The NHS is one of the largest employers in the UK, and its structured pay bands ensure fairness and consistency across various job roles. For those working in Band 4 roles, understanding how much they earn, how the pay is structured, and the benefits they receive is essential, especially as we move into 2025 with updated figures and policy changes.
This guide offers a detailed look at the Band 4 NHS pay, covering everything from basic salaries and hourly rates to benefits and career progression.
What is Band 4 NHS Pay in 2025?
Band 4 in the NHS pay scale sits within the Agenda for Change framework, which outlines pay rates and working conditions for NHS staff (excluding doctors, dentists, and very senior managers). In 2025, following the latest 2.5% NHS pay rise, the Band 4 salary scale has been updated as follows:
- Entry point: £25,147 per year
- Top of Band 4: £27,596 per year
This reflects full-time roles (37.5 hours per week). Monthly take-home pay will vary based on tax, National Insurance, and pension contributions but typically falls between £1,700 – £1,850, depending on your progression and any enhancements.
Those on Band 4 contracts often receive additional pay for:
- Working in London or high-cost areas
- Taking on shifts during unsocial hours (evenings, weekends, or nights)
- Participating in on-call duties or overtime
The hourly rate ranges between £12.89 and £14.11, which is competitive when compared with other sectors offering similar responsibilities.
How Does the NHS Pay Structure Work for Band 4 Roles?
The NHS uses the Agenda for Change pay structure, which is based on clear, consistent national guidelines. Every staff member is placed into a pay band depending on their role, responsibilities, and experience. Each band is split into pay points that increase annually, assuming the staff member meets satisfactory performance standards.
For Band 4:
- You start at the bottom of the band and move up annually.
- After three years (sometimes earlier with exceptional performance), you reach the top of the band.
- Movement up the band is called incremental progression and typically occurs each April.
The pay spine ensures equal treatment and clarity in salary expectations. Band 4 sits above support-level bands (1–3) and below professional or registered roles in Band 5.
This system supports career development, making it easier for staff to understand what’s required to move up in pay and responsibility.
Will Band 4 NHS Staff Get a Pay Rise in 2025?
Yes, a 2.5% average increase was announced for NHS workers in 2025, including those in Band 4 roles. This follows months of negotiations between healthcare unions, government bodies, and the NHS Pay Review Body (NHSPRB).
The goals behind this pay rise include:
- Addressing rising living costs
- Retaining skilled staff across the system
- Attracting new professionals into NHS support roles
This uplift is automatically applied to existing NHS contracts. New hires in Band 4 roles in 2025 will start at the new rate, while current employees will see their pay adjusted based on their position on the pay spine.
Though the increase might seem modest, it plays a significant role in improving morale and supporting everyday financial wellbeing for healthcare workers.
How Long Does It Take to Reach the Top of Band 4 in NHS?
Reaching the top pay point of Band 4 usually takes 3 years under normal progression routes. Here’s how it typically works:
- Year 1: Entry point – £25,147
- Year 2: Mid-point – £26,000 (approximate)
- Year 3/4: Top point – £27,596
However, the timeline can vary based on:
- Start date within the pay year
- Performance appraisals and staff reviews
- Whether the employee is part-time or full-time
- Breaks in service
Annual reviews conducted by line managers evaluate whether an employee should move to the next pay point. In cases where performance doesn’t meet expectations, progression can be delayed.
What Jobs Are Included in NHS Band 4?
Band 4 roles are considered semi-professional or senior support positions. They often serve as the bridge between clinical support workers (Bands 2–3) and registered professionals (Band 5+).
Common Band 4 jobs include:
- Assistant Practitioners: Work under the supervision of registered staff in nursing, radiography, or therapies.
- Pharmacy Technicians: Dispense medications and offer advice on drug use under pharmacy regulations.
- Medical Secretaries: Coordinate clinical schedules, transcribe medical notes, and manage communication.
- Healthcare Science Assistants: Support testing and diagnostic activities in labs or clinics.
- Rehabilitation Assistants: Work in occupational or physiotherapy departments supporting patients’ recovery.
- Outpatient Coordinators & Admin Leads: Handle patient referrals and booking systems.
Band 4 roles often require NVQ Level 3 or 4, relevant diplomas, or equivalent work experience. Many come with structured development plans for career progression.
