Band 4 NHS pay 2026/27
Band 4 Agenda for Change pay in England is £28,392 to £31,157 a year from 1 April 2026.
- Updated for 2026/27
- Official NHS and HMRC figures
- Checked 20 October 2026
| Pay point | Salary | Hourly | Take-home / month | Pension rate | Locum break-even | Inc. pension |
|---|---|---|---|---|---|---|
| Entry (3 years) | £28,392 | £14.52 | £1,874 | 6.5% | £15.61 | £21.61 |
| Top | £31,157 | £15.93 | £1,990 | 8.3% | £16.77 | £23.74 |
Full-time (37.5 hours a week), England income tax, NHS Pension Scheme member, no student loan. Locum break-even rates are PAYE hourly rates that match yearly take-home over the same hours actually worked (35 days' paid leave). "Inc. pension" also makes up for the value of NHS pension contributions.
Typical Band 4 roles
Roles are banded locally using the NHS Job Evaluation Handbook, so the same job title can sit in different bands at different employers. Typical Band 4 roles include:
- Assistant practitioner
- Nursing associate
- Pharmacy technician (trainee)
Band 4 vs locum and bank work
A Band 4 salary of £28,392 works out at £14.52 an hour. But that salary also pays you for 35 days of leave and comes with an employer pension contribution of 23.7%. A locum or agency shift needs to pay about £15.61 an hour (PAYE) to give the same take-home pay over a year, and about £21.61 to make up for the pension too.
Compare a Band 4 salary with your own locum rate or work out your exact take-home pay.
Unsocial hours
Band 4 staff working unsocial hours get +30% for Saturdays and weekday nights (8pm to 6am) and +60% for Sundays and public holidays. At the entry point that's £18.88 and £23.23 an hour.
Frequently asked questions
- How much is Band 4 NHS pay in 2026/27?
- Band 4 pay in England is £28,392 to £31,157 a year from 1 April 2026, which is £14.52 to £15.93 an hour for a 37.5-hour week.
- What is Band 4 take-home pay a month?
- A full-time Band 4 employee in England in the NHS Pension Scheme takes home about £1,874 a month at the entry point and £1,990 at the top, with no student loan.
- What locum or agency rate matches a Band 4 salary?
- To take home the same as a Band 4 entry-point salary over the same hours actually worked, a PAYE locum needs about £15.61 an hour, or £21.61 an hour to also make up for the NHS pension.
- How long does it take to reach the top of Band 4?
- Band 4 has 2 pay points. You move from entry to the next point after 3 years, so about 3 years in total.
Other bands
Band 1 · Band 2 · Band 3 · Band 5 · Band 6 · Band 7 · Band 8a · Band 8b · Band 8c · Band 8d · Band 9
Sources
- Pay scales for 2026/27 (Agenda for Change), NHS Employers. Checked 20 October 2026.
- NHS Terms and Conditions of Service Handbook (version 63), NHS Employers. Checked 20 October 2026.
- Pay and contributions, NHS Business Services Authority. Checked 20 October 2026.
- Income Tax rates and Personal Allowances, GOV.UK. Checked 20 October 2026.
Last updated .