NHS Medical Secretary Salary 2026/27: Band 3 to 4

This page is for administrators thinking of moving into medical secretary work, applicants comparing a Band 3 advert with a Band 4 one, and medical secretaries who want to know whether their band is typical. Medical secretary pay is not set by the job title, and the same title is graded differently across the NHS, so we explain what drives the difference.

Medical secretary pay points 2026/27 (England)

Use the NHS Pay Calculator for your exact take-home pay at any band and point, including High Cost Area Supplement. For every band side by side, see the Agenda for Change pay scales guide.

Scotland's rates

NHS Scotland has its own 2026/27 table. For this role it runs from £29,103 to £34,303. Band 3: £29,103 to £31,409. Band 4: £31,537 to £34,303. See NHS Scotland pay scales 2026/27 for every band.

Why some medical secretaries are Band 3 and some Band 4

NHS Careers states that medical secretary and personal assistant posts are paid on Agenda for Change at typically Band 3 or Band 4, and that you could progress to Band 5 with further training and qualifications. That is the national range. Which band a particular post carries depends on how the trust evaluated its job description.

Recent adverts show both. We saw Band 3 posts titled assistant medical secretary and medical support secretary, and Band 4 posts for medical secretaries, including a specialty-based oncology post and a Dudley post at the Band 4 range in our table. The pattern is that titles with assistant or support in them tend to be Band 3, but that is a pattern, not a rule, so read each job description.

Pay band follows the duties as evaluated under the national job evaluation scheme. Ask in the interview what the post was evaluated against, when that happened, and what kind of change in duties would trigger a review.

If you are on Band 3 doing a Band 4 job, see how to challenge your NHS pay band and NHS band regrading and rebanding appeals. Our Band 3 and Band 4 pages list who else is on each band.

Entry requirements and the AMSPAR and BSMSA qualifications

NHS Careers says there are no set entry requirements. Employers expect excellent keyboard skills and may ask for typing or word-processing qualifications, good literacy, numeracy and IT skills, and GCSEs or equivalent. You can enter through an administrative role or an apprenticeship, and NHS Careers lists medical secretary as a step up from clerk roles, such as ward clerk.

Training is on the job. It covers the department, IT and phone systems and procedures, and it may include customer care. NHS Careers also says that qualifications such as NVQs may be offered, including those from the Association of Medical Secretaries, Practice Managers, Administrators and Receptionists (AMSPAR) and the British Society of Medical Secretaries and Administrators (BSMSA). Membership of either body gives access to training, online forums and newsletters.

Those qualifications are not a legal requirement, and you do not need to hold one to apply. NHS Careers links further training and qualifications to progression to the more senior posts, so ask whether the trust funds them.

If you are starting out, see how to become an NHS administrator, NHS careers for school leavers, and NHS apprenticeships for the apprenticeship route.

Trainee posts, progression and moving on

Some trusts advertise trainee or assistant medical secretary posts. The Handbook's Annex 21, which deals with trainees, uses "trainee secretary" as its example of a trainee who learns on the job over a short period, usually under twelve months. For that type of trainee, the annex says the post can be evaluated with the NHS Job Evaluation Scheme, and that if national profiles exist the lowest banded profile is appropriate. It is a short, learn-on-the-job arrangement, so ask whether a post is advertised that way and what band it moves to afterwards.

From a Band 3 or Band 4 medical secretary post, NHS Careers lists several next steps: managing an administrative or secretarial department, moving into finance, human resources, health records, informatics or IT, or taking further training and qualifications for more senior medical secretary or personal assistant posts. Those senior posts can reach Band 5, and posts above that are management roles on higher bands.

Band changes need a post at the higher band, so a move up usually means applying for a new job in the same or another trust. For a realistic view of how long it takes, see NHS band progression: a realistic career timeline and the NHS admin and estates promotion guide.

Our NHS admin and estates pay hub shows how administrative bands fit together from Band 2 to director level, and the promotion calculator shows the take-home effect of a band change.

Hours, overtime and unsocial pay

NHS Careers gives the standard week as about 37.5 hours, and says some jobs may involve early starts, evenings or weekends. Whether your post includes unsocial hours depends on the department and the rota. If it does include qualifying hours, the Handbook's Section 2 applies in England.

• Band 3: time plus 35% for Saturdays and weekday hours between 8pm and 6am, and time plus 69% on Sundays and public holidays.
• Band 4: time plus 30% and time plus 60%.

Enhancements use basic pay and exclude High Cost Area Supplement (paragraph 2.8). Extra hours beyond 37.5 in a week are overtime paid at time and a half, or double time on public holidays (Section 3), and Bands 1 to 7 are eligible. Agree overtime with your manager before you work it, because the Handbook's overtime rates apply when the line manager or team leader has agreed the hours (paragraph 3.4). Time off in lieu is the alternative at plain time rates.

See NHS overtime rates explained and unsocial hours payments explained. If you want a part-time or flexible pattern, NHS job share arrangements and term-time only contracts are worth reading.

Scotland and Wales

Medical secretary roles exist across the UK, and the national careers pages do not distinguish between the nations. The bands are the same numbers, but the cash differs. Scotland has its own 2026/27 table, shown above. Its Handbook sets the full-time week at 36 hours from 1 April 2026, and its unsocial hours rates at Band 3 are time plus 37% and 74%, higher than England's 35% and 69%. Band 4 stays at 30% and 60%. Overtime in Scotland is open to every band from 1 to 9.

Wales publishes its own scales, and its Band 3 and Band 4 figures differ from England's, so Welsh medical secretaries should use NHS Wales pay scales and not the England table above. Wales has no High Cost Area Supplement.

The rest of the picture follows the same principle everywhere: the band comes from the evaluated job description. We have not verified how Scottish boards grade the title medical secretary specifically, so check the board's advert. For the full Scottish table, see NHS Scotland pay scales 2026/27.

If you are comparing the NHS with other employers, see NHS vs private sector healthcare pay, and for what each option leaves you with, use the NHS Pay Calculator.

Worked example: take-home pay for a medical secretary

Using the same 2026/27 Income Tax, National Insurance and NHS Pension Scheme rules as our NHS Pay Calculator, here is what a full-time medical secretary on the England scale takes home outside a High Cost Area Supplement zone, before any unsocial hours enhancements.

Why you can trust these medical secretary pay figures

• ✓ Every band and pay point comes from the published 2026/27 Agenda for Change tables, not from job adverts.
• ✓ Facts about training, registration and progression are checked against the sources listed below, and the date is shown at the top.
• ✓ No NHS, DHSC or trust affiliation: an independent reference, not official guidance.

Sources: NHS Careers: medical secretary/personal assistant; NHS Careers: clerk; NHS Terms and Conditions of Service Handbook (Sections 2 and 3, Annex 21); NHS Employers: unsocial hours payments; NHS Scotland Agenda for Change Handbook (updated 2026), Sections 2, 3 and 10; Scottish Government circular PCS(AFC)2026/2: 36-hour working week. Last checked October 2026.

More on pay and the tools that go with it