Questions about the deal overall
How is this offer different from the March 2026 offer?
- Nodal point reform will be fully implemented by April 2027. This represents additional investment into the nodal point reform over the next 10 months.
- The addition of new national training numbers, instead of new training places being converted. Note there will still be some (see below).
- Less than full-time doctors will have ARCPs set at 12 months by default, with the ability to progress at the same rate as full-time doctors if they meet their competencies.
- LEDs doctors will be offered a move onto substantive (permanent) contracts.
- LEDs doctors will be offered a transition onto a mirror of the 2016 TCS, providing all the associated rights such as exception reporting
- The academic flexible pay premia will increase to £10,000.
- The retention of the GP flexible pay premia in the long term and retaining contractual pay protection.
- Portfolio fees will be reimbursed.
- Royal College and Faculty membership fees will also be reimbursed.
What is the nodal point reform?
This nodal point reform is increasing the number of pay points on the pay scale.
Currently, we have 5 nodal points in our pay scale (doctors in England get a pay rise each time they move into these grades):
- FY1
- FY2
- ST1
- ST3
- ST6
This means ST2s receive the same pay as ST1s, ST5s and ST4s receive the same pay as ST3s, ST8s and ST7s receive the same pay as ST6s.
As part of this reform, there will be 10 nodal points in our pay scale (doctors in England will get a pay rise each time they move into these grades):
- FY1 – 6.2% increase
- FY2 – 7.1% increase
- ST1 – 5.5% increase
- ST2 (new pay point) – 8.1% increase
- ST3 – 3.5% increase
- ST4 (new pay point) – 6.6% increase
- ST5 (new pay point) – 9.8% increase
- ST6 – 3.5% increase
- ST7 (new pay point) – 6.3% increase
- ST8 (new pay point) – 9.1% increase
These increases will be delivered by April 2027.
- As a worked example, if you are an F2 now – this offer would mean:
You will receive a 7.1% pay uplift backdated to 1st April 2026. - If you move into ST1 in August, you will be paid 5.1% higher than an ST1 in 2025/26.
- In April next year you will receive a further pay uplift when the DDRB reports.
In August next year, if you move into ST2 you will be paid at least 8.1% higher than an ST2 in 2025/26.
How does this offer get us closer to full pay restoration?
Like the 2024 deal, this offer does not offer full pay restoration. It does however offer some progress towards it. You, our members, will decide if this is enough.
As of 15th June 2026, inflation for the 12 months leading to April 2026 was 3%. This offer represents an average uplift of 1.9% above the current measure of RPI (inflation) for this year. This is subject to change.
If accepted, in 2027 there is further investment from nodal point reform in addition to the DDRB to make progress towards full pay restoration.
The offer includes Government stating that all investment into this offer, including nodal point reform, shall not be considered by the DDRB when recommending next April’s pay award. If the DDRB fails us again in April 2027, of if inflation changes significantly at any point, nothing in this offer ties our hands or prevents doctors from pursuing a new dispute and industrial action.
What does the ‘average 6.6% payrise’ mean?
Pay will increase, on average, 6.6% across all grades over the next 10 months, by April 2027.
The methodology of the calculations can be found on the offer page.
The figure has been presented in the same way as the 2024 pay deal in England, and the 2025/26 Scottish pay deal (i.e. headline pay award + negotiated reform).
How could this offer reduce the gender pay gap?
The BMA’s Mend the Gap report highlights that “structural change so that issues such as treating LTFT doctors differently without justification” must happen.
The report specifically calls for:
“A shortening of the overall length of LTFT training through a focus on an acquisition of competence rather than time served. However, we need to ensure that the ability to shortening the length of training does not pressurise LTFT trainees to complete their training before they feel ready.”
This offer sets the ARCP of LTFT doctors at 12 months by default. There remains an option for LTFT doctors to delay their ARCP to between 12-15 months if they do not feel ready at 12 months.
Questions about jobs
How many new training posts are there?
An additional 250 jobs will added to the recruitment round for February 2027 starts. These will all be new national training numbers.
An additional 750 jobs will added to the recruitment round this year (for August 2027 starts). There will be an additional 1,500 (up to 1,750) posts recruited to in 2027, and a further 1,500 (up to 1,750) posts recruited to in 2028.
