For many NHS employees, NHS Band 4 take home pay will vary depending on pension contributions, student loans and additional shift payments.
NHS Band 4 take home pay in 2026/27 depends on your salary point, location, NHS pension contribution, tax code and any other deductions such as student loans. In England, NHS Band 4 salaries range from £28,392 to £31,157 for 2026/27. This guide shows your estimated monthly and annual take-home pay after Income Tax, National Insurance and NHS Pension contributions, with separate information for Scotland.
NHS Band 4 Salary 2026/27
| Pay point | Annual salary | Gross monthly pay |
| Band 4 entry | £28,392 | £2,366 |
| Band 4 top | £31,157 | £2,596 |
NHS Band 4 pay increases as you progress through the band. In England, the 2026/27 salary starts at £28,392 and rises to £31,157 at the top of Band 4. Your actual take-home pay will be lower after Income Tax, National Insurance, NHS Pension contributions and any other deductions.
NHS Band 4 Take-Home Pay After Tax
| Pay point | Gross salary | NHS pension | Income Tax | National Insurance | Estimated take-home |
| Band 4 entry | £28,392 | ~£1,845 | ~£2,795 | ~£1,266 | ~£22,485/year |
| Band 4 top | £31,157 | ~£2,586 | ~£3,200 | ~£1,487 | ~£23,884/year |
These figures are estimates for an NHS employee in England using a standard tax code and typical NHS Pension contributions. Your actual take-home pay may be different if you have a student loan, postgraduate loan, different tax code, salary sacrifice arrangement, overtime, unsocial-hours payments or other deductions.
NHS Band 4 Monthly Take-Home Pay
Based on the assumptions above, an NHS Band 4 employee in England could take home approximately £1,874 per month at the entry point and around £1,990 per month at the top of Band 4 after Income Tax, National Insurance and NHS Pension contributions.
NHS Band 4 Pay in Scotland 2026/27
NHS Band 4 take home pay in Scotland should be calculated separately because Scottish salaries and Income Tax rates differ from England.
NHS Band 4 pay is different in Scotland. For 2026/27, NHS Scotland Band 4 salaries range from £31,537 to £34,303, which is higher than the Band 4 salary range in England. Scotland also has different Income Tax bands, so take-home pay should be calculated separately rather than using the England figures.
NHS Band 4 take home pay in Scotland can differ from England because both NHS salaries and Income Tax rates are different.
| Pay point | Annual salary | Hourly rate |
| Band 4 entry | £31,537 | £16.80 |
| Band 4 top | £34,303 | £18.27 |
Because Scottish Income Tax is different from the rest of the UK, an NHS Band 4 employee in Scotland may have a different take-home amount even when earning a similar gross salary. Pension contributions, student loans, overtime and other deductions can also affect the final amount received.
NHS Band 4 Pension Contributions
NHS Pension contributions are based on your annual pensionable pay. From 1 April 2026, employees earning between £13,260 and £28,854 contribute 6.5%, while those earning between £28,855 and £35,155 contribute 8.3% of pensionable pay. This means an NHS Band 4 employee in England on the £28,392 entry salary would normally fall into the 6.5% contribution tier, while an employee earning £31,157 at the top of Band 4 would normally fall into the 8.3% tier.
| Band 4 pay point | Salary | Pension rate | Approx. annual contribution |
|---|---|---|---|
| Entry | £28,392 | 6.5% | ~£1,845 |
| Top | £31,157 | 8.3% | ~£2,586 |
NHS Pension contributions receive tax relief, so the reduction in your take-home pay is not necessarily the same as simply subtracting the full pension contribution from your gross salary. Your exact payslip may also differ depending on pensionable allowances, overtime and other earnings.
NHS Band 4 Hourly Rate
In England, the NHS Band 4 hourly rate for 2026/27 is £14.52 per hour at the entry point and rises to £15.93 per hour at the top of Band 4. These rates are based on the standard Agenda for Change working week and do not include overtime, unsocial-hours enhancements or High Cost Area Supplements.
| Band 4 pay point | Annual salary | Hourly rate |
|---|---|---|
| Entry | £28,392 | £14.52 |
| Top | £31,157 | £15.93 |
NHS employees working in London or certain surrounding areas may receive a High Cost Area Supplement, which can increase both annual and hourly pay. For example, Band 4 rates are higher in inner London, outer London and fringe areas.
NHS Band 4 Overtime and Unsocial Hours Pay
NHS Band 4 employees may receive additional pay for overtime, nights, weekends and other unsocial hours, depending on their role and working pattern. These payments can increase gross pay and therefore also affect Income Tax, National Insurance, pension contributions and final take-home pay.
