Band 4 pay in Northern Ireland, 2025/26

Band 4 in Northern Ireland, what the role involves

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.

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 NHS pay is set in Northern Ireland

Health and Social Care (HSC) staff in Northern Ireland sit on the same Agenda for Change framework as the rest of the UK. Pay is set by the Department of Health's Workforce Policy Directorate, which usually adopts the NHS Pay Review Body recommendation. Pay circulars are published as HSC (AfC) letters and apply to staff across the integrated HSC Trusts rather than separate NHS Trusts.

Northern Ireland's health service is integrated with social care, so Agenda for Change covers HSC Trusts rather than NHS Trusts only. The Department of Health takes the PRB recommendation, secures Executive approval (when there is a functioning Executive), and issues an HSC (AfC) pay arrangement circular. Pay is usually applied from 1 April with arrears paid later in the year, often after a delay caused by political processes at Stormont.

How Band 4 pay in Northern Ireland compares to other UK nations

At the top of Band 4 in Northern Ireland, staff earn £30,162 per year for 2025/26. Scotland pays Band 4 more at the top of band: £34,303, a difference of £4,141 per year (13.7% more than Northern Ireland).

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.

Recent NHS pay history in Northern Ireland

The 2025/26 settlement applied a 3.6% consolidated uplift, matching England and Wales in percentage terms. The previous round (2024/25) was delayed by Executive politics but eventually delivered. The 2026/27 settlement is expected later in 2026 following the PRB report and Executive approval. NI HSC pay has consistently tracked England exactly because the Department of Health applies the PRB recommendation in full.