Frequently Asked Questions
What is the NHS Band 4 salary in 2025/26?
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The NHS Band 4 Agenda for Change salary for 2025/26 runs from £26,530 at the minimum to
£29,114 at the top of the band, with a mid-scale of £27,822.
Staff in Inner London also receive the High Cost Area Supplement of £5,392, making the London mid-scale gross £33,214.
How much does an NHS Band 4 take home after pension?
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At Band 4 mid-scale, the employee NHS pension contribution is 5.1%.
In London, at gross £33,214, take-home after income tax, NI, and pension is approximately
£2,145/month. Outside London (no HCAS), take-home will be lower — see the city table above.
What does an NHS Band 4 do?
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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?
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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.