NHS Band 4 Salary 2026/27
Band 4 covers skilled support and technical roles — nursing associates, associate practitioners, pharmacy technicians and senior administrators. Pay runs from £28,392 to £31,157 in 2026/27.
NHS Band 4 salary by pay point — take-home 2026/27
| Pay point | Annual salary | Take-home / month | Pension |
|---|---|---|---|
| Entry | £28,392 | £1,873.79 | 6.5% |
| Top | £31,157 | £1,990.32 | 8.3% |
Typical Band 4 roles include nursing associates, associate practitioners, pharmacy technicians, assistant practitioners in therapies and radiology, and senior administrators or team leaders. Band 4 is also the ceiling of the support workforce in many services — the step before the registered professional roles at Band 5. Figures assume full-time hours, NHS Pension included, no student loan or enhancements.
Jobs at Band 4
Band 4 is the practitioner tier of the support workforce: assistant practitioners across nursing, therapies and imaging, registered nursing associates, dental nurses, pharmacy technicians, senior theatre and maternity support workers, and nursery nurses. Most Band 4 roles are reached through an apprenticeship or foundation degree route from Band 3 — including the two-year trainee nursing associate programme paid under Annex 21.
Band 4 hourly rate and unsocial hours pay
| Pay point | Hourly rate | Saturday / night rate | Sunday / bank holiday rate |
|---|---|---|---|
| Entry · £28,392 | £14.50 | £18.86 | £23.21 |
| Top · £31,157 | £15.92 | £20.69 | £25.47 |
Nursing associates, assistant practitioners and theatre support staff on Band 4 earn £14.50 to £15.92 an hour before enhancements. Saturdays and nights add 30% (up to £20.69 an hour) and Sundays and bank holidays add 60% (up to £25.47 an hour). A 7.5-hour Sunday shift at the entry point adds a premium of about £65.27 on top of basic pay for those hours — for rota-heavy Band 4 roles, a meaningful slice of monthly pay. Add your pattern in the calculator above to see it in your take-home. Every rate is worked out from the NHS Band 4 salary points for 2026/27.
Band 4 is where experienced support staff become specialists in their own right. Enter your hours, region and student loan in the calculator above to turn the NHS Band 4 salary into your own monthly take-home figure — your NHS Band 4 salary after pension, tax and NI, not just the headline number.
Pay progression at Band 4. Band 4 runs from £28,392 to £31,157, and take-home climbs from £1,873.79 a month at entry to £1,990.32 at the top point — £116.53 more a month. One wrinkle to know about: the band straddles a pension tier boundary. The entry point sits in the 6.5% NHS Pension tier, but the top point crosses the £28,854 threshold into the 8.3% tier — so a slice of the rise goes into your pension rather than your pocket. That’s not a bad trade: the extra contributions buy a bigger pension.
Pension and leave at Band 4. Band 4 straddles a pension tier boundary: the entry point pays 6.5%, but the top point (£31,157) crosses the £28,854 threshold into the 8.3% tier — £2,586.03 a year. That is why the final step buys less take-home than the gross rise suggests. Annual leave follows the standard Agenda for Change ladder — 27 days plus bank holidays on appointment, 29 days after five years and 33 days after ten, pro-rata for part-time hours.
Worked example — part-time at the top point. At 30 hours a week, the top-point salary pro-rates to £24,925.60 — and at that salary your pension drops back into the 6.5% tier. Pension takes £1,620.16 a year, income tax £2,147.09 and National Insurance £988.45 — leaving take-home of £1,680.83 a month. Sundays and bank holidays on top would lift it further at the +60% enhancement rate: one Sunday shift a month at the entry point adds around £786 a year before deductions. Try your own hours and enhancements in the calculator above.
Band 4 pay in London — HCAS. London Band 4 roles add the High Cost Area Supplement: 20% of basic pay in inner London, 15% in outer London and 5% in the fringe zone, within minimum and maximum payments (£5,794 to £8,746 inner, £4,870 to £6,137 outer, £1,346 to £2,270 fringe in 2026/27). At the inner rate, the top Band 4 point of £31,157 gains £6,231.40 of HCAS, taking gross pay to £37,388.40 and take-home to about £2,292.33 a month — £302.01 more than the same point outside London.
The supplement sits on top of the NHS Band 4 salary and is taxed and pensionable in the same way. Enter the HCAS figure from your payslip in the calculator above for your exact take-home.
Sources: NHS Employers Agenda for Change pay scales 2026/27; HMRC rates and thresholds 2026/27.
Band 4 part-time pay — take-home at 30 and 22.5 hours
Part-time pay is your full-time salary scaled by contracted hours — 30 hours is 0.8 of full-time, 22.5 hours is 0.6. One advantage hides in the pension: contribution tiers are set by your actual pay in England, so reducing hours can drop your rate and soften the cut. At Band 4, the top point pays 8.3% pension full-time but drops to 6.5% at both part-time patterns below.
| Pay point | Full-time (37.5h) | 30 hours (0.8) | 22.5 hours (0.6) |
|---|---|---|---|
| Entry point | £28,392 → £1,873.79/mo | £22,713.60 → £1,557.69/mo | £17,035.20 → £1,241.59/mo |
| Top point | £31,157 → £1,990.32/mo | £24,925.60 → £1,680.83/mo | £18,694.20 → £1,333.94/mo |
Working fewer or different hours? Run the NHS part-time calculator with your exact contracted hours.
Band 4 questions
How much does a Band 4 take home?
About £1,874 a month at the entry point (£28,392) and £1,990 a month at the top (£31,157), after NHS pension, tax and NI.
What pension does a Band 4 pay?
Band 4 straddles two tiers in 2026/27: 6.5% at the entry point (£28,392 sits inside the £13,260–£28,854 tier) and 8.3% at the top point (£31,157). Work part-time and your actual salary may fall back into the 6.5% tier.
How much more is Band 4 than Band 3?
At entry, £2,632 a year more in salary — about £147 a month more take-home. The top of Band 4 pays about £168 a month more take-home than the top of Band 3.
How do I move from Band 4 to Band 5?
Band 5 is registered professional level — staff nurses, radiographers, occupational therapists. Nursing associates can top up to a registered nurse qualification through a degree apprenticeship or top-up course, often funded by their trust.