NHS Band 4 · Agenda for Change 2026/27

NHS Band 4 Salary 2026/27

Associate Practitioner. Associate practitioner, assistant practitioner, therapy assistant, senior medical secretary.

Min salary
£27,405
Mid-scale
£28,740
Max salary
£30,075
Pension (emp)
5.1%
← All Bands ↓ Band 3 — £25,979/yr ↑ Band 5 — £32,074/yr
Updated April 2026 — 3.3% Agenda for Change pay award
2025/26 range
£26,530 – £29,114
+3.3%
2026/27 range
£27,405 – £30,075
+£875 at entry

NHS Band 4 Take-Home Pay by City

City Gross (inc. HCAS) Net after pension After 1-bed rent RTI%
London £34,310 £2,206/mo £56/mo 97%
Manchester £28,740 £1,896/mo £846/mo 55%
Birmingham £28,740 £1,896/mo £1,046/mo 45%
Edinburgh £28,740 £1,895/mo £795/mo 58%
Glasgow £28,740 £1,895/mo £995/mo 47%
Bristol £28,740 £1,896/mo £546/mo 71%
Leeds £28,740 £1,896/mo £996/mo 47%
Sheffield £28,740 £1,896/mo £1,071/mo 44%
Newcastle £28,740 £1,896/mo £1,146/mo 40%
Nottingham £28,740 £1,896/mo £1,046/mo 45%
Cardiff £28,740 £1,896/mo £996/mo 47%
Aberdeen £28,740 £1,895/mo £845/mo 55%
Liverpool £28,740 £1,896/mo £1,096/mo 42%
Leicester £28,740 £1,896/mo £1,096/mo 42%
Oxford £28,740 £1,896/mo £446/mo 76%
Cambridge £28,740 £1,896/mo £396/mo 79%
Reading £28,740 £1,896/mo £546/mo 71%
Brighton £28,740 £1,896/mo £496/mo 74%
York £28,740 £1,896/mo £946/mo 50%
Exeter £28,740 £1,896/mo £896/mo 53%

Net after pension = take-home after income tax, National Insurance, and 5.1% employee pension contribution. RTI% = rent-to-income ratio. London figure includes Inner HCAS of £5,570. Click any city for the full breakdown including council tax, transport, and monthly budget.

NHS Band 4 Pension

Contribution Rates
Employee rate 5.1%
NHS employer rate 23.7%
2015 CARE Scheme

NHS Band 4 staff are in the 2015 Career Average (CARE) defined-benefit scheme. Each year of service builds a guaranteed, inflation-linked pension — paid for life at retirement. The 23.7% NHS employer contribution is effectively additional salary you cannot withdraw early.

Frequently Asked Questions

What is the NHS Band 4 salary in 2026/27? +
The NHS Band 4 Agenda for Change salary for 2026/27 runs from £27,405 at the minimum to £30,075 at the top of the band, with a mid-scale of £28,740. Staff in Inner London also receive the High Cost Area Supplement of £5,570, making the London mid-scale gross £34,310.
How much does an NHS Band 4 take home after pension? +
At Band 4 mid-scale, the employee NHS pension contribution is 5.1%. In London, at gross £34,310, take-home after income tax, NI, and pension is approximately £2,206/month. Outside London (no HCAS), take-home will be lower — see the city table above.
What does an NHS Band 4 do? +
NHS Band 4 covers the Associate Practitioner grade. Associate practitioner, assistant practitioner, therapy assistant, senior medical secretary. The AfC framework defines the band by the skills, responsibility, and knowledge required — not just the job title.
How does the NHS pension work for Band 4? +
NHS Band 4 staff are enrolled in the 2015 CARE (Career Average) scheme. The employee contribution is 5.1% of pensionable pay. The NHS employer adds 23.7%. Each year of service accrues a guaranteed, inflation-linked annual pension of 1/54th of that year's pensionable pay. This is a defined-benefit scheme — your pension is not subject to investment risk.