Total increase over 3 years: £2,677 (9.7% rise)
Band 4 is simpler than higher bands. It has only 2 pay points compared to 3 for Band 5 and Band 6. This means fewer pay step meetings to worry about.
Pay Progression Requirements
Moving to the top of band isn’t completely automatic. According to NHS pay progression standards, you need to meet certain requirements at your pay step review:
- Successful annual appraisal in the last 12 months
- Not subject to formal capability procedures
- No live disciplinary sanctions on your record
- Completed all statutory and mandatory training
- If you’re a line manager, completed all your staff appraisals
Most staff who meet these basic requirements progress as expected. If you don’t meet the standards, your manager should discuss the reasons and consider any mitigating factors. You also have the right to contest decisions using your local procedure.
How to Progress from Band 3 to Band 4
If you’re currently working as a Band 3 support worker, you might be wondering whether it’s worth training to reach Band 4.
What’s the Difference Between Band 3 and Band 4?
| Factor |
Band 3 |
Band 4 |
Difference |
| Entry salary |
£24,937 |
£27,485 |
+£2,548 |
| Top of band |
£26,598 |
£30,162 |
+£3,564 |
| Time to top |
2 years |
3 years |
+1 year |
| Entry hourly |
£12.76 |
£14.06 |
+£1.30 |
| Top hourly |
£13.61 |
£15.43 |
+£1.82 |
Typical Pathway: Band 3 to Band 4
For clinical staff, the most common route is through the Nursing Associate programme:
- Apply for Trainee Nursing Associate (TNA) position — this is a Band 3 role during training
- Complete the 2-year foundation degree programme — you earn whilst you learn
- Register with NMC as a Nursing Associate
- Qualify as Registered Nursing Associate (RNA) and move to Band 4
Other routes include:
- Pharmacy Technician training and GPhC registration
- Assistant Practitioner programmes
- Foundation degrees in relevant subjects
Is Band 4 Worth the Extra Training?
Let’s be honest about the pros and cons:
Reasons Band 4 is worth it:
- £2,548 more at entry — meaningful increase from day one
- £3,564 more at top — significant over your career
- Professionally qualified status with protected title
- Clear pathway to further progression to Band 5
- More clinical autonomy and responsibility
- Better career security
Things to consider:
- Training takes time (typically 2 years)
- More responsibility and accountability
- Some programmes require academic study alongside work
Most support workers who complete Band 4 qualifications find the training worthwhile for both pay and career development. The Nursing Associate route is particularly attractive because you earn a salary throughout your training and don’t build up student debt.
What’s the Difference Between Band 4 and Band 5?
If you’re at Band 4, you might already be thinking about the next step. Here’s how Band 5 compares.
Salary Comparison
| Factor |
Band 4 |
Band 5 |
Difference |
| Entry salary |
£27,485 |
£31,049 |
+£3,564 |
| Top of band |
£30,162 |
£37,796 |
+£7,634 |
| Time to top |
3 years |
4 years |
+1 year |
| Entry hourly |
£14.06 |
£15.88 |
+£1.82 |
| Top hourly |
£15.43 |
£19.33 |
+£3.90 |
The difference at the top of band is substantial — £7,634 more as a Band 5 Staff Nurse compared to a Band 4 Nursing Associate.
Key Differences
| Band 4 |
Band 5 |
| Foundation degree (Level 5) |
Full degree (Level 6) |
| NMC Nursing Associate register |
NMC Nurses register |
| Works under supervision of registered nurses |
Autonomous clinical practice |
| Supports patient care delivery |
Leads patient care delivery |
| Cannot prescribe |
Can complete prescribing qualifications |
How to Progress from Band 4 to Band 5
For Nursing Associates wanting to become Registered Nurses:
- Complete a top-up degree (typically 2 years part-time or 18 months full-time)
- Many employers offer funded routes or apprenticeships
- Register with NMC as a Registered Nurse
- Apply for Band 5 Staff Nurse positions
The top-up degree builds on your existing Nursing Associate qualification, so you don’t start from scratch.
Nursing Associate Career Pathway
The Nursing Associate role is the most common Band 4 clinical position, so it deserves a closer look.
What is a Nursing Associate?
Nursing Associate is a standalone registered profession introduced in 2019. It:
- Bridges the gap between Healthcare Assistants and Registered Nurses
- Requires 2-year foundation degree training
- Leads to NMC registration and protected title
- Provides a career progression opportunity for support workers
Nursing Associate Salary Progression
| Stage |
Band |
Salary Range |
| Trainee Nursing Associate |
Band 3 |
£24,937 – £26,598 |
| Registered Nursing Associate |
Band 4 |
£27,485 – £30,162 |
| Registered Nurse (with top-up) |
Band 5 |
£31,049 – £37,796 |
Is Nursing Associate a Good Career Choice?
