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Restoring pay for SAS doctors in Northern Ireland

Specialists, associate specialist and specialty doctor pay in Northern Ireland has dropped by nearly a third in real-terms over the last 16 years. Now more than ever we need to restore pay to retain and attract doctors to the SAS workforce and protect the future of our profession.

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Ballot for industrial action

Following our indicative ballot where 86.5% of respondents said they were willing to take industrial action, NISAS committee have now voted to proceed to a full ballot.

Why we are asking for full pay restoration

For years, SAS doctors here have been working harder and longer, with more complex cases in a much more challenging environment, whilst a crisis builds in the health service.

We were cautiously optimistic that the newly appointed Health Minister would act to address pay issues, but this has not happened. Currently the pay award for 2023-2024 has not been paid.

We are asking for the health minister to take immediate steps to reverse this decline. This must begin with a pay uplift for 24/25 that makes meaningful progress towards full pay restoration and a commitment to continue to work towards this goal.

Pay deterioration for SAS doctors in Northern Ireland

The table below clearly illustrates pay deterioration faced by SAS doctors in Northern Ireland as successive pay uplifts have not kept up with inflation. Each step in the table shows the value of the pay point for the 2008 contract, what that value was in 2008, what is now, and what it would be if uplifts had reflected RPI levels of inflation. Those who have reached the top of the 2008 Specialty Doctor contract are now over £35,000 worse off because of the failure of successive pay uplifts to take account of inflation.

Specialty Doctor (2008) (Northern Ireland)

Scale Value	2008/09	2022/23	2022/23 (if kept up with RPI)	Difference
Min	£35,904	£44,515	£63,286	£18,771
1	£38,974	£48,323	£68,697	£20,374
2	£42,965	£53,270	£75,732	£22,462
3	£45,104	£55,922	£79,502	£23,580
4	£48,186	£59,744	£84,935	£25,191
5	£51,256	£63,551	£90,346	£26,795
6	£54,395	£67,442	£95,879	£28,437
7	£57,535	£71,335	£101,414	£30,079
8	£60,675	£75,227	£106,949	£31,722
9	£63,814	£79,120	£112,482	£33,362
10	£66,954	£83,013	£118,016	£35,003

Figure 1 - SAS difference in pay uplifts vs inflation

The table below shows the impact of sub-inflationary pay uplifts over the last 15 years on SAS pay in Northern Ireland.

Figure 2 - Real decline of pay awards for SAS doctors in Northern Ireland

SAS vacancies in Northern Ireland

Whist the number of SAS doctors in Northern Ireland is growing, so too are the number of vacant posts. This suggests that growth is not sufficient to keep up with service demands.

According to data obtained via BMA Northern Ireland freedom of information requests, as of September 2021, vacant SAS posts in Northern Ireland as a proportion of the overall establishment (vacancy rate) was 25.4%. In September 2023, the vacancy rate was 31.8%.

However, when looking exclusively at the number of SAS vacancies reported by the Department of Health, the rate is significantly less – just 8.3% in 2021 and 7.71% in 2023.

This suggests that the Department of Health are significantly underreporting the true extent of SAS vacancies in Northern Ireland due to the narrow scope of its definition of a vacancy. This inevitably leads to an inability to make effective workforce plans and enables huge staffing pressures to go unchecked.

SAS doctors across the rest of the UK have made clear they are willing to take action to fix pay and fix the pay review body by balloting for industrial action. In Northern Ireland, junior doctors have announced fresh dates for further strike action (TBC) and consultants are currently balloting for industrial action.

Now more than ever we need to restore pay back to the level it should be at in order to retain and attract to the SAS workforce and protect the integrity of our profession.

How you can get involved