Understanding Band 4 NHS Pay
Band 4 NHS salary represents a significant milestone in NHS careers, marking the transition to professionally qualified roles within the Agenda for Change pay bands framework. The NHS Band 4 wage reflects the enhanced skills, qualifications, and responsibilities required for these positions, including Nursing Associates and Assistant Practitioners who deliver specialized patient care across the NHS.
Band 4 NHS Pay Scale 2025/26
Current Agenda for Change pay bands rates across all UK regions
| Years | Type | England | Wales | Scotland | Northern Ireland |
|---|---|---|---|---|---|
| 0–2 | per year | £27,485 | £27,898 | £30,353 | £26,530 |
| 0–2 | per hour | £14.09 | £14.31 | £15.73 | £13.61 |
| 2+ | per year | £30,162 | £30,615 | £33,016 | £29,114 |
| 2+ | per hour | £15.47 | £15.70 | £17.11 | £14.93 |
* These Band 4 NHS pay rates are effective from April 2025 under the Agenda for Change pay bands framework, based on a standard 37.5 hour working week.
Typical Roles in NHS Band 4
NHS Band 4 wage positions require professional qualifications, apprenticeship completion, or equivalent Level 4-5 credentials. These roles deliver specialist care and support across clinical and technical services:
Career Progression from Band 4
Band 4 NHS salary positions offer excellent progression opportunities within the Agenda for Change pay bands structure:
Develop Professional Expertise
Build specialist skills and demonstrate competency in your Band 4 role while maintaining professional registration where required.
Consider Degree Completion
Many Band 4 staff pursue full degree qualifications (nursing, allied health professions) to reach Band 5 registered professional roles.
Progress to Band 5
With appropriate qualifications, move to Band 5 registered professional roles earning £31,049-£37,796 (Staff Nurse, Physiotherapist, etc.).
Specialist Pathways Available
Some Band 4 roles offer specialist progression routes without requiring full degree qualification, including senior technical positions.
NHS Band 4 Benefits & Perks
NHS Pension Scheme
6.5% employee contribution with excellent employer contributions
Annual Leave
27 days rising to 33 days, plus 8 bank holidays
Professional Development
Access to continuing professional development (CPD) and degree programs
Overtime & Enhancements
Enhanced rates for overtime and unsocial hours
Sick Pay
Comprehensive occupational sick pay scheme
NHS Discounts
Exclusive discounts for NHS staff nationwide
Compare Agenda for Change Pay Bands
Understanding Agenda for Change Pay Bands
Agenda for Change (AfC) is the National Health Service's comprehensive pay and grading system, implemented in December 2004 to standardize pay scales and ensure fair, consistent compensation across the NHS. The Agenda for Change pay bands framework covers over one million NHS staff members, providing a clear structure for career progression from entry-level support roles to senior professional positions.
The system applies to most NHS employees including nurses, midwives, paramedics, healthcare assistants, therapists, and administrative staff. Band 4 NHS pay sits at the mid-point of the nine-band structure (Bands 1-9), representing professionally qualified or apprenticeship-completed roles that bridge the gap between support workers and registered professionals.
A key component of Agenda for Change is the Knowledge and Skills Framework (KSF), which supports personal development and career advancement. For Band 4 roles, the KSF ensures staff have the professional competencies required for their specialized positions, with annual pay progression based on satisfactory performance within the NHS Band 4 wage structure.
The Band 4 NHS salary reflects the significant step up in qualification requirements, professional responsibility, and clinical autonomy compared to lower bands. This positioning within the Agenda for Change pay bands makes Band 4 an attractive career milestone for NHS support staff pursuing professional qualifications and registered status.
NHS Pay Rise 2025/26
3.6% Pay Increase for 2025/26 | Backdated to April 1, 2025
In May 2025, the UK government announced a 3.6% pay increase for all Agenda for Change staff for the 2025/26 financial year, backdated to April 1, 2025. This increase has positively impacted Band 4 NHS pay rates, with the starting salary rising to £27,485 and the top point reaching £30,162 in England. These above-inflation pay rises recognize the vital role that Nursing Associates, Assistant Practitioners, and other Band 4 professionals play in delivering quality NHS care.
The Band 4 NHS salary improvements reflect consecutive years of above-inflation awards (3.6% in 2025/26 following 5.5% in 2024/25), ensuring that professionally qualified Band 4 staff within the Agenda for Change pay bands receive fair compensation for their enhanced skills and responsibilities. This represents a cumulative increase of over £4,000 for Band 4 positions since 2022/23.
Recent NHS Pay Awards Timeline:
These pay increases apply uniformly across all Agenda for Change pay bands, ensuring that NHS Band 4 wage earners receive the same percentage uplift as colleagues in other bands. The government has worked closely with NHS Employers and trade unions to negotiate these settlements, balancing the need to reward professionally qualified staff appropriately while maintaining fiscal responsibility across the Band 4 NHS pay structure and beyond.