Advantages:
- Earn whilst you learn (paid training at Band 3)
- No tuition fee debt — employer funded
- Protected professional title
- Clear pathway to Registered Nurse if desired
- Can remain at Band 4 as a permanent career
- Work across different clinical settings
Considerations:
- 2-year training commitment
- Academic study required alongside work
- Less autonomy than Registered Nurses
For many Healthcare Assistants, the Nursing Associate route offers an excellent way to progress without the financial burden of a traditional nursing degree.
Is Band 4 a Good Salary?
This is the question many people really want answered. Let’s look at the facts.
Band 4 vs UK Average Salary
| Benchmark |
Amount |
How Band 4 Compares |
| UK Median Full-Time Salary |
~£35,000 |
Entry below, top approaching |
| National Living Wage (annual) |
~£22,000 |
Band 4 significantly higher |
| Average Support Worker Salary |
~£24,000 |
Band 4 exceeds this |
At £27,485, a Band 4 Nursing Associate earns above the average for care sector workers and well above minimum wage.
Total Compensation Value
Your NHS salary is just part of the picture. The full compensation package includes valuable benefits:
| Benefit |
Estimated Annual Value |
| NHS Pension (employer contribution at 14.38%) |
£3,953 – £4,337 |
| Annual Leave (27-33 days plus 8 bank holidays) |
£2,500 – £3,500 equivalent |
| Sick Pay (up to 6 months full, 6 months half) |
Significant protection |
| Estimated Total Package Value |
£34,000 – £38,000+ |
When you factor in the pension alone, your employer adds nearly £4,000 to your compensation each year.
Affordability Reality Check
Being honest:
- Outside London: Band 4 provides comfortable income for individuals. Mortgage achievable with careful budgeting or a partner’s income.
- In London: HCAS helps significantly (up to £36,195 at top). Shared accommodation often needed at entry level.
- At top of band with overtime: Much more comfortable position in most areas.
NHS Band 4 Benefits and Entitlements
Beyond salary, Band 4 staff receive excellent benefits through Agenda for Change.
NHS Pension Scheme
The NHS Pension is one of the best workplace pensions available:
| Pensionable Pay Range |
Member Rate |
| £13,260 – £27,797 |
6.5% |
| £27,798 – £33,868 |
8.3% |
- Entry salary (£27,485) — 6.5% contribution
- Top salary (£30,162) — 8.3% contribution
- Employer contributes 14.38%
- 2015 NHS Pension Scheme (career average)
- Normal pension age linked to State Pension age
Annual Leave Entitlement
| NHS Service |
Annual Leave |
Plus Bank Holidays |
| Under 5 years |
27 days |
+ 8 days |
| 5-10 years |
29 days |
+ 8 days |
| Over 10 years |
33 days |
+ 8 days |
That’s up to 41 days of paid leave per year for long-serving staff.
Other Key Benefits
- Sick Pay: Up to 6 months full pay, followed by 6 months half pay
- Maternity Pay: 8 weeks full pay, 18 weeks half pay, plus statutory maternity pay
- Paternity Leave: 2 weeks at full pay
- Professional Development: Access to CPD and degree programmes
- Flexible Working: Part-time, job share options available
- NHS Discounts: Access to Blue Light Card and Health Service Discounts
NHS Band 4 Part-Time Salary
Not everyone works full-time. Here’s what Band 4 pays for different contracted hours.
Part-Time Salary Examples (England)
| Contracted Hours |
% of Full-Time |
Entry Salary |
Top Salary |
| 37.5 (full-time) |
100% |
£27,485 |
£30,162 |
| 30 hours |
80% |
£21,988 |
£24,130 |
| 22.5 hours |
60% |
£16,491 |
£18,097 |
| 15 hours |
40% |
£10,994 |
£12,065 |
Annual leave is also calculated pro-rata based on your contracted hours.
NHS Pay Rise History and 2026/27 Outlook
Understanding recent pay awards helps you see how your salary has grown.
Recent NHS Pay Awards
| Year |
Pay Rise |
Band 4 Entry After Rise |
| 2023/24 |
5.0% |
£25,147 |
| 2024/25 |
5.5% |
£26,530 |
| 2025/26 |
3.6% |
£27,485 |
The government confirmed the 3.6% pay rise for 2025/26 as an above-inflation award, backdated to 1 April 2025.
Cumulative Improvement
Since 2022/23, Band 4 entry salary has increased by over £4,000. These consecutive above-inflation awards recognise the vital role of professionally qualified support staff in the NHS.
2026/27 Pay Outlook
According to recent government evidence to the NHS Pay Review Body, the Department of Health and Social Care has indicated that 2.5% is considered affordable within current budgets for 2026/27. However, the independent Pay Review Body may recommend a different figure.
The government has also committed to funding changes to the Agenda for Change pay structure from 1 April 2026, following discussions with the NHS Staff Council and trade unions.
