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🏥 NHS Agenda for Change · Band 4 · 2026/27

NHS Band 4 Pay 2026/27
Nursing Associate & Pharmacy Tech Take-Home

Last updated: 11 September 2026 · AfC 3.3% award effective 1 April 2026

Band 4 runs from £28,392 to £31,157 across three spine points. Monthly take-home after tax, NI and 6.5% NHS pension ranges from £1,874 to £1,990.

✓ Three spine points✓ 6.5% NHS pension✓ 3.3% pay award
Calculate Exact Take-Home →2027 Pay Rise Scenarios

Band 4 Take-Home at Every Spine Point — 2026/27

England · Tax code 1257L · 6.5% NHS pension (net-pay arrangement) · No London weighting

Spine PointAnnual GrossIncome TaxNINHS Pension 6.5%Monthly Take-Home
4.1 (Entry)£28,392−£2,794−£1,265−£1,845£1,874
4.2£29,775−£3,052−£1,376−£1,935£1,951
4.3 (Maximum)£31,157−£3,311−£1,486−£2,025£2,028

Excludes unsocial hours, London HCAS and bank shifts. Pension deducted before income tax.

What is NHS Band 4?

Band 4 is an associate practitioner level under Agenda for Change. It sits between support staff (Bands 2–3) and fully qualified registered staff (Band 5+). Roles at Band 4 typically require a relevant qualification such as a foundation degree, NVQ Level 4, or equivalent.

Typical Band 4 NHS roles

  • Nursing Associate (RNA) — registered with NMC after 2-year foundation degree
  • Assistant Practitioner — clinical support across therapy, imaging and diagnostics
  • Pharmacy Technician — GPhC registered, dispensing and medicines management
  • Senior Medical Secretary — complex clinical admin including coding
  • Bed Manager — patient flow and capacity management

Band 4 vs Band 5 — the key decision point

Many Band 4 nursing associates consider progressing to Band 5 via a top-up degree. Band 5 entry is £29,970 — lower than Band 4 max (£31,157). However, Band 5 has four spine points reaching £36,483, making long-term earning potential significantly higher. The pension contribution rate also increases from 6.5% to 8.3% at Band 5, which reduces the immediate take-home benefit.

2027 pay rise — Band 4 impact

A 4% rise would take Band 4 entry to ~£29,528, adding approximately £40/month net. Use our NHS Pay Rise 2027 calculator for the full Band 4 scenario breakdown.

All NHS AfC Bands — 2026/27 Take-Home

🏥
Band 2 — £25,272
HCA, Porter
→🏥
Band 3 — £25,760–£27,476
Senior HCA, Phlebotomist
→🏥
Band 5 — £29,970–£36,483
Staff Nurse, Physiotherapist
→🏥
Band 6 — £37,338–£44,962
Senior Nurse, Specialist
→🏥
Band 7 — £49,387–£56,515
Ward Manager, Advanced Practitioner
→🏥
Band 8a — £57,528–£64,750
Consultant AHP, Senior Manager
→

NHS Band 4 — frequently asked questions

At Band 4 entry (£28,392), monthly take-home is approximately £1,874. At the midpoint (£29,775) it's £1,955, and at maximum (£31,157) it's approximately £1,990. All figures assume tax code 1257L, no London weighting, and 6.5% NHS pension contributions.

Band 4 covers associate-level clinical roles requiring a formal qualification or significant supervised experience. Typical roles include Nursing Associates, Assistant Practitioners, Pharmacy Technicians, Senior Medical Secretaries, and Bed Managers.

All Band 4 spine points (£28,392–£31,157) fall within the 6.5% NHS pension contribution tier (FTE between £26,832 and £39,154). The pension is deducted before income tax, giving automatic full tax relief.

Band 5 entry (£29,970) is actually close to Band 4 maximum (£31,157) in gross terms, but Band 5 carries an 8.3% pension tier which increases deductions. At Band 5 entry, take-home is approximately £2,040/month — about £50/month more than Band 4 max despite having a lower pension contribution rate applied.

Yes. Registered Nursing Associates (RNAs) who have completed the NMC-approved two-year foundation degree are typically placed at Band 4, with progression opportunities to Band 5 and further training towards full nurse registration.

Yes, if your role involves working evenings, nights, or weekends under AfC Schedule 3, you receive enhancements of 37% (evenings/Saturdays) or 100% (Sundays/bank holidays) on top of your base pay. These are pensionable and subject to PAYE and NI.

Model your exact Band 4 take-home

Include unsocial hours, London weighting or your exact tax code.

Take-Home Calculator →NHS 2027 Pay Rise →

Related Tools & Guides

Take-Home Pay Calculator →Salary Comparison Tool →Net to Gross Calculator →Tax Code Checker →