What Is the NHS Medical Secretary Pay at Band 4 in 2025?
A medical secretary working at Band 4 in 2025 earns between £25,147 and £27,596 depending on experience.
Medical secretaries are essential to NHS operations. They:
- Prepare clinical letters
- Book appointments and manage diaries
- Maintain medical records and ensure GDPR compliance
- Liaise between patients and clinical teams
Some departments, especially in surgical or oncology units, offer enhanced pay rates for high-pressure environments. Secretaries in London may receive a high-cost area supplement, increasing their basic pay by up to 20%.
In high-demand specialties, NHS Trusts may also offer retention bonuses or training incentives to experienced Band 4 secretaries.
What Is the New Pay for NHS Band 4 Roles in 2025?
The updated pay for Band 4 in 2025 reflects the 2.5% increase across the NHS:
- Entry Point: £25,147
- Mid-level: Approx. £26,000
- Top of Band: £27,596
These figures apply across England, though slight variations may occur in Scotland, Wales, and Northern Ireland, which set their own public sector pay agreements.
This pay adjustment aligns with government inflation forecasts and is part of a multi-year plan to restore real-terms pay value for NHS workers. For many Band 4 employees, this translates to an increase of around £500–£650 annually compared to 2024.
How Much is Band 4 NHS Bank Pay in 2025?
Bank workers are NHS staff who work on a flexible or ad-hoc basis, often covering short-staffed shifts or busy periods. They are paid hourly and don’t always receive the same benefits as permanent employees.
In 2025, the Band 4 NHS bank rate ranges between:
- £13.00 and £15.00 per hour (depending on the trust and shift times)
Extra pay is available for:
- Evening or weekend shifts
- Night shifts
- Bank holidays
Advantages of NHS bank work:
- Flexibility in scheduling
- Opportunity to gain varied experience
- Useful for semi-retired professionals or students
However, bank staff are not always guaranteed shifts and may not receive pensions or sick leave unless on a longer-term contract.
What Is the NHS Band 4 Hourly Rate and Weekly Earnings?
Let’s break this down using 2025 figures.
- Hourly Pay: £12.89 – £14.11 (based on experience)
- Weekly Pay: Based on 37.5 hours per week
| Experience Level | Weekly Pay |
| Entry Point | ~£483 |
| Mid-Level | ~£505 |
| Top of Band | ~£537 |
Overtime is typically paid at time-and-a-half and night/weekend work attracts unsocial hours enhancements (up to 30–60% more per hour).
What Benefits Do NHS Band 4 Employees Receive in 2025?
NHS Band 4 employees are eligible for a generous range of benefits:
- NHS Pension Scheme: Up to 20% employer contribution
- 27 Days Annual Leave (rising with service)
- Paid Sick Leave: Increasing with years of service
- Maternity/Paternity Leave: Enhanced packages available
- Flexible Working: Job sharing, compressed hours, and remote admin roles
- Training & Development: Access to courses, apprenticeships, and secondments
- NHS Discounts: On retail, travel, technology, and more
These benefits make NHS employment highly competitive, especially for those seeking long-term job security.
How Does Band 4 NHS Pay Compare Regionally in the UK?
NHS staff in London and surrounding areas receive High-Cost Area Supplements (HCAS) to reflect the cost of living. These are added as a percentage of the base salary.
| Region | Supplement Type | % Increase |
| Inner London | High Cost Area (HCAS) | Up to 20% |
| Outer London | HCAS | Up to 15% |
| Fringe Area | HCAS | Up to 5% |
Devolved nations like Scotland and Wales have slightly different pay scales, though they remain closely aligned with the Agenda for Change structure.
What Is the Career Progression Path from NHS Band 4?
Band 4 is often a stepping stone to higher positions. With training and qualifications, employees can move to Band 5, which includes roles such as:
- Registered Nurses
- Physiotherapists
- Operating Department Practitioners
- Senior Healthcare Scientists
Pathways for progression include:
- Apprenticeships
- Foundation Degrees
- NVQ Level 5 or higher
- In-house training programmes
Career progression is actively encouraged in the NHS, with many Trusts offering fully funded development opportunities.
How to Use the NHS Pay Calculator for Band 4 in 2025?
To get a clear view of what you’ll earn, including take-home pay and deductions, use a NHS pay calculator.
