Why has the committee decided to put this offer out to members?
After several months of negotiations with NHS Wales Employers, your committee voted unanimously that the resulting contract offer, which includes 4% additional investment in resident doctors in Wales, should be put to you, BMA resident doctor members, in a referendum.
We believe this represents a significant step forward in improving working conditions, furthering our pay restoration journey, tackling medical unemployment and delivering study budget reform. We also believe this is the limit of what we can achieve without entering a trade dispute and undertaking industrial action, although this risks us losing the investment and additional benefits we have secured in this offer.
What happens if this package is rejected?
In the event of a no vote, your elected committee would decide the next steps after engaging with you, our members.
If we reject the contract, it would not be implemented. The current status quo would remain, and resident doctors in Wales would remain on the current terms and conditions of service. Rejection could risk the loss of the additional investment altogether and all of the beneficial non-payment elements that this new contract offers.
We think it is highly unlikely that Welsh Government would provide additional funding to allow further negotiation to take place on the contract. We believe that to secure additional investment in resident doctors in Wales we would likely need to enter into a dispute and prepare a ballot for industrial action. This is something we would need to consider further if the contract offer is rejected.
What is the next step for the full pay restoration (FPR) campaign if this is accepted?
The package represents 4% additional investment in the resident doctor workforce and provides further progress to FPR, but we still have a significant way to go. The Welsh Government has already remitted our pay review body, the DDRB, to provide an annual pay award in April 2026, and this would be applied to the contract before it begins.
We do not believe the DDRB is fit for purpose, and we'll be preparing ahead of this pay award announcement in case of a poor award. This will include engaging with membership and exploring alternatives to the DDRB. We remain prepared to take action for pay restoration.
Is there anything that would come in for me before August 2026 if this is accepted?
The study budget reforms and annual uplifts to relocation expenses will come in as soon as possible and we also expect that work on bottleneck solutions will also begin imminently. We also expect employers to progress fatigue and facilities measures ahead of August 2026 and will work both nationally and locally for this.
Why does this contract move away from banding?
When we conducted our engagement events, the view from you, our members, was decidedly mixed on banding vs. hours-based pay. However, we worked very hard to understand the key elements surrounding this to inform our negotiation strategy.
The reasons you told us you liked banding included the simplicity of banding supplements themselves, their generosity, and a sense that it appropriately remunerated intense patterns.
However, you also told us that you disliked the complexity of banding criteria, ‘under-banding’ scenarios (such as 40% for 48-hour average working weeks) and some of the arbitrary and paradoxical situations it causes (such as similar pay for very different work intensity). There was no consensus on either retaining or moving away from banding.
There was, however, strong consensus from you that rota monitoring was not fit for purpose. We know that very few rotas have been uprated in banding in recent years whereas several have been downrated, typically from 1a to 1b (50% to 40%). We expect this to continue. Despite local challenge, many rotas are not routinely monitored and, when they are, the monitoring is often invalid. The banding system can only work well with good rota monitoring, and we have struggled to effectively organise for this despite committee efforts to do so. Read more details on pay banding.
You told us you cared strongly about unpaid overtime and recognised that the current system does not account for single instances where you work over your scheduled hours. You told us that you thought that an exception reporting system had potential if key issues were solved. The overtime claim system we have developed through contract negotiation addresses these issues but does require us to switch to an hours-based system of pay in order to work.
Many of you told us you would rather have personalised pay, based upon the hours you work, both in plain time and unsocial hours, albeit with the recognition this needs an hours-based system to operate. We also heard testimony from specific groups, such as foundation doctors in unbanded posts from widening participation backgrounds, or Less Than Full Time (LTFT) doctors in unbanded specialties, who genuinely struggled with low incomes from unbanded pay. It was also recognised that an hours-based system could bring an end to certain posts comparing poorly in terms of pay to counterparts in England.
We were cognisant that retaining banding may well have also required concessions elsewhere. In addition, by moving a greater proportion of your pay into basic pay, the new contract offers greater consistency in pay across rotations. It also increases the value of your pension as your basic pay - up to 40 hours full time equivalent (FTE) - which is pensionable is significantly increased under the proposed contract. With all of the above in mind, using the feedback that you gave to us, we opted for an hours-based system in contract negotiations.
The choice is ultimately yours though. A choice between a pay system with increased basic pay that rises linearly with total and unsocial hours worked, or remaining on the current system, which has lower basic pay, the longstanding out of hours supplements and large jumps and drops in pay around specific, often all or nothing, rostering criteria.
Why would some rotas still pay more on the 2002 contract?
The current banding system can produce a high variation in pay even when similar work is being done. In other words, banding has ‘winners’ and ‘losers’. Any move away from it is therefore challenging for distribution of pay as that variation may be corrected in the process.
Utilising the additional investment, we modelled and negotiated a contract which secured higher frontloaded basic (pensionable) pay, a 1.5x out of hours rate, an NROC availability rate, payment for additional hours, and some pay premia. These elements ensure that the majority of rotas would gain pay by switching to this contract in addition to securing numerous non-pay elements.
The contract, if accepted, would end some rota patterns due to the comprehensive safe rostering rules it introduces. This includes the end of band 2 and 3 rotas and some less than full time FA rotas – the former due to the 48-hour average working week limit and the latter due to a provisional 1 in 7 weekend frequency limit for LTFT residents. If you move on to the new contract from one of these rotas and were to a see a loss in pay you would however be eligible to claim pay protection on transition (see below) and then benefit from safer, less intense rotas on the new contract.
