NHS Pay Check

NHS Band 4 Salary & Take Home Pay 2026/27

Band 4 pays £28,392 rising to £31,157 in England for 2026/27: £1,874 to £1,990 a month take home full time. It's the band for assistant practitioners, registered nursing associates and emergency medical technicians, and the first band in England whose starting rate (£14.52 an hour) beats the Real Living Wage.

Salary (England)

£28,392 to £31,157

Take home a month

£1,874 to £1,990

Hourly rate (entry)

£14.52

NHS pension rate

6.5% to 8.3%

Work out your own Band 4 take home pay

Pay advice

England · 2026/27 · monthly

Payments

Basic pay£2,366.00
Total pay£2,366.00

Deductions

Income tax-£232.94
National Insurance-£105.48
NHS pension (6.5%)-£153.79
Net pay£1,873.79

£432.41 a week · £22,485.46 a year

Take home 79%NHS pension 7%Income tax 10%National Insurance 4%

Rates

Hourly rate (basic)£14.52
Income tax as a share of pay10.5%

Band 4 pay in each UK country, 2026/27

Monthly take home at the bottom of Band 4, full time. Bars start at £1,500 to show the gaps. *Northern Ireland is on 2025/26 rates until its award is paid.
CountryPay pointsTake home a monthHourly (entry)
England£28,392 / £31,157£1,873.79 / £1,990.32£14.52
Scotland£31,537 / £34,303£2,041.65 / £2,154.33£16.80
Wales£28,819 / £31,626£1,897.56 / £2,015.86£14.74
Northern Irelandaward pending£27,485 / £30,162£1,819.63 / £1,932.10£14.06

Full time (36 hours a week in Scotland, 37.5 elsewhere), NHS pension at each country's own rates, 1257L tax code, Scottish tax for Scotland, no student loan, London weighting or shift pay. Northern Ireland is on the rates in force from 1 April 2025 until its 2026/27 award is paid.

Where your Band 4 pay goes each month

Take home 79%NHS pension 7%Income tax 10%National Insurance 4%Bottom of Band 4, England, full time: £2,366.00 a month before deductions.
England, full timeEntryTop of band
Gross pay£2,366.00£2,596.42
NHS pension (6.5% / 8.3%)-£153.79-£215.50
Income tax-£232.94-£266.68
National Insurance-£105.48-£123.91
Take home£1,873.79£1,990.32

A three-year wait for the top point

Band 4 has two pay points, and you wait a year longer for the top one than on Band 3: you're eligible after 3 years, not two. The rise is £2,765 a year, but take home only goes up by £116.53 a month, because the top point also moves you into a higher NHS pension tier (6.5% to 8.3% of all your pay).

Band 4 or Band 5

Band 5 is where registered professionals start: NHS Health Careers puts newly qualified adult nurses on Band 5. Band 4 jobs work alongside them with a defined scope. Assistant practitioners usually have a two-year level 5 foundation degree (which can be done as an apprenticeship) or an HND. Moving up to Band 5 is worth £916 a year from the top of Band 4 and £3,681 from the bottom.

Is Band 4 an entry-level band?

For some jobs, yes. Emergency medical technicians, NHS 111 health advisers and trainee mental health and wellbeing practitioners usually start at Band 4. For nursing associates and assistant practitioners it's the band you reach once qualified: student nursing associates are usually paid on Band 3, and some trusts appoint trainee assistant practitioners on Band 3.

Trainees on a percentage of Band 4

Some Band 4 jobs are trained on the job, and the handbook sets trainee pay as a share of the band's top point rather than its starting rate: 75% in the last 12 months of training, 70% one to two years before qualifying, 65% two to three years before and 60% more than three years before. On Band 4 that runs into the minimum wage: 75% of £31,157 is £23,368, below the £24,853 a year that the National Living Wage works out at full time, so trainees must be paid at least the minimum wage instead. If you're offered a trainee post on "75% of Band 4", check the figure in your contract is at least £12.71 an hour.

The unsocial hours step down

Band 4 is the first band on the standard unsocial hours rate: 30% for Saturdays and weekday nights and 60% for Sundays and public holidays, down from 35% and 69% on Band 3. If you work a lot of shifts, a move from the top of Band 3 is worth less than it looks. With no unsocial hours, Band 4 entry takes home £50.99 a month more than the top of Band 3. With 30 hours of Saturday or night work and 15 hours of Sunday work a month, the gain shrinks to £29.23.

Living wage

England's Band 4 starts at £14.52 an hour, above the £14.10 Real Living Wage announced on 15 October 2026. Northern Ireland's Band 4, still on the 2025/26 scale, starts at £14.06, just under it.

Extra pay on Band 4: shifts, overtime and London

Unsocial hours. Band 4 gets 30% on top of the hourly rate for Saturdays and weekday nights (8pm to 6am) and 60% for Sundays and public holidays. Two Saturday shifts and one Sunday shift of 7.5 hours a month would add £130.68 a month before deductions at the bottom of the band in England, and lift take home from £1,873.79 to £1,925.13. The payments count towards your NHS pension.

Overtime. Hours over 37.5 a week are paid at time and a half (£21.78 an hour at the bottom of Band 4), or double time on a general public holiday. Part-timers get their normal rate until they pass 37.5 hours in a week. You can ask for time off in lieu instead (at plain time), but if you can't take it within three months it has to be paid as overtime.

London weighting (England). The High Cost Area Supplement for Band 4, a year:

ZoneEntryTop of band
Inner London (20%)£5,794 (minimum)£6,231
Outer London (15%)£4,870 (minimum)£4,870 (minimum)
Fringe (5%)£1,420£1,558

Moving up the band. You become eligible for the top of Band 4 after 3 years on the entry point. In England you move up on your pay step date if your appraisal was done in the last 12 months and meets your trust's standards, you're not in a formal capability process, you have no live disciplinary sanction, and your statutory and mandatory training is up to date.

Jobs on Band 4

Bands are set by job evaluation, so the same job title can sit in different bands at different trusts. These are the bands NHS Health Careers gives for each role.

  • Assistant practitioner

    Usually Band 4; trainees sometimes Band 3.

  • Registered nursing associate

    Usually Band 4; students are usually Band 3.

  • Emergency medical technician

    Usually Band 4; trainees may get a percentage of the Band 4 rate.

  • NHS 111 health adviser

    Usually Band 4; service advisers Band 2, senior health advisers Band 5.

  • Trainee mental health and wellbeing practitioner

    Usually Band 4 while training, Band 5 once qualified.

  • Pharmacy technician

    Newly qualified pharmacy technicians usually start at Band 4.

  • Assistant clinical psychologist

    Usually Band 4 or 5.

  • Senior phlebotomist

    Senior phlebotomy posts are Band 4.

  • Emergency care assistant

    Usually Band 3 or 4.

  • Ambulance call handler

    Typically starts at Band 3 or 4.

Band 4 questions

£28,392 to £31,157 in England, £28,819 to £31,626 in Wales, £31,537 to £34,303 in Scotland, and £27,485 to £30,162 in Northern Ireland (2025/26 rates while its award is pending). Full time in England that's £1,874 to £1,990 a month after deductions.

Band below

Band 3 take home pay

Band above

Band 5 take home pay

Compare

Band 3 vs Band 4

Compare

Band 4 vs Band 5

Sources (checked 18 October 2026)