NHS Band 4 salary 2026/27: £28,392–£31,157 and hourly rate

The pay points

Step	2026/27	2025/26	Hourly	Time to next step
Entry	£28,392	£27,485	£14.52	3 years
Top	£31,157	£30,162	£15.93	—

Hourly figures are derived — how, and why they are not published.

What work sits in band 4

8 published profiles score into band 4 from the ambulance service and nursing and radiography and occupational therapy and midwifery job families — these are the profiles a ambulance service worker’s or nurse’s or radiographer’s or occupational therapist’s or midwife’s post is matched to. A post is banded by matching it to one of these, not by its job title, which is why two jobs with the same title can sit in different bands.

Dispatcher

Job evaluation score 271–276

Ensure the effective deployment and efficient management of emergency and non-emergency vehicles.
Receives requests for emergency, urgent and routine ambulance services from other call centre staff and then dispatches to appropriate vehicle crews for a response.
Referral to and liaison with appropriate services including some direct patient contact.

Nursing: 4i

Job evaluation score 274–321

Implements care packages or programmes in a range of settings under the supervision of registered clinical practitioners or as part of a multi-professional/multi-agency team.
Carries out specific care duties for patients, as delegated by a registered nurse or other relevant professional.
Monitor and contribute to care delivery and escalates any concerns.
May supervise support workers

Nursing: 4ii

Job evaluation score 274–323

Implements care packages or programmes for children in a range of settings under the supervision of registered clinical practitioners.
Carries out care activities for children, e.g. clinical observations, participates in social inclusion and/or parenting support activities
May supervise/assess support workers
May participate in case conferences and case review meetings, e.g. safeguarding

Assistant Practitioner (Radiography)

Job evaluation score 275–303

Carries out screening, imaging, therapy procedures
Assists radiographer in carrying out specialist procedures
Carries out clerical and administrative duties in radiography department

Occupational Therapy Technician

Job evaluation score 277–292

Plans and provides programmes of therapeutic activities tailored to client group e.g. those with mental health problems, within the framework laid down by the Occupational Therapist
Implements and evaluates delegated OT interventions for patients/clients in activities relating to their treatment programme

Midwifery 4

Job evaluation score 278–323

Assists the midwife in providing physical, social and psychological support to clients, newborns and their families.
Undertakes a range of delegated clinical care duties in a variety of settings and implements care packages under the supervision of the midwife.
May supervise maternity support workers.
Provides detailed advice on health promotion issues e.g. smoking cessation and feeding.

Ambulance Practitioner

Job evaluation score 280–301

Responds to emergencies, urgent and routine calls, delivers treatment
Undertakes emergency driving; lifts and carries patients
Undertakes daily vehicle checks, check and re-stock equipment and supplies.

Call handler higher level

Job evaluation score 301–321

Mentor or coach a team of call handlers to ensure performance objectives and achieved.
Provides a front-line service answering emergency and urgent care calls.
Provides clinical triage advice and inputs key information into computerised system;provides emergency condition related advice from protocols.
Escalates call / refers to appropriate service.

Quoted from National profiles for ambulance service — NHS Staff Council Job Evaluation Group national job profiles; National profiles for nursing — NHS Staff Council Job Evaluation Group national job profiles; National profiles for diagnostic and therapeutic radiographers — NHS Staff Council Job Evaluation Group national job profiles; National profiles for occupational therapy — NHS Staff Council Job Evaluation Group national job profiles; National profiles for midwifery — NHS Staff Council Job Evaluation Group national job profiles.

The same jobs at every band they reach, on one page each: ambulance service pay, midwifery pay, nursing pay and radiography pay.

What changes between band 3 and band 4

A ambulance service worker’s post moves up when the job evaluation score does, not when enough time has passed. In the ambulance service family the highest band 3 profile (Call handler) tops out at 252, and the lowest here (Dispatcher) starts at 271 — the band boundary sits in that gap. Crossing it means the work described at band 3 has changed.

A nurse’s post moves up when the job evaluation score does, not when enough time has passed. In the nursing family the highest band 3 profile (Nursing: 3) tops out at 267, and the lowest here (Nursing: 4i) starts at 274 — the band boundary sits in that gap. Crossing it means the work described at band 3 has changed.

