NHS Band 4 Salary 2026/27: Pay Points, Take-Home and Typical Jobs

Band 4 sits between support roles and registered professional roles. Nursing associates, assistant practitioners, pharmacy technicians in some trusts, team administrators and medical secretaries are commonly paid here. It is often the band people reach after an apprenticeship or a foundation degree.

Band 4 pay for 2026/27

The step after three years adds £2,765 a year. Like other pay steps, it depends on a pay step review confirming your appraisal is up to date and your mandatory training is complete.

What Band 4 takes home each month

Full time, with the NHS Pension and tax code 1257L:

Notice the pension rate. At the top of Band 4 your pensionable pay passes £28,854, so your contribution moves from 6.5% to 8.3%. That is why the take-home rise after the step is smaller than the salary rise suggests. You are not losing money: the higher contribution buys the same pension accrual rate as everyone else, and it is taken before tax so you get relief at 20%. The pension contributions calculator shows where your pay sits in the tiers.

Student loans on Band 4

At the top pay point, Band 4 crosses the Plan 2 threshold of £29,385. A Plan 2 borrower repays 9% of earnings above that line, which on basic pay is about £13 a month. Plan 1 borrowers start repaying at £26,900 and so repay more. Our student loan guide explains each plan.

Unsocial hours and overtime

From Band 4 upwards, unsocial hours enhancements are the same percentage for every band:

• Weekday nights and Saturdays: plus 30%
• Sundays and public holidays: plus 60%

For a Band 4 at entry, that is about £18.88 an hour on a Saturday and £23.23 an hour on a Sunday. Overtime is paid at time and a half, or double time on public holidays.

Jobs paid on Band 4

Common Band 4 roles include:

• Nursing associates, a registered role with the NMC that bridges healthcare assistants and registered nurses
• Assistant practitioners in therapies, radiography and other clinical areas
• Pharmacy technicians in some trusts (others pay them at Band 5)
• Medical secretaries and team administrators
• Senior estates, finance and IT support roles

Is Band 4 a stepping stone?

For many people it is. Nursing associates can top up to become registered nurses, often through a shortened apprenticeship, and move to Band 5 when they register. Assistant practitioners can follow a similar route into allied health professions.

Here is how the next step compares:

The jump in basic pay is £3,681 a year. Over a full career, Band 5 and above also have more pay steps, so the long-term difference is larger.

Annual leave on Band 4

The same as every band: 27 days plus 8 public holidays to start, 29 days after five years of NHS service and 33 after ten. Part-time staff get the same entitlement in proportion to their hours. The annual leave calculator converts this into hours.

Questions people ask about Band 4

Will I start at the top if I have experience? Normally you start at entry. Some employers will agree a higher starting point, but it is discretionary and must be agreed before you accept.

What if I was promoted from Band 3? You move to the entry point of Band 4. If you were already at the top of Band 3, your pay still rises, because Band 4 entry is higher than the top of Band 3.

Is a nursing associate Band 4 everywhere? Nationally the role is profiled at Band 4, and this is consistent in most trusts in England.

See your own figures

Your payslip will vary with your hours, enhancements and any salary sacrifice. Put your details into the take-home pay calculator for an accurate monthly figure.