NHS Band 4 Pay 2026/27
NHS Band 4 sits between Band 3 and Band 5 and covers a range of roles requiring more skill, training or responsibility than Band 3, on Agenda for Change in England. It is not one single job title. For 2026/27, full-time Band 4 salary ranges from £28,392 at entry to £31,157 at the top of the scale, across two pay points.
NHS Band 4 salary and pay points, 2026/27
Band 4 has two pay points: Entry and Top. Figures below are full-time equivalent, based on standard Agenda for Change hours of 37.5 a week. This page covers NHS England Agenda for Change staff only, not doctors, dentists, Very Senior Managers, or staff in Scotland, Wales or Northern Ireland.
| Pay point | Annual salary (FTE) | Monthly gross equivalent |
|---|---|---|
| Entry | £28,392.00 | £2,366.00 |
| Top | £31,157.00 | £2,596.42 |
What NHS Band 4 covers
Band 4 is a wide band used across clinical support, administrative and technical roles, such as assistant practitioner-style clinical support roles and senior administrative or clerical roles with greater responsibility than Band 3. The exact job title and duties for a Band 4 post are set by the individual role and NHS trust, using the NHS Job Evaluation Scheme, rather than by a single fixed Band 4 job description.
Estimated Band 4 take-home pay
Estimated figures for England, 2026/27, based on 37.5 contracted hours a week, NHS Pension Scheme membership, outside any High Cost Area, no undergraduate student loan and no Postgraduate Loan.
| Pay point | Annual gross | NHS Pension | Income Tax | Employee NI | Monthly take-home |
|---|---|---|---|---|---|
| Entry | £28,392.00 | £1,845.48 | £2,795.30 | £1,265.76 | £1,873.79 |
| Top | £31,157.00 | £2,586.03 | £3,200.19 | £1,486.96 | £1,990.32 |
Calculate your personalised NHS pay estimate
Change your pay point, contracted hours, HCAS zone, NHS Pension membership and student loan to get an estimate for your own circumstances.
Use the NHS Pay CalculatorNHS Pension for Band 4 staff
Most Band 4 staff are automatically enrolled in the NHS Pension Scheme. Your contribution rate is tiered and based on your actual annual pensionable pay. At full-time hours in 2026/27, the estimated rate is 6.5% at entry, rising to 8.3% at the top point.
Because the tier depends on your actual pay, working part-time can place you in a lower contribution tier than a full-time colleague on the same pay point. NHS Pension contributions are deducted from your pay before Income Tax is calculated, so you receive tax relief automatically through payroll; they are not deducted before National Insurance or student loan calculations, which use your full gross pay.
Band 4 part-time pay
Standard Agenda for Change full-time hours are 37.5 a week. Part-time basic salary is calculated proportionally: your contracted hours divided by 37.5, multiplied by the full-time equivalent salary. The examples below use the Band 4 entry point.
| Contracted hours | Actual basic salary | Estimated monthly take-home |
|---|---|---|
| 30 hours | £22,713.60 | £1,557.69 |
| 22.5 hours | £17,035.20 | £1,241.59 |
| 18.75 hours | £14,196.00 | £1,083.54 |
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Band 4 pay in London (HCAS)
The High Cost Area Supplement (HCAS), also called London weighting, is an additional payment for staff working in or near London, calculated as a percentage of basic salary and subject to a minimum and maximum for each zone. HCAS is based on your workplace location, not your home address, and is pensionable, taxable and subject to National Insurance in the normal way.
| Zone | HCAS amount | Gross pay | Estimated monthly take-home |
|---|---|---|---|
| Inner London | £5,794.00 | £34,186.00 | £2,155.30 |
| Outer London | £4,870.00 | £33,262.00 | £2,104.97 |
| Fringe | £1,419.60 | £29,811.60 | £1,917.04 |
Student loans and Band 4 pay
Student loan repayments reduce take-home pay and are calculated on your full gross pay, in the same way as National Insurance, not on your pay after pension contributions. The NHS Pay Calculator supports Plan 1, Plan 2, Plan 4, Plan 5 and the Postgraduate Loan, including both an undergraduate plan and a Postgraduate Loan at the same time.
| Scenario | Estimated monthly take-home |
|---|---|
| No student loan | £1,873.79 |
| Plan 2 undergraduate loan | £1,873.79 |
Band 4 pay progression
Agenda for Change pay progression through a band's pay points is not automatic or guaranteed. Progression is normally linked to time in post and satisfactory performance, in line with the NHS Terms and Conditions of Service Handbook and local trust arrangements, rather than being a fixed annual salary increase.
Band 4 has two pay points, Entry and Top. Staff often move into Band 4 from a Band 3 role, or from training/development posts, then progress into Band 5 as their role and responsibilities grow.
Why your Band 4 payslip can differ from this estimate
- Your specific tax code
- Whether you are a member of the NHS Pension Scheme
- Your actual contracted hours
- Your High Cost Area Supplement zone, if any
- Any student loan or Postgraduate Loan repayments
- Overtime
- Unsocial-hours enhancements
- On-call payments
- Local or individual deductions
- Prior-period payroll adjustments and back pay
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Frequently asked questions
What is NHS Band 4 salary in 2026/27?
What roles are NHS Band 4?
How much is NHS Band 4 take-home pay per month?
How much NHS Pension does a Band 4 employee pay?
What is Band 4 pay for 22.5 hours a week?
How much does a Band 4 employee earn in London?
How do you progress through NHS Band 4?
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This is an estimate for general guidance only. It is not an official NHS calculator and is not affiliated with or endorsed by the NHS. It covers NHS England Agenda for Change staff only, not doctors, dentists, Very Senior Managers, or staff in Scotland, Wales or Northern Ireland, and does not include overtime, unsocial-hours enhancements, on-call payments, recruitment and retention premia or salary sacrifice. Your actual payroll can differ due to your tax code, local arrangements, prior-period payroll, benefits, deductions and other circumstances. This is not financial or employment advice. Check NHS Employers, NHSBSA or GOV.UK guidance, or your payslip, for your exact figures.