Band 4 Salary 2026/27: Hourly, Weekly and Annual Pay Explained

Understanding Band 4 Salary in the NHS

The band 4 salary is a key pay grade within the NHS Agenda for Change system, covering a wide range of healthcare roles that sit between support staff and registered professionals. For 2026/27, the band 4 salary in England ranges from £28,392 at entry to £31,157 after three years of service, as confirmed by NHS Employers pay scales. This article breaks down the band 4 salary into hourly, weekly and annual figures, compares it with statutory minimum wage rates, and explains what you can expect to take home.

Annual Salary for Band 4

The band 4 salary is structured with two pay points. New starters join on the entry point of £28,392 per year. After three years of satisfactory service, they progress to the top point of £31,157 per year. These figures are for England and are based on a 37.5-hour full-time contract. Roles at this band include assistant practitioner, pharmacy technician, dental nurse, senior medical secretary, and trainee psychological wellbeing practitioner, according to Health Careers.

It is important to note that pay varies across the UK. Scotland pays a higher top rate for Band 4 at £34,303 per year, which is over 10% more than England. Wales and Northern Ireland have their own pay scales, so always check the relevant Agenda for Change rates for your region.

Hourly Rate Breakdown

The hourly rate for band 4 is calculated by dividing the annual salary by the standard NHS working year of 1,955 hours (37.5 hours × 52.143 weeks). At entry, this gives £14.52 per hour. At the top step, it rises to £15.93 per hour. These are basic rates before any enhancements for unsocial hours. For staff working in high-cost areas such as London, Higher Cost Area Supplements (HCAS) are added, increasing both annual and hourly pay.

For a typical 12-hour shift (with a 30-minute unpaid break, giving 11.5 paid hours), a Band 4 worker earns £166.98 at entry and £183.24 at the top. For an 8-hour shift (7.5 paid hours), the figures are £108.90 and £119.51 respectively. These calculations come from NHS Pay Bands analysis, which also explains that unsocial hours enhancements add 30% for weekday nights and Saturdays, and 60% for Sundays and bank holidays.

Weekly and Take-Home Pay

A full-time Band 4 worker on a 37.5-hour week earns a gross weekly salary of £545 at entry and £599 at the top. However, take-home pay is significantly lower after deductions. You can expect roughly 30% to be deducted for income tax, National Insurance and the NHS pension contribution. For example, a top-step Band 4 salary of £31,157 would give a monthly take-home of around £2,000 to £2,100, depending on your tax code and pension tier.

It is also worth noting that the band 4 salary is well above the statutory minimum wage. The National Living Wage for workers aged 21 and over is £12.71 per hour, while the National Minimum Wage for 18-20 year olds is £10.85 per hour. Band 4 hourly rates start at £14.52, making it a competitive option for those entering healthcare support roles. For more context on pay rates across different sectors, see our pay guides and pay data pages.

How Band 4 Compares to Statutory Minimum Wage

The band 4 salary comfortably exceeds all statutory minimum wage rates. The apprentice rate and under-18 rate are both £8.00 per hour, while the 18-20 rate is £10.85. Even at the entry point, Band 4 pays £14.52 per hour, which is 14% above the National Living Wage. This reflects the skilled nature of Band 4 roles, which often involve supervisory duties, technical work, or direct patient care under the supervision of registered professionals.

However, it is important to remember that the band 4 salary is a basic rate. Many NHS staff work shifts that attract unsocial hours enhancements, which can significantly boost weekly earnings. A Band 4 worker doing regular weekend shifts could see their effective hourly rate rise to over £25 per hour on Sundays.

Progression and Regional Variations

Progression within Band 4 takes three years to reach the top point. After that, staff may apply for Band 5 roles (registered nurse, midwife, allied health professional) or remain at Band 4 if the role suits them. The band 4 salary also varies by region due to HCAS. Inner London attracts the highest supplement, adding around 20% to basic pay. Outer London and fringe areas have lower supplements.

For those considering a move to Scotland, the top Band 4 rate of £34,303 is notably higher. Always check the specific Agenda for Change pay scales for your nation, as they are updated annually. For more information on how pay bands work across the UK, visit our topics section.

Frequently Asked Questions

What is the band 4 salary for 2026/27? For 2026/27, the NHS Band 4 salary in England starts at £28,392 per year for new starters and rises to £31,157 after three years at the top of the band. The hourly rate is £14.52 at entry and £15.93 at the top, based on a standard 37.5-hour week. These figures are from the NHS Employers pay scales and apply to roles such as assistant practitioner, pharmacy technician, dental nurse and trainee psychological wellbeing practitioner.

How does band 4 pay compare to the National Living Wage? The National Living Wage for workers aged 21 and over is £12.71 per hour (2026/27). The Band 4 entry hourly rate of £14.52 is well above this, and the top rate of £15.93 is even higher. However, Band 4 pay is for specific healthcare roles with responsibilities, while the National Living Wage is the legal minimum for all workers. For comparison, the average weekly earnings across all UK employees is around £745, and a Band 4 full-time worker earns between £545 and £599 per week before deductions.

What is the hourly rate for band 4 and how is it calculated? The Band 4 hourly rate is calculated by dividing the annual salary by the number of paid hours in a year. The NHS uses a 37.5-hour week and 52.143 weeks per year, giving 1,955 paid hours. For the entry salary of £28,392, this works out at £14.52 per hour. At the top step of £31,157, it is £15.93 per hour. This is the basic rate before any unsocial hours enhancements for nights, weekends or bank holidays. For a 12-hour shift (11.5 paid hours after a 30-minute break), entry pay is £166.98 and top pay is £183.24.