A radiographer’s post moves up when the job evaluation score does, not when enough time has passed. In the radiography family the highest band 3 profile (Clinical Support Worker, Higher Level (Radiography)) tops out at 244, and the lowest here (Assistant Practitioner (Radiography)) starts at 275 — the band boundary sits in that gap. Crossing it means the work described at band 3 has changed.

A occupational therapist’s post moves up when the job evaluation score does, not when enough time has passed. In the occupational therapy family the highest band 3 profile (Clinical Support Worker Higher Level (Occupational Therapy)) tops out at 252, and the lowest here (Occupational Therapy Technician) starts at 277 — the band boundary sits in that gap. Crossing it means the work described at band 3 has changed.

Nights, weekends and bank holidays

Bands 4 to 9 share one unsocial hours rate, so this is the same for band 4 as for any band above 3. All four nations’ rates, and the rules for which hours qualify. Work out the take-home on this band.

When	Enhancement	Hourly at the entry step	At the top
Saturday, and weekdays 8pm–6am	+30%	£18.88	£20.71
Sundays and public holidays	+60%	£23.23	£25.49

Which hours qualify, and the rules that decide it — including what is excluded and how the other nations differ.

If you work in or near London

A percentage of basic salary, but with a floor and a ceiling — so what band 4 actually gets is not simply the percentage.

Zone	Rate	At the entry step	At the top
Inner London	20%	£5,794.00 (the minimum)	£6,231.40
Outer London	15%	£4,870.00 (the minimum)	£4,870.00 (the minimum)
Fringe London	5%	£1,419.60	£1,557.85

At band 4 the straight 20% would come to less than the minimum, so inner London pay is lifted to £5,794.00 — worth proportionally more here than further up the scale.

What band 4 actually pays after deductions

The gross figure is not what reaches your bank. Run through income tax, National Insurance and the pension contribution for an England member in the scheme, each step of band 4 comes out at:

Step	Gross	Hourly	Pension tier	Take-home	A month
Entry	£28,392	£14.52	6.5%	£22,485.94	£1,873.83
Top	£31,157	£15.93	8.3%	£23,884.34	£1,990.36

England, in the pension scheme, standard tax code, no student loan and no salary sacrifice. Unsocial hours and overtime are paid on top of these figures and are not in them. An estimate from published rates, not a payslip and not financial advice — check it against your own before acting on it. Change any assumption, or pick another nation.

Moving up a step crosses a pension tier

Going from entry to top raises gross pay by £2,765 — but it also moves you from the 6.5% pension tier to the 8.3% one. The scheme charges that rate on your whole pensionable pay, not just the part above the threshold, so your contribution rises by £740.55 and you keep £1,398.40 of the £2,765 rise.

That is a real feature of the scheme rather than a rounding artefact, and it is why the calculator shows the tier it used.

Band 4 in the other nations

The four nations set their own Agenda for Change rates, and this year they set four different ones. One of them has not made an award yet, so its figures are the previous year’s — the table says which.

Nation	Entry	Top	Steps	Week	Hourly at entry
England	£28,392	£31,157	2	37.5h	£14.52
Scotland	£31,537	£34,303	2	36h	£16.80
Wales	£28,819	£31,626	2	37.5h	£14.74
Northern Ireland 2025/26 — no newer award	£27,485	£30,162	2	37.5h	£14.06

Hourly rates are not comparable across the row without reading the week column: Scotland works 36 hours where the others work 37.5, so the same salary buys a higher hourly rate there.

If you work part time

What you keep does not scale with your hours.

Hours a week	Gross	Pension tier	Take-home	A month	Kept
18.8	£14,196	6.5%	£13,003.01	£1,083.58	91.6%
22.5	£17,035.20	6.5%	£14,899.57	£1,241.63	87.5%
30	£22,713.60	6.5%	£18,692.82	£1,557.74	82.3%
37.5 — full time	£28,392	6.5%	£22,485.94	£1,873.83	79.2%

Entry step, England, in the pension scheme. Enter your own hours.

The step before and after

Below this sits band 3. The next band up is band 5, which most people reach by applying for a different post rather than by progression — the steps within a band are time-served, but moving between bands is not.

Other bands

Band 2 Band 3 Band 5 Band 6 Band 7 Band 8a

All bands in one table · Methodology · Sources