What will the allocation of jobs be?
The majority of the 1000 training places opening in 2026 will be in core training.
Going forward, a distribution group will decide the split of jobs geographically and in which specialties and the BMA will be part of that group (as part of this offer). For training places opening in 2027 and 2028, the split will be between core and higher training, as decided by the distribution group to minimise higher specialty training bottlenecks.
These training places opening in 2026 will be split across specialties, with intention to offer places across anaesthetics, core surgical training, paediatrics, psychiatry, IMT as well as other secondary care training programmes. This would be confirmed by the distribution group your BMA representatives would sit on.
Will all these additional training jobs be in GP?
No, none of these 4500 additional jobs will be GP training posts.
They will be a mixture of all the different specialties, not predominantly one specialty.
Are all these jobs converted from LED posts?
No.
Trusts will be asked to create these roles with funding partially coming from repurposing spending on medical locums, agency work and some LED roles coming to an end.
No LED contract will be terminated early as a result of job conversion into training posts.
No LED posts coming to an end will be converted prior to August 2027.
There are approximately 28,000 LED posts in England.
There will be a mixture of completely new training numbers, training numbers funded by diverting funding away from locum agency spend and conversions from LEDs coming to the end of their contracts.
As part of the offer, the BMA is being offered a seat on the distribution group, where the job locations and specialties are decided. The BMA would have access to data, down to a department level. This allows the BMA to be able to legally challenge any conversion which affects doctors unlawfully (e.g. if a doctor has been in that LED job for >2 years).
Will higher specialty training places also be included in these job increases?
Yes, with the additional jobs, there will be a mix of higher specialty training places and core training places.
For future years, the distribution group, that the BMA would be part of as part of this offer, would decide the split/ where and in which specialties jobs would be.
Why can’t there be more jobs over a shorter timeframe?
4500 additional training jobs is the maximum the Government have said they can offer without compromising quality of training for doctors, and without exceeding current training capacity.
What does this offer do for locally employed doctors (LEDs)?
They will be offered a transition to fully mirrored 2016 terms and conditions if not already on them.
There will then be a new national contract for LEDs which matches the 2016 contract for doctors in training (with the only changes to remove references to training and add entitlement to enhanced appraisals). This means LEDs would gain all associated protections such as exception reporting, work scheduling, and access to a Guardian of Safe Working Hours. This national contract would have equal status to other national contracts in the NHS.
From August 2026, LEDs will transition to substantive contracts except where these are used to cover statutory leave (e.g., maternity leave).
LEDs will gain access to an ACRP-like enhanced appraisal, which will allow them to progress up nodal points.
LEDs can choose to remain on 2002 terms in their current role if they wish.
What does this offer mean for less than full time (LTFT) doctors?
It means we move to a nationally enforced competency-based system rather than time-based (excluding the 1-year legal time requirement for FY1).
You will be entitled to an ARCP every 12 months, unless you choose to delay it. If you meet your competencies at ARCP, you will progress. This means you can progress at the same speed as full-time colleagues if you meet your competencies. This allows for annual progression through the nodal points, unlocking higher pay sooner.
Questions about the deal, the dispute and strikes
If this offer were to be accepted, does it mean we cannot strike?
No.
The current dispute would end, as the dispute did in 2024, but the BMA can re-enter dispute (as we did in May 2025) and begin the ballot process for industrial action at any time (for example if pay erosion continued, or progress through the DDRB process next year was unsatisfactory).
If this offer gets accepted this means that the current dispute on jobs and pay will be resolved for now.
What does a rejected offer mean?
The contents of this deal will not be implemented, and we will proceed with significantly escalated strikes.
This would mean escalated action across July, followed by commencing the reballot process which would lead to further industrial action, if successful.
The new Secretary of State has stated that this deal will not remain on the table if it is rejected.
Will we need to reballot if this offer is rejected?
Yes. We would need to begin the reballot process.
The current mandate to take strike action expires on the 2nd August 2026.
As it stands, this would be a paper reballot and would require a 50% turnout threshold.
How does this compare to the 2024 deal?
The July 2024 deal saw 11 rounds of industrial action achieve an additional 4% ongoing uplift with backdated pay, alongside other elements including exception reporting reform. This deal will see an additional 3.1% ongoing uplift with jobs and other elements.