NHS Band 4 vs Band 5: Pay and the Step to Registration (2026/27)
Band 5 starts £3,681 a year above Band 4 in England, £166.42 a month more after tax, NI and pension. It's the line between support roles and registered professionals: Band 5 is where newly qualified nurses, paramedics, physiotherapists and most other registered staff start. By the top of each band the gap is £7,886 a year.
Side by side
| Band 4 | Band 5 | |
|---|---|---|
| Pay points (England) | £28,392, £31,157 | £32,073, £34,592, £39,043 |
| Take home a month, bottom | £1,873.79 | £2,040.21 |
| Take home a month, top | £1,990.32 | £2,380.80 |
| Years to the top point | 3 | 4 |
| Pension rate, bottom of band | 6.5% | 8.3% |
The unsocial hours rates are the same on both bands, so shifts don't change the comparison.
Promotion from the top of Band 4
From the top of Band 4 (£31,157) to the bottom of Band 5 (£32,073) is a rise of £916 a year, about £49.89 a month in take home. The top of Band 4 already pays 8.3% pension, so the tier doesn't change on the move. The real gain is the Band 5 ladder: two more pay points, reaching £39,043 after 4 years.
Moving from Band 4 to Band 5 usually means qualifying
Band 5 is where registered professionals start, so for most people the step is a course rather than an interview:
- Nursing associates (usually Band 4) can put their training towards a shortened nursing degree or a registered nurse degree apprenticeship, which can come down to two years.
- Trainee mental health and wellbeing practitioners are usually paid Band 4 while training and Band 5 once qualified.
- Assistant clinical psychologists are usually Band 4 or 5, depending on the post. Qualifying as a clinical psychologist means a funded clinical psychology doctorate, paid on Band 6 while you train.
Compare with your own shifts
Take home is for a full-time England contract with the NHS pension, before London weighting, shifts or student loan.
Promoted from the top of Band 4 to Band 5
On promotion your basic pay starts at the bottom of the new band. Add the unsocial hours you work in a typical month to see what the move is really worth.
Pay before deductions
+£916 a year
Take home
+£49.89 a month
Band 4 vs Band 5: questions
£3,681 a year at the bottom of each band in England, £166.42 a month after deductions, rising to £7,886 a year at the top.
Band 4 pay in full
Every pay point in all four countries, take home, shifts and London weighting
Band 5 pay in full
Every pay point in all four countries, take home, shifts and London weighting
Other band comparisons
Sources (checked 18 October 2026)
- Pay scales for 2026/27 (NHS Employers)
- NHS Terms and Conditions of Service Handbook (version 63) (NHS Employers)
- NHS Pension Scheme member contributions (NHS Employers)
- Nursing associate (NHS Health Careers)
- Mental health and wellbeing practitioner (NHS Health Careers)
- Assistant clinical psychologist (NHS Health Careers)
- Clinical psychologist (NHS Health Careers)
- Adult nurse (NHS Health Careers)