Scotland Two-Year Pay Deal
Scotland has secured a two-year pay agreement:
| Pay Point |
2025/26 |
2026/27 |
Two-Year Increase |
| Entry |
£30,353 |
£31,492 |
+£1,139 |
| Top |
£33,016 |
£34,254 |
+£1,238 |
Scottish Band 4 staff receive 4.25% in 2025/26 and 3.75% in 2026/27.
What is Agenda for Change?
Agenda for Change (AfC) is the pay system that determines NHS Band 4 salary and conditions for over one million NHS staff.
Key Facts About Agenda for Change
- Introduced: December 2004
- Coverage: All NHS staff except doctors, dentists, and very senior managers
- Structure: Nine pay bands (Band 1-9), with Band 1 now closed to new entrants
- Basis: Jobs evaluated against 16 factors using the NHS Job Evaluation Scheme
How Band 4 is Determined
The NHS Job Evaluation Scheme assesses jobs against factors including:
- Knowledge, training, and experience required
- Responsibility for patients and resources
- Physical, mental, and emotional effort
- Working conditions
Band 4 recognises roles requiring:
- Level 4/5 qualifications
- Professional competencies
- Working with appropriate supervision
- Enhanced responsibilities compared to Band 3
The Knowledge and Skills Framework
The Knowledge and Skills Framework (KSF) supports Agenda for Change. It sets out the skills and knowledge NHS staff need to do their jobs well and helps with:
- Annual appraisals
- Pay progression decisions
- Identifying development needs
Frequently Asked Questions
What is the NHS Band 4 salary for 2025/26?
NHS Band 4 salary ranges from £27,485 to £30,162 per year in England for 2025/26. Scotland pays highest (£30,353 – £33,016), Northern Ireland pays lowest (£26,530 – £29,114). These figures include the 3.6% pay rise effective April 2025.
What is NHS Band 4 salary after tax?
A Band 4 Nursing Associate at entry point (£27,485) takes home approximately £1,870 per month after tax, National Insurance, and pension deductions. At top of band (£30,162), take-home rises to around £2,020 per month.
What is the NHS Band 4 hourly rate?
NHS Band 4 hourly rate ranges from £14.06 (entry) to £15.43 (top of band) in England. Overtime pays time and a half (£21.09 – £23.15), and bank holidays pay double time (£28.12 – £30.86).
How long does it take to get to top of band 4 in NHS?
It takes 3 years to reach the top of Band 4. You start at £27,485 and move to £30,162 after 3 years, subject to successful pay step review. Band 4 has only 2 pay points — simpler than higher bands.
What is a band 4 role in the NHS?
Band 4 roles include Nursing Associates, Assistant Practitioners, Pharmacy Technicians, Dental Nurses, Theatre Support Workers, and senior administrative staff. These positions require formal qualifications (Level 4-5) but not full professional degree registration.
What is the NHS pay increase for 2025?
NHS Agenda for Change staff received a 3.6% pay rise in 2025/26, backdated to April 2025. Band 4 entry increased from £26,530 to £27,485.
What pension contribution does Band 4 pay?
Band 4 staff contribute 6.5% at entry (salary up to £27,797) and 8.3% at top of band (salary £27,798-£33,868). The employer contributes 14.38%, making total pension contributions worth over 20% of salary.
Can Nursing Associates progress beyond Band 4?
Yes. Nursing Associates can complete a top-up degree (typically 18 months to 2 years) to become Registered Nurses at Band 5. Many NHS Trusts offer funded routes for this progression.
Is Band 4 better than Band 3?
Yes, financially. Band 4 pays £2,548 more at entry and £3,564 more at top than Band 3. Band 4 also provides professionally qualified status, more clinical responsibility, and clearer career progression pathways.
Do Band 4 staff get overtime pay?
Yes. Band 4 staff receive time and a half (1.5×) for overtime beyond 37.5 hours per week, and double time (2×) for bank holidays. Unsocial hours (nights, weekends) also attract enhanced pay of 30-60% on top of basic rates.
Summary: NHS Band 4 Salary at a Glance
| Key Information |
Details |
| Salary Range (England) |
£27,485 – £30,162 |
| Hourly Rate |
£14.06 – £15.43 |
| Time to Top of Band |
3 years |
| 2025/26 Pay Rise |
3.6% |
| Inner London (with HCAS) |
£33,094 – £36,195 |
| Monthly Take-Home (Entry) |
~£1,870 |
| Total Package Value |
~£34,000 – £38,000 |
| Band 3 to Band 4 Increase |
+£2,548 at entry |
NHS Band 4 represents an important career milestone for healthcare support staff. It marks the transition to professionally qualified roles, offering better pay, more responsibility, and clear pathways to further progression. For many, the Nursing Associate route provides an excellent opportunity to advance without the financial burden of traditional university education.
