Sundays and bank holidays. On a typical ward-style rota of about 8 night or Saturday hours and 4 Sunday hours a week, Band 4 entry grosses £32,026 and takes home about £2,038 a month. Overtime is paid at time and a half (£21.78 an hour at entry) and double time on bank holidays.
| High Cost Area Supplement | Gross a year | Take-home a month |
|---|---|---|
| Inner London (20%) | £34,186 | £2,155 |
| Outer London (15%) | £33,262 | £2,105 |
| Fringe (5%) | £29,812 | £1,917 |
Part-time Band 4 pay
Pay is pro rata to your contracted hours. On 22.5 hours, Band 4 entry pays £17,035 a year, about £1,242 a month after deductions. On 30 hours, Band 4 entry pays £22,714 a year, about £1,558 a month after deductions. The NHS part-time calculator works it out for any hours.
Band 4 or Band 5: what the next band is worth
Band 5 starts at £32,073, £916 above the top of Band 4. Moving from Band 4 entry to Band 5 entry adds about £166 a month after tax and pension, but from the top of Band 4 it adds only £50 a month at first. The bigger gain is the Band 5 ceiling of £39,043. See NHS Band 5 salary.
Other bands: Band 2, Band 3, Band 5, Band 6, Band 7, Band 8a, Band 8b, Band 8c, Band 8d, Band 9. For every band in one calculator, use the NHS pay calculator.
Common questions
What is the Band 4 NHS salary in 2026/27?
In England, Band 4 pays £28,392 to £31,157 a year full time from 1 April 2026. Scotland pays £31,537 to £34,303.
How much does Band 4 take home a month?
About £1,874 a month at entry in England after Income Tax, National Insurance and the NHS Pension, rising to £1,990 at the top of the band. Shift pay and London weighting are extra.
What is the Band 4 hourly rate?
£14.52 an hour at entry in England, based on a 37.5-hour week, and £15.93 at the top.
How long does it take to reach the top of Band 4?
3 years in England. Moving up depends on meeting the normal appraisal standards.
What band is a nursing associate?
Registered nursing associates are usually on Band 4. Trainee nursing associates are often on Band 3 while they train.