Agenda for Change
NHS band 4 pay
Band 4 in England pays £28,392 to £31,157 a year in 2026/27. All four UK nations publish a band 4 scale, and they do not match — each row below is labelled with its own nation and pay year.
Band 4 pay points, nation by nation
Annual full-time rates as published in each nation's Agenda for Change circular. The pay year is not the same everywhere, so it is stated on every row.
| Nation | Pay year | Entry | Top | Top of band |
|---|---|---|---|---|
| England | 2026/27 | £28,392 | £31,157 | £31,157 |
| Northern Ireland | 2025/26 | £27,485 | £30,162 | £30,162 |
| Scotland | 2026/27 | £31,537 | £34,303 | £34,303 |
| Wales | 2026/27 | £28,819 | £31,626 | £31,626 |
Uplifts applied to these scales: England 3.3% for 2026/27, Northern Ireland 3.6% for 2025/26, Scotland 3.75% for 2026/27 and Wales 3.3% for 2026/27 . Agenda for Change scales are uplifted each April, and an award agreed later in the year is backdated to 1 April.
What a band 4 post actually is
Band 4 is the assistant practitioner grade: a foundation degree or level 5 qualification, working to a registered professional’s plan with a good deal of day-to-day autonomy. It is also the band most degree apprentices sit at while they train.
The band is attached to the post, not to you. Job evaluation matches the job description against national profiles, so two people doing genuinely different work in the same team can sit at different bands, and moving employer at the same band means no change in basic pay at all. That is the practical reason people compare bands rather than salaries when they look at NHS jobs.
Coming from band 3: the top of band 3 in England is £27,476 and band 4 starts at £28,392, so a promotion taken at the top of the band below is a smaller immediate rise than the gap between the two starting salaries suggests — what you gain is the ceiling you are moving under. Where you land within band 4 depends on the employer's assessment of relevant experience, and starting above the bottom point is possible but not automatic.
Everything on this page is basic pay. Unsocial hours enhancements, on-call payments and any high cost area supplement sit on top; the NHS pension contribution, income tax and National Insurance come off. For a benchmark outside the NHS, median gross annual pay for full-time workers in United Kingdom was £39,039 in 2025 — a whole-economy figure across all occupations, not a health one.
- Pay structure
- NHS Agenda for Change
- Pay year shown
- 2025/26 and 2026/27
- Pay points
- 2
- Uplifted
- Each April, following the NHS Pay Review Body recommendation
- Effective from
- 1 April 2026
Band 4 with London weighting
Posts in and around London attract a high cost area supplement on top of basic pay. The uplifted figures below are calculated by this site: the published band 4 range for England (2026/27) plus the published percentage for each zone, with the published minimum and maximum applied.
| Zone | Supplement | Floor and cap | Starting, with supplement | Top of band, with supplement |
|---|---|---|---|---|
| Outside the zones | None | None | £28,392 | £31,157 |
| Inner London | 20% | £5,794–£8,746 | £34,186 | £37,388 |
| Outer London | 15% | £4,870–£6,137 | £33,262 | £36,027 |
| Fringe | 5% | £1,346–£2,270 | £29,812 | £32,715 |
Calculation: basic pay plus 20% for Inner London, 15% for Outer London and 5% for Fringe, where the supplement cannot fall below the published minimum or rise above the published maximum for the zone. At the bottom of the lower bands the floor is what actually applies, which is why the percentage alone will not reproduce these figures. Supplement values are for 2026/27 and apply in England only.
Band 4 by profession
The scale is identical whichever allied health profession you are in — what differs is what the post involves and how many band 4 jobs exist in that service.
Band 4 art therapist
What band 4 means in art therapist practice.
Band 4 diagnostic radiographer
What band 4 means in diagnostic radiographer practice.
Band 4 dietitian
What band 4 means in dietitian practice.
Band 4 dramatherapist
What band 4 means in dramatherapist practice.
Band 4 music therapist
What band 4 means in music therapist practice.
Band 4 occupational therapist
What band 4 means in occupational therapist practice.
Band 4 operating department practitioner
What band 4 means in operating department practitioner practice.
Band 4 orthoptist
What band 4 means in orthoptist practice.
Band 4 osteopath
What band 4 means in osteopath practice.
Band 4 paramedic
What band 4 means in paramedic practice.
Band 4 physiotherapist
What band 4 means in physiotherapist practice.
Band 4 podiatrist
What band 4 means in podiatrist practice.
Band 4 prosthetist/orthotist
What band 4 means in prosthetist/orthotist practice.
Band 4 speech and language therapist
What band 4 means in speech and language therapist practice.
Band 4 therapeutic radiographer
What band 4 means in therapeutic radiographer practice.
Neighbouring bands
- Band 3 — From £25,760 in England
- Band 5 — From £32,073 in England
- All bands and the full scales — Every nation, every band
Next
- Find band-level vacancies — Job market by profession
- The professions — What each job involves
- Funding while you train — Before the first payslip
- England pay scale — 2026/27
- Northern Ireland pay scale — 2025/26
- Scotland pay scale — 2026/27
- Wales pay scale — 2026/27
Where this page’s data comes from
Pay values are the numeric rates published in each nation's Agenda for Change circular. Figures shown with a high cost area supplement are calculated by this site from those published rates and the published supplement percentages.
- Agenda for Change pay scales and NHS terms and conditions handbookNHS Employers (NHS Confederation) · No open licence stated; NHS Employers copyright · checked 3 September 2026
- ONS Annual Survey of Hours and Earnings (ASHE) via NomisOffice for National Statistics, delivered by Nomis (Durham University) · Open Government Licence v3.0 · checked 3 September 2026Source: Office for National Statistics licensed under the Open Government Licence v3.0.
- health-ni.gov.ukCited page
- bso.hscni.netCited page
- publications.scot.nhs.ukCited page
- nhs.walesCited page