NHS Pay Bands

NHS Band 4 salary, England 2026/27

Senior assistant practitioners and team leaders below registered professional level.

Minimum

£28,392

Maximum

£31,157

Hourly at entry

£14.52

Hourly at top

£15.93

Calculate your Band 4 take-home pay

Band 4 pay scale, England 2026/27

Step Years from entry Annual Hourly (37.5h)
Entry From day one £28,392 £14.52
Top After 3 years £31,157 £15.93
Full range £28,392 to £31,157 £14.52 to £15.93

England, 2026/27, effective 2026-04-01. Source: Pay scales for 2026/27 — NHS Employers.

About Band 4

Band 4 is the bridge between unregistered support roles and registered professional practice. Nursing associates (registered with the Nursing and Midwifery Council), assistant practitioners, pharmacy technicians, senior medical secretaries and team leaders all sit at Band 4. Many staff use it as a stepping stone to a Band 5 registered nurse, midwife or allied health professional role, but plenty of others stay at Band 4 long term because the work suits them.

What Band 4 staff actually do

A nursing associate provides hands-on care across a much wider range of clinical tasks than a healthcare assistant, working alongside registered nurses and increasingly leading patient care for stable patients. They administer medications (including injections), take responsibility for a small group of patients on a shift, and contribute to care planning. A pharmacy technician dispenses and checks medicines, runs discharge clinics, and supports medicines reconciliation when patients are admitted or moved.

How to get on Band 4

Nursing associate roles require completion of the two-year foundation degree apprenticeship and NMC registration. Other Band 4 roles typically need a Level 4 or Level 5 qualification plus extensive Band 3 experience. Direct external applicants often come from related fields like adult social care, pharmacy, or other allied health support work. The apprenticeship route is the most common entry path for clinical Band 4 staff.

Moving up from Band 4

Many Band 4 nursing associates go on to complete a top-up nursing degree (an 18-month or two-year programme) to become registered nurses at Band 5. Pharmacy technicians can progress to Band 5 senior technician roles, often specialising in aseptic services, oncology or medicines management. Assistant practitioners can move into Band 5 roles in their specialty (operating department practitioner, physiotherapy assistant practitioner moving to qualified physio).

Band 4 across the four UK nations

Band 4 is paid at a similar level across all four UK nations. Scotland uses a two-step structure with progression after three years; the other three nations use the same approach with the same gap between steps. Welsh Band 4 entry has been slightly higher than the English figure in recent years, by a few hundred pounds.

Nation Minimum Maximum
England £28,392 £31,157 View pay scale
Scotland £31,537 £34,303 View pay scale
Wales £28,819 £31,626 View pay scale
Northern Ireland £27,485 £30,162 View pay scale

Example Band 4 roles

Band 4 covers a range of NHS jobs. The roles below are typical of this band.

Band 4 pay over time

Band 4 pay rose from £27,485 to £28,392 at entry between 2025/26 and 2026/27, a 3.3% change. Top of band moved from £30,162 to £31,157.

Band 4 common questions

Is a nursing associate the same as a nurse?
No. Nursing associates are a distinct registered profession sitting between healthcare assistants and registered nurses. They can administer medications and lead specific care tasks, but they don't carry the same autonomous accountability as a registered nurse. The NMC regulates both professions, but the scope of practice for a nursing associate is narrower. Many nursing associates do go on to qualify as registered nurses via a top-up degree.
Do pharmacy technicians need a degree?
No. Pharmacy technicians complete a two-year apprenticeship combining classroom study with workplace training, leading to General Pharmaceutical Council registration. A pharmacy degree (the MPharm) takes four years and qualifies you as a pharmacist, which is a different role at Band 6 or above. Pharmacy technicians at Band 4 dispense and check medicines under the supervision of a pharmacist.
Can I go from Band 4 to Band 5 without leaving the NHS?
Yes, and the NHS actively funds these transitions. A Band 4 nursing associate can complete an 18-month or two-year top-up nursing degree (usually as an apprenticeship) and step up to Band 5 as a registered nurse. The Trust generally pays your salary throughout, and the Apprenticeship Levy covers tuition. Similar routes exist for AHPs and pharmacy.
What's the take-home pay for a Band 4 NHS worker?
On the 2026/27 England pay scale, Band 4 runs from £28,392 at entry to £31,157 at the top step. After tax, NI and the NHS pension contribution tier, take-home is roughly £1,950 a month at entry and £2,110 a month at the top, assuming no student loan and no London weighting. Use the calculator above to model your own scenario.