Updated 29 June 2026
NHS Band 4 Pay
Band 4 is where specialist support and technical roles sit: assistant practitioners, pharmacy technicians, dental nurses, healthcare science associates, and maternity support workers. These roles need specialist training beyond Band 3 but not a degree-level registration.
Gross · 2026/27
£28,392–£31,157
Take-home / yr
≈ £22,486–£23,884
across 2 pay points
What Band 4 pays
Band 4 has 2 pay points. You start at entry (£28,392) and reach the top of the band (£31,157) after two years, subject to meeting the national pay progression standards.
If you’re promoted from Band 3 to Band 4, your pay moves to the minimum of Band 4. Since adjacent bands don’t overlap, this always gives a pay rise. See pay on promotion for the full rule. Time served at Band 3 doesn’t count toward your Band 4 progression. Your clock resets when you move bands.
For 2026/27, the headline pay award was 3.3%, but how it lands on your payslip depends on where you work. Scotland, Wales and Northern Ireland negotiate separately and the awards differ. Rates are published by the NHS Employers website.
Your entire Band 4 salary falls within the basic-rate tax bracket (20%). The higher-rate threshold sits above the Band 4 range, so bank shifts or unsocial hours enhancements alone won’t take your pay into it. Salary sacrifice arrangements (cycle to work, EV lease schemes) reduce both your income tax and National Insurance, though they also reduce your pensionable pay. Try the Casomo Calculator to model the impact. For a step-by-step walkthrough of how pension, tax, and NI combine, see How UK Take-Home Pay Is Calculated.
NHS Band 4 salary by pay point (2026/27)
| Pay point | Gross salary | Pension | Monthly take-home |
|---|---|---|---|
| Year 1 | £28,392 | 6.5% | £1,874 |
| Year 3+ | £31,157 | 8.3% | £1,990 |
Gross from the latest 2026/27 Agenda for Change pay scales (England), published by NHS Employers. Take-home assumes the standard tax code, no student loan or salary sacrifice.
Your Band 4 pension entitlements
You’re in contribution tier 3 of the NHS Pension Scheme, which means 6.5% of your gross pay goes to your pension. At Band 4 entry that’s £1,845 a year (£154/month); at the top it’s £2,586 (£216/month).
Your pension contribution is 6.5%, and your employer adds around 23.7% on top. Use the Casomo Calculator with pension toggled on and off to see exactly how it affects your monthly take-home. The NHS Pension Scheme guide covers the wider mechanics (accrual rates, when you can take it, how the 1995/2008/2015 schemes interact).
Frequently Asked Questions
The 2026/27 pay award for AfC staff in England was 3.3%, applied to all pay points. Wales, Scotland and Northern Ireland negotiate separately and the awards differ. Scotland, in particular, tends to settle at a different number and on a different timeline. The full breakdown of who got what, when, is in the 2026/27 NHS pay rise article.
Not directly. The AfC pay points are the same nationally. What London-area staff get on top is High Cost Area Supplement (HCAS), paid as a percentage of basic salary with a minimum and maximum cash floor and ceiling. There are three HCAS zones: Inner London (20.0%, capped between £5,794–£8,746), Outer London (15.0%), and the Fringe (5.0%). HCAS is pensionable and is paid in addition to your Band 4 base salary. If you’re working at a Trust in one of these zones, your take-home will be higher than the figures in the table above. Use the calculator with HCAS selected for a personalised number.
Band 5 is the entry point for degree-level registered professionals: newly qualified nurses, midwives, physiotherapists, and other AHPs. Band 4 covers specialist support roles that require training but not degree-level registration. Band 5 entry (£32,073) is £3,681 above Band 4 entry, but Band 5 also comes with a higher pension contribution tier than Band 4. Moving from Band 4 to Band 5 usually means completing a degree or gaining a registered qualification. It’s not a standard promotion.
Your pension contribution at Band 4 is 6.5%. Your employer adds around 23.7% on top, nearly three times your contribution. The trade-off depends on your personal finances. People sometimes opt out because of cash-flow pressure, and you can opt back in at any time.
Use the Casomo Calculator to toggle pension on and off and see the exact monthly difference.