How long it takes to reach the top of Band 4
Band 4 has 2 pay points. From entry to the top step takes 3 years on the current pay scale, provided your annual appraisal is satisfactory at each progression point.
Band 4 pay progression timeline
Each pay point represents a fixed period of service that you need to complete before moving to the next step. Progression assumes a satisfactory annual appraisal at each review point.
Band 4 gross pay forecast, year 1 to year 4 (2026/27 scale)
Gross pay at each year of service on the current 2026/27 scale. Step changes happen at the end of the qualifying period of satisfactory service. National pay deals add a further cost-of-living rise on top each April.
| Step | When you reach it | Annual pay | Hourly (37.5h) |
|---|---|---|---|
| Entry | From day one in post | £28,392 | £14.52 |
| Top | After 3 years of satisfactory service | £31,157 | £15.93 |
How step progression actually works
Pay step progression in the NHS is based on time served in post combined with a satisfactory annual appraisal. The system is designed to be predictable: most staff move through their steps on schedule, with the date locked in at the start of employment and reviewed each year. The appraisal must be completed before the progression date for the step change to apply.
If an appraisal raises performance or conduct concerns, the line manager can recommend that progression is paused until the issues are resolved. This is genuinely uncommon in practice: most Trusts handle performance problems with development plans rather than withheld progression. When progression is paused, you stay on your current step and the next review is brought forward.
Continuous service from previous NHS roles counts. If you move between Trusts at the same band, you take your current step with you. If you move to a different band, you usually reset to entry. Some Trusts offer experienced applicants a higher entry step in shortage specialties to attract candidates, but this is a local arrangement rather than a national rule.
Moving up from Band 4 to Band 5
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).
On the 2026/27 pay scale, the cash uplift from the top of Band 4 (£31,157) to the entry step of Band 5 (£32,073) is £916 a year at the point of promotion. The top of Band 5 is £39,043, so over your time at the new band you can expect a further £6,970 of step progression on top of any national pay rises.
See Band 5 pay and progressionCommon questions
- How long does it take to get to the top of Band 4?
- From entry to the top step on Band 4 takes 3 years on the current pay scale. You join on entry (£28,392), and progress to the top step (£31,157) after 3 years. Progression is not automatic; it depends on satisfactory annual appraisal.
- What if my appraisal is unsatisfactory?
- Progression to the next step can be paused if your annual appraisal raises performance or conduct concerns. This is rare in practice. Most Trusts give clear feedback and a development plan before withholding progression, and most staff move through the steps as expected. If progression is paused, you stay on your current step until the next satisfactory appraisal.
- Can I bring service from a previous NHS Trust forward?
- Usually yes. When you move between NHS Trusts (or between an NHS and HSC role in Northern Ireland) at the same band, you take your pay step with you under continuous service rules. Moving to a different band resets your step to entry, although some Trusts use experience to offer a starting point above entry in shortage specialties. Check the recruitment pack before accepting an offer.
- How do I move from Band 4 to Band 5?
- Promotion to Band 5 typically requires either additional qualifications, completed competency portfolios, or moving into a more senior role. 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). On the 2026/27 pay scale, the cash jump from the top of Band 4 (£31,157) to Band 5 entry (£32,073) is £916 a year at promotion.
- Do part time staff progress through the band at the same speed?
- Yes. Progression through pay steps is based on calendar time in post, not hours worked. A part time staff member who works 18.75 hours a week on Band 5 still moves from entry to the intermediate step after two years and to the top step two years later, exactly the same as a full time colleague.