Final year students at Welsh medical schools will get the chance to vote in the online referendum which will run from 24 November – 15 December this year. We’ll also be hosting a medical student webinar on Tuesday 25 November from 7pm  to answer further questions.

Here’s an overview of the proposed new contract. The proposed new contract includes:

– A 4% additional investment in resident doctors pay on top of the 5.4% average pay uplift this year

– A reformed, bespoke resident doctor contract. Reforms to the study budget and study leave

– Measures to tackle medical unemployment and training bottlenecks. 

Restoring your pay

The Welsh resident doctors committee is committed to restoring your future pay to the levels seen in 2008, before pay erosion took place. We have made progress and currently have 19.1% left of pay to restore. The investment offered as part of the contract package would take us to 16.1%, which we believe keeps us on track for our pay restoration goals.

Currently, new foundation doctors in Wales start on lower basic pay than colleagues across the border – £35,390 in Wales v £38,831 in England. Although a foundation doctor’s pay in Wales is currently topped up significantly by banding supplements if they work more than 40 hours a week, this lower basic pay has a negative impact on their pension earnings as these are only based on your career average basic pay. It also results in lower pay for foundation doctors doing unbanded community placements and we’ve heard from many members how difficult this can be. On the proposed contract, starting basic pay for a new doctor will be £40,000, the highest in the UK.  

The proposed contract has a reformed basic pay scale, ranging from £40,000 to £78,000 per year. There are pay points for foundation year 1s and F2s, followed by a specialty trainee 1/ core trainee 1+ pay scale with five pay points and progression with every 2 years of work/training after your foundation years. Pay is frontloaded compared to the 2002 contract, so slightly more of your career earnings will be earned as a foundation doctor when your pay is relatively lower and you need it more.

If you work more than 40 hours on average a week then you will also get pay topped up for those additional hours over 40 too. If you work less than 40 hours a week, your basic pay will be paid according to your average total hours per week. Any work done outside Monday to Friday 7am-7pm or on a bank holiday will be paid at 1.5 x the normal hourly rate ensuring your antisocial working gives you another additional bonus.

Your pay will be calculated as an average across your personal rota slot for the relevant roster/rotation and will be paid a consistent monthly amount. If you work any overtime on a shift, then you will just be able to claim payment directly with no supervisor involvement or electronic proof required.

If you do on-call work at home (non-residential on-call) then you will be paid an availability rate for the hours you are available, with an ability to then directly claim payment for any work performed. Additional payment will be given for being available for and performing work in anti-social hours and if you work more than 75% of the shift then you will be paid as if you worked it all.

This new payment system means that every minute of work done by any doctor will be counted and valued, rising in a clear linear fashion as more is done and/or takes place out of hours. This is in stark contrast to the current 2002 banding systems (typically a 20%, 40% or 50% bonus of basic pay) that produce winners and losers through large rises or drops in pay if certain criteria are met, regardless of how much work is done. Banding results in big pay differences despite similar work being carried out.  It also doesn’t account for busy on-calls, overtime or missed breaks, with the current rota monitoring system (requiring all the doctors on the rota to fill in time sheets) being plagued by issues.  

Training

The new contract will also function as a genuine training contract. It introduces a new job planning system, which would set out your typical working hours, training objectives, minimal staffing levels and time for studying and portfolio work.Your employer will provide your job plan eight weeks in advance and your roster six weeks in advance, with fines if they are delivered late.

They will also convene resident doctor forums in your workplace which you will be able to attend and will review workplace issues and spend fines money. 

Safety and leave

The proposed contract is also a safer one that incorporates in our Fatigue and Facilities Charter. This means safer rostering limits, more rest entitlements, and provisions on facilities, such as secure car parking, hot food out of hours, and too tired to drive home measures.

This will end unsafe patterns like 12 day runs, short post-nights rest, and high weekend frequencies. The contract also provides for stronger leave rights and protections as seen for other NHS colleagues, including the ability to book leave before you start as a doctor.

We have also now contractualised standards for your residential accommodation if you choose to take up the free F1 accommodation offer here. This means that you and your local BMA reps will be better able to hold your employer to account if your accommodation is substandard.

Implementation

If you vote for the new contract offer, its implementation will be staged from August 2026, and all new foundation doctors will start on it. We aim to attend as many foundation doctor August inductions as possible where we will talk through the proposed contract and highlight how we can support you. 

Other measures

As part ofthe offer, we’ve also agreed recommendations with employers on our study budgets. In this package, we’ve moved to rapidly implement changes within the existing budget as soon as for the contract package is accepted. From your second foundation year onwards, this will mean more flexible private study leave, a higher cap (£1000 per year with unlimited rollover) and reimbursement at point of payment. All relocation, study budget and excess travel caps will start to be uplifted by annual inflation.

Following this, we’ll work on the rest of the review which will include centralising the whole study budget and paying for mandatory and approved courses out of this, rather than your individual pots which will solely be for discretionary study and work.

Finally, the package includes a review of training bottlenecks with an ambition to increase training and local posts to relieve identified bottlenecks. This builds on the significant training post expansion recommended by HEIW for next year following our medical unemployment campaign. We are committed to resolving the post-foundation bottleneck that we know many of you worry about.

Get ready to vote on the offer

There will be plenty of time for you to read and consider the deal and ask your questions before any vote takes place. If you want to hear more or have any questions, we’d encourage you to go along to join our online webinar on Tuesday 25 November from 7pm.

The contract referendum will take place from 24 November to 15 December. You must join the BMA by 9 December to have your say.

Deiniol Jones is deputy chair (terms and conditions) of the BMA Welsh resident doctors committee