Band 4 pay in Wales, 2026/27

Band 4 in Wales, 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 Wales

NHS Wales follows the same Agenda for Change framework as the rest of the UK but issues its own pay circulars (AfC(W) letters) signed off by the Welsh Government's Health and Social Services Group. Welsh settlements have historically tracked England closely, although the 2025/26 deal pulled Welsh entry rates slightly ahead at the bottom of the scale.

The Welsh Government considers the NHS Pay Review Body recommendation alongside its own pay strategy. Welsh ministers usually adopt the PRB uplift, but they have occasionally gone further or applied it differently for specific bands. Pay circulars are published by the Health and Social Services Group and apply from 1 April with backdated arrears paid later in the year.

How Band 4 pay in Wales compares to other UK nations

At the top of Band 4 in Wales, staff earn £31,626 per year for 2026/27. Scotland pays Band 4 more at the top of band: £34,303, a difference of £2,677 per year (8.5% more than Wales).

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 Wales

The 2025/26 settlement applied a 3.6% consolidated uplift, mirroring England in percentage terms. Welsh Band 3 entry was lifted to £25,313 (slightly above England's £24,937), reflecting the Welsh Government's stated commitment to keep the lowest entry rates above the Living Wage Foundation real Living Wage. The 2026/27 deal applied 3.3% on top, again broadly in line with England.