Overtime rates are not always the same for every NHS employee, so your exact payment will depend on your contract, hours worked and whether the shift qualifies for an enhanced rate. Unsocial-hours enhancements may apply to certain evening, night, weekend and public-holiday shifts under Agenda for Change arrangements.
| Extra payment | Effect on pay |
|---|---|
| Overtime | Can increase gross monthly pay |
| Night shifts | May attract unsocial-hours enhancement |
| Weekend shifts | May attract enhanced pay |
| Public holidays | May attract enhanced rates depending on contract |
If you regularly work overtime or enhanced shifts, your monthly take-home pay can be noticeably higher than the basic Band 4 estimate shown above.
Does a Student Loan Reduce NHS Band 4 Take-Home Pay?
Yes. If you have a student loan and your earnings exceed the repayment threshold for your plan, repayments will be deducted from your salary through PAYE. This means your NHS Band 4 take-home pay may be lower than the estimates shown above.
For 2026/27, the annual repayment thresholds are £26,900 for Plan 1, £29,385 for Plan 2, £33,795 for Plan 4, £25,000 for Plan 5 and £21,000 for postgraduate loans. Plans 1, 2, 4 and 5 are repaid at 9% of earnings above the relevant threshold, while postgraduate loans are repaid at 6% above the threshold.
| Loan type | 2026/27 threshold | Repayment rate |
|---|---|---|
| Plan 1 | £26,900 | 9% above threshold |
| Plan 2 | £29,385 | 9% above threshold |
| Plan 4 | £33,795 | 9% above threshold |
| Plan 5 | £25,000 | 9% above threshold |
| Postgraduate Loan | £21,000 | 6% above threshold |
For example, an NHS Band 4 employee in England earning £31,157 with a Plan 2 loan would repay only on the portion of earnings above £29,385. Someone on Plan 5 would begin repayments at a lower income because its threshold is £25,000.
NHS Band 4 Frequently Asked Questions
How much does an NHS Band 4 employee take home per month?
In England, an NHS Band 4 employee could take home around £1,874 per month at the entry point and approximately £1,990 per month at the top of Band 4, based on the assumptions used in this guide. Actual take-home pay can vary because of tax codes, pension contributions, student loans, overtime and other deductions.
What is the NHS Band 4 salary for 2026/27?
In England, NHS Band 4 salaries for 2026/27 range from £28,392 to £31,157. In Scotland, Band 4 salaries are higher, ranging from £31,537 to £34,303.
How much is NHS Band 4 per hour?
In England, the 2026/27 NHS Band 4 hourly rate is £14.52 at the entry point and £15.93 at the top of the band. Employees receiving overtime, unsocial-hours payments or High Cost Area Supplements may earn more.
Does NHS Band 4 pay include pension deductions?
No. The published NHS Band 4 salary is gross pay before deductions. NHS Pension contributions are normally taken from your salary, along with Income Tax, National Insurance and any applicable student-loan repayments.
Is NHS Band 4 pay higher in Scotland?
Yes. For 2026/27, NHS Scotland Band 4 salaries range from £31,537 to £34,303, compared with £28,392 to £31,157 in England. Scotland also uses different Income Tax bands, so take-home pay should be calculated separately.
Can an NHS Band 4 job in England offer visa sponsorship?
Some NHS Band 4 jobs in England may qualify for visa sponsorship, but Band 4 status alone does not make a role eligible. Sponsorship depends on the occupation code, the specific job, the employer and the current UK immigration rules. Following changes introduced in July 2025, many Band 3 and Band 4 roles are no longer open to new Skilled Worker sponsorship applications, although some exceptions and transitional arrangements may apply. Applicants should always check the individual NHS vacancy and the latest GOV.UK visa guidance before applying.
Can an NHS Band 4 job in Scotland offer visa sponsorship?
Some NHS Band 4 jobs in Scotland may also qualify for visa sponsorship, but again, Band 4 itself does not automatically make a role sponsorable. Eligibility depends on the occupation code, the duties of the job, the sponsoring employer and current UK immigration rules. The same immigration framework applies across the UK, including Scotland, although the employer may be NHS Scotland rather than an NHS trust in England. Applicants should check the individual NHS Scotland vacancy and current GOV.UK visa guidance to confirm whether sponsorship is available.
Calculate Your NHS Band 4 Take-Home Pay
Your exact NHS Band 4 take home pay depends on your salary point, tax code, pension contribution, student-loan plan, overtime and other deductions. Use the WeFixPay salary and payroll tools to estimate your own figures and understand how each deduction affects your payslip.