Steps:
- Go to nhspay.org or nhsemployers.org
- Select Band 4
- Enter your years of experience, working hours, and location
- Input any enhancements (London weighting, unsocial hours, etc.)
- View your gross and net pay breakdown
These tools help with:
- Financial planning
- Understanding pension deductions
- Preparing for interviews or promotions
What Is the Take-Home Pay for NHS Band 4 Staff After Deductions?
While the gross salary for Band 4 NHS staff in 2025 ranges from £25,147 to £27,596 annually, it’s important to understand what that translates to in actual take home pay after all necessary deductions.
Main deductions include
- Income Tax (based on UK thresholds)
- National Insurance Contributions (NIC)
- NHS Pension Scheme contributions (typically 7.1% to 9.3% depending on income)
For a Band 4 employee earning the starting salary of £25,147:
- Estimated net monthly pay: ~£1,700 – £1,750
- After deductions of around £350–£400, depending on tax code and pension rate
At the top of the band (£27,596):
- Estimated take-home: ~£1,850 – £1,900 per month
Employees can use online NHS pay calculators to get a personalised estimate of their take-home salary, which also factors in enhancements for overtime or unsocial hours.
Are Band 4 NHS Employees Paid for Overtime and Unsocial Hours?
Yes, Band 4 NHS staff are entitled to additional payments for working beyond regular hours or during designated unsocial times. This includes:
Overtime Pay
- Usually paid at time and a half (1.5x hourly rate)
- Applies after 37.5 hours/week unless agreed otherwise by the Trust
- Must be authorised in advance
Unsocial Hours Enhancements
Under the Agenda for Change terms, the following hours are considered “unsocial” and attract premium pay:
| Day / Time | Extra Pay Percentage |
| Weekdays (8pm – 6am) | 30% extra |
| Saturdays (all day) | 30% extra |
| Sundays & Public Holidays | 60% extra |
Example: A Band 4 staff member earning £13/hour on a Sunday could earn £20.80/hour with the 60% enhancement.
These enhancements make a significant difference to monthly earnings, especially for staff regularly working shifts outside the typical Monday–Friday daytime pattern.
What Are the Usual Working Hours for Band 4 NHS Staff?
The standard working week for full-time NHS employees, including those in Band 4 roles, is 37.5 hours.
Typical working patterns include
- Early or late shifts (e.g. 7am–3pm or 1pm–9pm)
- Night shifts (particularly in clinical settings)
- Rotational shifts, including weekends and public holidays
Many Band 4 staff especially in admin, secretarial or outpatient roles may work a more traditional Monday–Friday, 9–5 schedule, depending on department.
Part-time roles are also available and are often pro-rated for salary and benefits. The NHS encourages flexible working arrangements where possible, including:
- Compressed hours
- Job sharing
- Remote admin work (in some non-clinical roles)
Staff can discuss their preferences with line managers through a flexible working request, which Trusts are now encouraged to accommodate wherever practical.
Conclusion
The Band 4 NHS pay scale in 2025 offers a fair and structured salary system with significant benefits. Whether you’re already in a Band 4 role or aspiring to move up, understanding how the system works, how pay progresses, and what benefits are available can help you make informed career decisions.
With opportunities for progression, flexible work arrangements, and a strong support structure, Band 4 remains a valuable tier in the NHS framework.
FAQs About Band 4 NHS pay
What qualifications are needed for Band 4 NHS jobs?
Most Band 4 roles require an NVQ Level 3/4 or relevant healthcare experience. Some may need foundation degrees.
Does Band 4 include unsocial hours pay?
Yes, working evenings, weekends or nights attracts additional pay under NHS terms.
Can part-time workers earn increments in Band 4?
Yes, increments are based on service length and not hours worked.
Are Band 4 employees eligible for NHS pension?
Absolutely. All Band 4 staff qualify for the NHS Pension Scheme if they meet the minimum service requirements.
How does tax affect Band 4 NHS take-home pay?
Tax, National Insurance, and pension deductions reduce gross pay. Net monthly take-home is usually around 70–75% of gross.
Is Band 4 a good entry-level NHS job?
Yes. It’s an excellent route for those moving into healthcare with experience or qualifications but not yet registered professionals.
Do Band 4 salaries differ in Scotland and Wales?
Yes. Each devolved nation can set their own rates, though they often closely mirror England’s Agenda for Change pay bands.
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