NHS Band 4 Pay
Band 4 pays £28,392 to £31,157 a year in England for 2026/27, depending on your step. That is about £1,874 a month take-home at the entry step.
| Band | Step | Annual | Monthly Gross | Hourly | Monthly Take-Home |
|---|---|---|---|---|---|
| Band 4 | Entry step | £28,392 | £2,366 | £14.52 | £1,874 |
| Band 4 | Top step | £31,157 | £2,596 | £15.93 | £1,990 |
Take-home assumes tax code 1257L, NHS pension membership, no London supplement and no student loan. Work out your own figure.
Band 4 across the Four Nations
Same band, same step, four different answers — separate awards, separate tax, and a shorter week in Scotland.
| Nation | Week | Award | Gross | Take-Home |
|---|---|---|---|---|
| England | 37.5h | 3.3% | £28,392 | £22,486 |
| Scotland | 36h | 3.75% | £31,537 | £24,500 |
| Wales | 37.5h | 3.3% | £28,819 | £22,771 |
| Northern Ireland provisional | 37.5h | — | £28,392 | £22,441 |
Band 4 Pay over Five Years
| Year | Award | Entry Step | Top Step | Full Tables |
|---|---|---|---|---|
| 2026/27 | 3.3% | £28,392 | £31,157 | 2026/27 scales |
| 2025/26 | — | £27,485 | £30,162 | 2025/26 scales |
| 2024/25 | — | £26,530 | £29,114 | 2024/25 scales |
| 2023/24 | — | £25,147 | £27,596 | 2023/24 scales |
| 2022/23 | — | £23,949 | £26,282 | 2022/23 scales |
Entry-step pay has risen £4,443 since 2022/23, an increase of 18.6% over five years before inflation.
Which Jobs Are Band 4?
55 nationally profiled job titles are matched to Band 4, across 35 job families, from the NHS Employers A–Z job profile index.
A national profile is not a guarantee. A national profile is the job-evaluation match for a role. Individual posts are matched locally, so an employer may band a job differently from the national profile.
Band 4 Pay by Profession
Pay is set by the band, not the profession: a Band 4 midwife and a Band 4 pharmacy technician on the same step are paid the same basic salary. What differs is which of a profession’s national profiles sit at this band, and where the next one up is.
| Profession | National Profiles at Band 4 | Pay Range | Next Profile Up |
|---|---|---|---|
| Midwife | Midwifery band 4 | £28,392 to £31,157 | Midwife Entry Level (Band 5) Midwifery band 5 (Band 5) |
| Pharmacy technician | Pharmacy Technician | £28,392 to £31,157 | Pharmacy Technician Higher Level (Pharmacy or Primary Care) (Band 5) |
| Assistant or associate practitioner | Assistant Practitioner (Radiography) Associate Practitioner/Nursery Nurse Clinical Psychology, Assistant Practitioner Healthcare Science Associate Practitioner Nurse Associate Practitioner (Community) Nurse Associate Practitioner (Mental Health) Nurse Associate Practitioner Acute Speech and Language Therapy Assistant/Associate Practitioner Speech and Language Therapy Associate Practitioner (bi-lingual) Therapy, Assistant Practitioner |
£28,392 to £31,157 | Clinical Psychology, Assistant Practitioner (Higher Level) (Band 5) Residential Senior Care - Social Work Assistant Practitioner (Band 5) |
| Dental nurse | Dental Nurse | £28,392 to £31,157 | Dental Nurse Higher Level (Band 5) Dental Nurse Team Leader (Band 5) |
Profile titles and bands from the NHS Employers A–Z job profile index (January 2026). Pay range runs from the entry step of the lowest band to the top step of the highest band the profiles cover. Your own post is banded by local job matching, which can differ from the national profile.
All 55 Profiled Job Titles at Band 4
- Ambulance Practitioner ES
- Anatomical Pathology Technician (Mortuary) Anatomical pathology
- Assistant Practitioner (Radiography) Diagnostic and Therapeutic Radiographers
- Associate Practitioner/Nursery Nurse NM
- Call handler higher level Ambulance Service
- Clinical Coding Officer Higher Level Patient Services
- Clinical Psychology, Assistant Practitioner Psychological professions
- Communications Assistant Public Relations
- Cook Team Manager SS
- Cytology Screener Cytology
- Dental Nurse Dental Nursing
- Dispatcher Ambulance Service
- Finance Officer (Higher Level) Finance
- Finance Team Leader Finance
- General Office Manager/Admin Team Leader AS
- General Office Team Manager/Admin Team Leader Secretarial and Clerical Generic
- Health Improvement Resource Assistant Higher Level Public Health/Health Improvement
- Health Records Officer Higher Level/Team Leader Patient Services
- Healthcare Science Associate Practitioner Health Care Science
- Home Care Organiser (Client Assessment) Home Care
- Home Care Organiser (Staff) Home Care
- HR Administrator Human Resources
- IM&T Analyst/Technician Information Technology
- Information Technician (Statistics/Information Management/Public Health Intelligence) Information Technology
- Legal Secretary AS
- Library Technician Higher Level Information Services
- Maternity Care Assistant NM
- MDT Co-Ordinator AS
- Medical Engineering Technician, Entry Level Medical Technology
- Medical Secretary Higher Level AS
- Midwifery band 4 Midwifery
- Nurse Associate Practitioner (Community) NM
- Nurse Associate Practitioner (Mental Health) NM
- Nurse Associate Practitioner Acute NM
- Nursery Nurse (Community) NM
- Nursery Nurse (Neonatal Unit) NM
- Nursing: Band 4i Combined Nursing
- Nursing: Band 4ii Combined Nursing
- Occupational Therapy Technician Occupational Therapy
- ODP: Band 4 Operating Department Practitioners
- Optometrist Entry Level Orthoptists and Optometrists
- Patient Support Officer Higher Level Public Relations
- Pharmacy Technician Pharmacy
- Play Specialist Play Specialists
- Podiatry Technician Podiatry
- Procurement, Administrative Officer Support Services
- Procurement, Administrative Officer Higher Level SS
- Project Support Officer Higher Level Business & Projects
- Secretary Higher Level AS
- Secretary Higher Level/Medical Secretary Higher Level/Admin Team coordinator Secretarial and Clerical Generic
- Speech and Language Therapy Assistant/Associate Practitioner Speech and language Therapy
- Speech and Language Therapy Associate Practitioner (bi-lingual) Speech and Language Therapy
- Support Service Supervisor Higher Level Support Services
- Therapy, Assistant Practitioner Generic Therapy
- Tradesperson Estates & Maintenance
Full job descriptions and the responsibilities each role is scored against are published by NHS Employers as national profile documents. We link them rather than reproduce them, so you always read the current version: browse the profile documents. To understand how a role ends up in this band at all, see how pay bands are decided.