We also identified some rotas with high banding relative to the amount of work undertaken, for example 1b (40%) rotas with 41 or 42 hours on average a week. This couldn't be reconciled with an hours-based pay system that, by definition, pays more intense rotas more and less intense rotas less. This is why we secured pay protection, meaning your pay would be protected by a cash floor or ‘no-detriment’ arrangement based upon your salary, including banding, the day prior to your transfer. In addition to this, we also secured an extended transition period which means that if you are already in a speciality training programme, you can opt to remain on the 2002 contract until 2028 and potentially beyond if you are within 12 months of completing training at the time or you have extenuating circumstances.
Will this contract mean some resident doctors are left behind?
Current resident doctors regularly see rota changes and rotate through different rotas, most of which would see gains in pay on the proposed contract.
As part of our negotiations, we secured an extended transition period, which means if you are already in a core training post you won’t transfer to the new contract until August 2027, and if you are in speciality training you can opt to remain on the current contract until August 2028.
If you are within 12 months of completing training at the time, or you have extenuating circumstances, you may be able to remain on it for longer. We also secured cash floor or ‘no-detriment’ pay protection as part of this transfer process. This means resident doctors moving from the 2002 contract onto the new contract as part of implementation will see their pay protected by a cash floor, or ‘no-detriment’ arrangement, based upon their salary, including banding, the day prior to their transfer.
Therefore, those who are on a rota which benefits under the current contract can remain on the existing contract for the foreseeable future and then benefit from pay protection if they would still see a drop in pay at the point of transfer to the new contract.
What about future resident doctors?
Resident doctors who are on the new contract that move in the future on to rotas which would have been better remunerated on the current contract will do so in the future having benefited from a front-loaded pay scale earlier into their careers. This means that by the time they reach the rotation they will have higher career earnings as a result, despite that rotation in the reformed contract paying less than it would have done in the current contact.
It is also unlikely that these rotas will remain indefinitely as they are. Non-compliant rotas will have to be made safer and less intense, and our recent experience is that the compliant rotas with relatively generous banding, given their relative intensity, are in any case being re-banded down by employers over time.
Additionally, some of the investment in the current contract has been allocated for pay protection. As the need for this diminishes with time, we will work with NHS Wales Employers to identify where to reinvest this money, and this will likely focus on rotas that would pay more under the current contract.
Do I have to switch to this contract straight away?
As part of our negotiations, we secured an extended transition period, and when you transfer depends on where you are in your training pathway.
If this contract offer is accepted, transition will begin in August 2026 with resident doctors already in foundation training or in a speciality with un-banded rotas. In addition, all new appointments will be made on the new contract.
If you are already in a core training post you won’t transfer to the new contract until August 2027, and in if you are a registrar already in speciality training you can opt to remain on the current contract until August 2028.
By August 2028, with the exception of those within 12 months of CCT, all remaining speciality registrars will be transferred to the new contract. There will however be an ongoing exemption for doctors with extenuating circumstances, such as factors related to protected characteristics, who wish to remain on the 2002 contract.
Does incremental credit still work as it does on the 2002 contract?
For example, locum work counting at half the rate and maternity leave counting towards incremental credit.
Yes, the current system for how incremental credit is calculated will remain the same, although we would take the opportunity resulting from the contract being accepted to update, clarify, and publicise the incremental credit position.
I’m a GP registrar - what are the benefits for me?
We worked with the BMA GP registrars committee throughout the negotiations and there are several GP registrars on your Welsh resident doctors committee. As a GP registrar under the new contract, you will benefit from job plans that specifically have COGPED guidance incorporated into them. Business travel expense rules for home visits have also been clarified and simplified.
If accepted, under the new contract you will be able to claim overtime without practice involvement. The new contract will also replace your current banding with a GP premium linked to a pay point, which means it will benefit from annual uplifts to basic pay. This has not been the case in England, where the GP pay premium has remained static for several years.
It is important to note that this premium is not linked to participating in an out of hours rota as is currently the case with banding. Therefore, if you undertake additional work, such as GP out of hours, under the new contract you would get paid for this on top of the GP pay premium. It is also worth noting that the contract offer ensures a substantial increase to the value of basic pay, which, from our modelling, balances out the difference in value between current GP banding and the GP pay premium offered in the new contract on average.
The typically shorter training pathway compared to certain medical or surgical specialties also means that many GP registrars will benefit from receiving greater career earnings overall when taking account of an increase in basic pay during foundation training and earlier into the registrar pay scale.
Finally, we are keen to use the training bottleneck workstream that would come out of the contract to improve the employment situation for GP registrars approaching the end of their training, for example by securing longer grace periods.
What are the specific benefits for clinical academics?
We have worked with the BMA joint academic trainees subcommittee throughout the negotiations process. Medical academics will continue to benefit from pay parity and, most importantly, access to years-in-service pay progression. This means that resident doctors will not lose out on crucial pay progression whilst undertaking additional qualifications, such as a PhD, or whilst they are undertaking integrated academic training. We have further clarified the language around incremental credit so that additional postgraduate qualifications relevant to academic training, such as master’s degrees, may now be counted towards years-in-service pay progression.
There are several other benefits for academic trainees in Wales. Academic trainees should now get individualised job plans, for both their clinical and academic work, in accordance with the Follett principles. The proposed package will investigate and seek to resolve training bottlenecks, with specific reference to academic bottlenecks, given the significant challenges facing the academic workforce across Wales.
Finally, the package also provides an opportunity for us to develop a standard NHS honorary contract, helping to reduce local variation and challenges faced by academic trainees in receiving timely contracts.