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.
Who is being asked to vote in the referendum?
The below groups are all being asked for their say on whether to accept the proposed contract:
- Doctors and dentists in foundation, specialty or core training in Wales, including clinical academics.
- Locally employed doctors working in resident doctor roles (‘F3s’, clinical fellows, etc) employed by Welsh NHS organisations.
- Medical students in their final year of training in Welsh medical schools.
I’ve not yet received my voting link what should I do?
If you are eligible (see above) to participate in the referendum, by now you should have received your link to vote in the referendum. If not check the following:
Try finding the email by searching by sender
The Civica emails have been sent by ‘[email protected]’ and you should be able to search and find emails by sender from that address.
Try finding the email by searching by subject
You should also be able to find emails by subject, searching for ‘BMA Cymru Wales: Referendum for Resident doctor contract - your voting link.
It is worth searching in your inbox, spam or junk folders and your deleted or bin folders.
Request a replacement link
If you cannot find the email, after completing the above steps please request a new one as soon as possible by completing this form.
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 securing any further investment in resident doctors in Wales would require entering a formal dispute and preparing a ballot on 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 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.
I’ve received a link to vote in the referendum but don’t think I’m eligible. What should I do?
The following groups are being asked whether they wish to accept the proposed contract:
- Doctors and dentists in foundation, specialty or core training in Wales, including clinical academics.
- Locally employed doctors working in resident doctor roles (‘F3s’, clinical fellows, etc) employed by Welsh NHS organisations.
- Medical students in their final year of training in Welsh medical schools.
If you do not fall into any of the above categories, then please let us know by completing our opt out form.
Under an hours-based system, will my pay change significantly month to month? What will this mean for getting a mortgage?
The pay system features a higher basic pay level that helps to reduce variation across rotations and specialties as well as the use of a fixed GP premium for GP registrars rather than GP banding and a fixed Oral and maxillo-facial surgery premium.
The pay calculations for additional hours, LTFT pay, unsocial hours payment, and NROC availability are based off an average calculated across a reference period, typically the length of the rota cycle or up to 26 weeks. The averaged pay elements when combined with basic pay (and pay premia where relevant) will give a consistent total amount that will be paid each month, acting as a baseline or floor.
In terms of what this means for getting a mortgage, we would expect this baseline to be acceptable to certain lenders and related bodies, given that some accept banding supplements. For lenders that will only accept basic pay, the higher basic pay in the proposed system will be an advantage.
How is flexible working (LTFT) defined?
To be clear both in the current 2002 contract and in the proposed contract, you must have total average hours per week (normal and unsocial) of less than 40 to be classified as training flexibly (LTFT) for pay purposes. If you are working more than 40 hours on average per week currently then you should not be being paid as a LTFT resident doctor and we would recommend that you contact us to discuss further.
How are those who train flexibly (LTFT) paid on the proposed contract?
In the proposed contract, if you train flexibly, you will be paid as a % of full-time pay according to your actual total average hours per week (all hours are counted, not just plain time). It is not directly based on your flexible working % or pro-rating. You will be paid for the total average hours worked per week divided by 40 hours (as basic pay is based on the 40-hour week).
So, as an example, a resident doctor is training flexibly at 60% but works an average of 29.75 hours per week. That doctor’s basic pay would be 29.75/40 multiplied by the relevant pay point. The weekly amount will then be turned into an annual figure and the doctor will be paid 1/12th of the annual figure for each complete month, or a proportion thereof for any partial months worked. As this forms part of your basic pay, this is pensionable and therefore will increase the pension earnings for those working flexibly compared to the current contract.
Any hours worked outside of 7am-7pm Monday to Friday are paid at 1.5 your basic rate as is the case for a doctor who is training full time, and this is paid in addition to your basic pay.
What are some of the specific benefits to those who train flexibly of the proposed contract?
We have set out the specific benefits to those training flexibly (LTFT) as well as the general benefits offered by the contract in our comparisons document. However, to summarise briefly, the proposed contract retains years-in-service pay progression which is based upon calendar years, it gives bespoke job plans, it frontloads the pay scale with fewer points than the 2002 contract, it offers a 1 in 7 weekend frequency limit for those training flexibly, and a Guardian for Safe and Flexible Working will promote and support you to get flexible working entitlements.
How will overtime be paid?