What Makes a Job Band 4
Bands are not assigned by judgement. Every NHS role is scored against 16 factors under the NHS Job Evaluation Scheme — knowledge and experience, responsibility for patient care, freedom to act, physical and emotional effort, working conditions and others. Each factor is awarded points according to the level the job demands, and the 1000 points available add up to a single total.
That total decides the band. Band 4 covers jobs scoring 271-325 points.
| Band | Total Score |
|---|---|
| Band 1 | 0-160 points |
| Band 2 | 161-215 points |
| Band 3 | 216-270 points |
| Band 4 | 271-325 points |
| Band 5 | 326-395 points |
| Band 6 | 396-465 points |
| Band 7 | 466-539 points |
| Band 8 | 540-584 points |
| Band 9 | 585-629 points |
This is why taking on extra duties does not by itself change your band: the job description has to be re-evaluated and score into the next range. How the 16 factors are scored →
Pension at Band 4
At £28,392 your contribution tier is 6.5%, which is £1,845 a year, or £154 a month. Because it comes out before income tax, the real cost to your take-home is less than the headline rate.
Your employer pays 23.7% on top — £6,729 a year at this salary. That is money most pay calculators never show you, and it is the single biggest reason opting out is rarely a good deal.
Tiers are slabs, not slices. Cross a threshold and the higher rate applies to all your pensionable pay, not just the part above it. A pay rise that nudges you over a boundary can leave a smaller increase than you expected — the calculator shows which tier you land in and why.
London Weighting at Band 4
England only. A percentage of basic pay, capped at an annual minimum and maximum — which is why the headline percentage is not what everyone receives.
| Zone | Rate | Supplement | Extra Take-Home |
|---|---|---|---|
| Inner London | 20% | £5,794 (at the minimum) | +£3,378 |
| Outer London | 15% | £4,870 (at the minimum) | +£2,774 |
| Fringe | 5% | £1,420 | +£519 |
Moving Up from Band 4
What a promotion is actually worth, after tax, National Insurance and pension — not the gross difference.
| Band | Gross | Take-Home | Difference |
|---|---|---|---|
| Band 3 entry step | £25,760 | £20,728 | −£1,758 |
| Band 4 entry step | £28,392 | £22,486 | — |
| Band 5 entry step | £32,073 | £24,483 | +£1,997 |
What does it take to reach Band 5? There is no national answer, and any site that gives you one has invented it. Agenda for Change does not publish promotion criteria — each vacancy sets its own person specification, and the post is banded by job evaluation. What you can do is read the national profiles for Band 5 to see the responsibilities those roles are scored against, then compare them with your current job description.
Moving up a step within your own band is different, and happens on your incremental date — see when your increment is due.
Common Questions
How Much Does Band 4 Earn in 2026/27?
In England, Band 4 pay runs from £28,392 to £31,157 a year full time for 2026/27. The entry step of £28,392 works out at about £1,874 a month after tax, National Insurance and pension.
What Is Band 4 Take-Home Pay a Month?
About £1,874 a month at the entry step, on a standard tax code with NHS pension membership and no London supplement. Your own figure depends on your step, hours, nation and circumstances.
Which Jobs Are Band 4?
55 nationally profiled job titles are matched to Band 4, across families including ES, Anatomical pathology, Diagnostic and Therapeutic Radiographers, NM. Individual posts are banded locally, so an employer may band a job differently from the national profile.
What Are the Requirements to Reach the Next Band?
There is no national answer. Agenda for Change does not publish promotion criteria — each vacancy sets its own person specification and the post is banded by job evaluation, not by the person filling it. The national job profiles show the responsibilities roles at the next band are scored against.
Does Band 4 Pay Differ in Scotland, Wales and Northern Ireland?
Yes. Each nation negotiates its own award, and Scotland also has a shorter standard working week — 36 hours from April 2026 against 37.5 elsewhere. The comparison table on this page shows all four.