NHS Agenda for Change pay · 2026/27 tax year

NHS band 4 salary after tax 2026/27

NHS band 4 starts on £28,392 a year in England for 2026/27. After an NHS pension contribution of £1,845 (6.5%), Income Tax of £2,795 and National Insurance of £1,266, you take home £22,485 a year, which is £1,873.79 a month. At the top of the band (3 years or more, £31,157) take-home rises to £1,990.32 a month.

Pay scales and pension tiers checked against NHS Employers and NHSBSA on 25 September 2026.

Entry salary

£28,392

a year before tax

Take-home per month

£1,874

entry point, after pension

Top of band per month

£1,990

3 years or more

NHS pension rate

6.5% to 8.3%

of pensionable pay

NHS band 4 take-home pay by pay point, 2026/27

Full-time pay in England from 1 April 2026. Take-home is after the NHS pension, Income Tax and National Insurance, with no student loan.

Experience	Gross a year	NHS pension	Income Tax	National Insurance	Take-home a year	Take-home a month
Under 3 years	£28,392	£1,845 (6.5%)	£2,795	£1,266	£22,485	£1,873.79
3 years or more	£31,157	£2,586 (8.3%)	£3,200	£1,487	£23,884	£1,990.32

NHS band 4 pay in London and the fringe, 2026/27

Gross pay including the high cost area supplement (HCAS), which is pensionable. Inner London adds 20% of basic pay (minimum £5,794, maximum £8,746), outer London 15% (£4,870 to £6,137) and the fringe 5% (£1,346 to £2,270).

Experience	Inner London gross	Inner take-home a month	Outer London gross	Outer take-home a month	Fringe gross	Fringe take-home a month
Under 3 years	£34,186	£2,155.30	£33,262	£2,104.97	£29,812	£1,917.06
3 years or more	£37,389	£2,292.37	£36,027	£2,219.54	£32,715	£2,075.18

NHS band 4 take-home pay with a Plan 2 student loan

Plan 2 takes 9% of pay over £29,385 a year, worked out on gross pay, so the NHS pension does not reduce it.

Experience	Plan 2 repayment a year	Plan 2 a month	Take-home a month with Plan 2
Under 3 years	£0	£0	£1,873.79
3 years or more	£159	£13.29	£1,977.03

Roles on band 4

NHS Health Careers gives these as examples of band 4 jobs: assistant practitioner, audio visual technician, pharmacy technician, dental nurse and trainee psychological wellbeing practitioner. Your band depends on how your own job is evaluated, not only its title.

Your NHS pension tier

The entry point falls in the 6.5% tier (£13,260 to £28,854) and the top point in the 8.3% tier (£28,855 to £35,155). The rate applies to all your pensionable pay, not just the part above the line, so at the top point the higher tier costs £561 a year more than 6.5% would on the same pay. Tiers are set by NHSBSA from 1 April 2026 and use your actual pay, so part-time staff are placed on what they earn.

Why the pension saves tax but not NI

NHS pension contributions come off your pay before Income Tax but not before National Insurance. At the band 4 entry point the £1,845 contribution cuts your Income Tax by £369, so it really costs you £1,476 a year. NI is still charged on the full £28,392.

Pay progression on band 4

You move up on your pay step date if you meet the standards in annex 23 of the NHS terms and conditions handbook. On band 4 that means £31,157 after 3 years, a rise of £2,765 before tax or £116.53 a month after it.

Unsocial hours on band 4

Hours on Saturdays and weekdays between 8pm and 6am are paid at time plus 30% on band 4, and Sundays and public holidays at time plus 60%. On the entry hourly rate of £14.52 that is £18.88 and £23.23 an hour before tax. These payments are pensionable, so they can move you into a higher pension tier.

Overtime on band 4

Hours over 37.5 a week are paid at time and a half, or double time on general public holidays. At the entry rate of £14.52 an hour that is £21.78 an hour. Part-time staff get plain time until they pass 37.5 hours in the week.

Scotland, Wales and Northern Ireland

These are England rates. NHS Scotland, Wales and Northern Ireland have their own pay sections in the NHS handbook and can pay differently. As a tax example only: a Scottish taxpayer on the England band 4 entry salary would take home £40 more a year (£1,877.09 a month), because Scotland has its own Income Tax bands.

Guides and definitions

High Income Child Benefit Charge: how it is worked out and cut (Guide)
How to read your payslip: every line explained, with an example (Guide)
National Insurance rates 2026/27: what you pay and how it works (Guide)
Emergency tax code (An emergency tax code, marked W1, M1 or X, taxes each payday on its own, as if you were paid that amount every period of the year.)
Marginal tax rate (Your marginal tax rate is the share of your next pound or dollar of income that goes in tax and deductions.)
P60 (A P60 is the yearly summary of your pay and tax from one employer, due by 31 May if you work there on 5 April.)
Personal Allowance (The Personal Allowance is the income you can earn each UK tax year before Income Tax starts: £12,570 for 2026/27.)
Tax code (A UK tax code tells your employer or pension provider how much tax-free pay to give you; 1257L, meaning £12,570, is the most common.)

Add your own hours, tax code and student loan

Other NHS bands

NHS Band 2 (£1,700 a month at entry)
NHS Band 3 (£1,727 a month at entry)
NHS Band 5 (£2,040 a month at entry)
NHS Band 6 (£2,430 a month at entry)

Every NHS band compared · £28,000 after tax · Add your own hours, tax code and student loan

Common questions

How much is band 4 after tax?

£22,485 a year at the entry point in 2026/27, rising to £23,884 at the top. That is after the NHS pension, Income Tax and National Insurance on salaries of £28,392 and £31,157.

What is band 4 per month?

£2,366 before tax and £1,873.79 after (under 3 years) and £2,596.42 before tax and £1,990.32 after (3 years or more). Monthly take-home is after the NHS pension, tax and NI, with no student loan.

How much NHS pension do I pay on band 4?

6.5% at the entry point (£1,845 a year) and 8.3% at the top (£2,586). The whole of your pensionable pay is charged at your tier rate, and the contribution comes off before Income Tax.

How long does it take to reach the top of band 4?

The top point is for staff with 3 years or more on the band, provided you meet the pay progression standards at each pay step date. It is worth £2,765 a year more than the entry point before tax.

How much is band 4 in London?

In inner London the entry point is £34,186 including the high cost area supplement, which leaves £2,155.30 a month after pension, tax and NI. Outer London pays £33,262 and the fringe £29,812.

Sources and assumptions

Full-time Agenda for Change pay in England for 2026/27 (37.5 hours a week), effective from 1 April 2026.
NHS Pension Scheme member contributions use the tier for your actual annual pensionable pay from 1 April 2026, charged on all of that pay, and come off before Income Tax but not National Insurance.
Income Tax and National Insurance use 2026/27 rates for England, Wales and Northern Ireland and the standard 1257L tax code. Student loans are left out unless a figure says otherwise.
Unsocial hours, overtime, on-call and recruitment premia are not included. Payroll works these out each month, so your payslip can differ by a few pounds.

These are estimates, not financial advice. Your payslip depends on your hours, tax code, pension tier and any enhancements.