NHS Band 4 Salary in Wales 2026/27

NHS Wales is managed by the Welsh Government and operates through 7 health boards and 3 NHS trusts (including the Welsh Ambulance Service). It's smaller than NHS England but still employs around 90,000 staff. The AfC pay scales in Wales are the same as England — identical salaries for every band and step — so your gross pay won't change if you cross the border.

Where Wales stands out is cost of living. Housing costs across most of Wales are dramatically lower than in England, particularly compared to London and the South East. A Band 5 nurse in Cardiff might pay £700-800 per month in rent, compared to £1,400-1,800 for a comparable property in outer London. This means your NHS salary stretches significantly further, even without any London weighting supplement.

Some roles in NHS Wales require or prefer Welsh language skills, particularly in community-facing positions in North and West Wales. This isn't universal — many roles have no Welsh language requirement — but it's worth checking job adverts if you're considering a move. NHS Wales uses the same 37.5-hour working week and UK income tax rates as England. Pay is negotiated through the NHS Staff Council alongside England, though the Welsh Government can choose to accept or vary the pay award independently.