Skip to main content
NHS Pay

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.

Band 4 full-time salary, 2026/27
Pay pointAnnual 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.

Band 4 estimated take-home pay, standard scenario
Pay pointAnnual grossNHS PensionIncome TaxEmployee NIMonthly 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
This is an estimate for general guidance, not an official NHS calculator, and it is not affiliated with or endorsed by the NHS.

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 Calculator

NHS 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.

Band 4 entry point, part-time examples
Contracted hoursActual basic salaryEstimated 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

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.

Band 4 entry point, full-time, by HCAS zone
ZoneHCAS amountGross payEstimated 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.

Band 4 entry point, effect of a student loan
ScenarioEstimated 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
TaxEngines provides an estimate for general information. It is not an official NHS calculator and is not affiliated with or endorsed by the NHS. This is not financial, tax or employment advice.

Official sources

Explore more NHS pay

Frequently asked questions

What is NHS Band 4 salary in 2026/27?
For 2026/27, full-time Band 4 salary ranges from £28,392.00 at entry to £31,157.00 at the top of the scale, across two pay points.
What roles are NHS Band 4?
Band 4 covers a range of clinical support, administrative and technical roles, such as assistant practitioner-style clinical support roles and senior administrative roles. The specific job title depends on the role and NHS trust, not one single Band 4 job description.
How much is NHS Band 4 take-home pay per month?
At the entry point, full-time, England, with NHS Pension membership and no student loan, estimated take-home pay is around £1,873.79 a month. Your own figure depends on your pay point, hours, pension status, HCAS zone and student loan.
How much NHS Pension does a Band 4 employee pay?
It depends on your actual pensionable pay. At the entry point the estimated contribution rate is 6.5%; at the top point it is 8.3%.
What is Band 4 pay for 22.5 hours a week?
At the entry point, 22.5 contracted hours a week gives an estimated actual basic salary of £17,035.20 and estimated monthly take-home of around £1,241.59.
How much does a Band 4 employee earn in London?
With Inner London HCAS at the entry point, full-time, estimated gross pay is £34,186.00 and estimated monthly take-home is around £2,155.30. Outer London and Fringe rates are lower; select your zone on the NHS Pay Calculator for an estimate.
How do you progress through NHS Band 4?
Band 4 has two pay points (Entry and Top). Progression between them is not automatic; it is normally linked to time in post and satisfactory performance under the NHS Terms and Conditions of Service Handbook and local trust arrangements.

Last reviewed

Reviewed

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.