On occasion additional work may be undertaken that is not detailed in your job plan. This may include, but is not limited to:
- Staying beyond a scheduled shift end time due to service demands.
- Performing work (either remotely or on-site) during a non-resident on-call duty period.
- Undertaking work outside of scheduled hours to participate in a training opportunity required for progression within the training programme.
In these circumstances you will be able to report the additional hours worked outside of your job plan via the overtime reporting system. The overtime reporting system will be part of the normal payment system; it should be a simple electronic system which does not require supervisor and is administered by the payroll team. However, as noted in the framework agreement, authorisation for additional pay will be in accordance with the organisation’s pay and financial controls processes.
This is the same for other NHS staff groups. It is expected that all submissions for additional pay/overtime are accurate and genuine and as such no separate clinical supervisor sign-off will be required. Where the payroll team identifies concerns regarding the validity of a roster, these concerns must be referred to the person authorising the roster and, where necessary, Guardian of Safe and Flexible Working for review/investigation.
How will non-resident on-call (NROC) shifts be paid?
For non-resident on call (NROC) shifts you will be paid an availability allowance of 50% for all hours you are rostered to be available to return work or provide telephony advice. As with your average working hours, NROC availability in the proposed contract will be based off an average calculated across a reference period, typically the length of the rota cycle or up to 26 weeks.
Separate to the availability allowance for any hours you work during an NROC shift, you will report these via the electronic overtime reporting system. You will then be paid at the relevant hourly rate (1.5 if outside of plain time hours). In the event you work over 75% of the shift, you will be paid for the full shift.
As set out above, the overtime reporting system will be part of the normal payment system, it should be a simple electronic system which does not require supervisor and is administered by the payroll team.
How will exception reporting work for residents working NROC shifts?
Exception reporting will also be introduced but will be separate to NROC hours worked claims which will be reported via the overtime reporting system. Exception reporting will mainly be for safety and training issues. Exception reporting in the proposed contract will be between you, your educational supervisor and the Guardian. The clinical supervisor is still not involved. The key concern of exception reporting is safety, and it is kept distinct from pay and overtime.
The main relevant point relating to exception reporting for a resident doctor working an NROC shift could be an overnight rest breach. This could be the case because you failed to get 8 hours total rest or 5 hours continuous rest whilst completing an NROC shift overnight. In either circumstance, you would then be able to exception report. This in turn would generate a fine. Half the money goes to you, half to a pot for resident doctors, and time off in lieu the next day would be arranged for you (for safety) with no detriment in pay for you.
We do expect breaches will occur, and occasional fines are tolerable. The main aim of exception reporting is to identify if it keeps occurring. This is because it is a safety problem and it may be a sign that the service either needs to increase staffing or convert the NROC duty to resident on-call, pay you and colleagues more and roster rest the next day. Similarly, the Guardian will be able to monitor overall on-call claim patterns and trends and proactively identify issues and intervene to secure patient safety.
We are aware of practices around overtime and NROC working that would conflict with what is set out as safe limits in the proposed contract. However, it is worth noting that these are often not compatible with existing working time regulations and would be picked up by rota monitoring, if it was being conducted regularly and accurately. This is to say that retaining banding does not endorse or ensure these practices continue. The contract referendum will not change that either way.
The ethos of the new Guardians and overtime and exception reporting systems is ultimately about shifting to a more safety positive culture where many of these scenarios are avoided or minimised.
How does this affect resident doctors who are NOT in training?
Locally employed doctors (LEDs) are able to vote in the referendum. If the new contract is accepted, the framework agreements sets out that the new contract should also be introduced for resident doctors who are locally employed. The ambition set out in the framework agreement is that LEDs will be transferred to the new contract alongside their equivalent training groups.
However, employers will be afforded some leeway to prioritise residents in formal training programmes over locally employed doctors on a temporary basis where justified. In any event, all locally employed doctors in scope must be transferred to the new contract by August 2028, and no new locally employed doctor should be employed on terms mirroring the 2002 TCS from August 2026 onwards.
If the contract is accepted by members, NHS Wales Employers has committed to working in social partnership to develop a clear and consistent process for eligible resident doctors to apply to become a specialty doctor and secure permanent employment.
How did you arrive at these anti-social and non-resident on-call (NROC) rates?
During the engagement work we undertook before commencing negotiations, it was clear that unsocial work and on-call work needed to remunerate appropriately in a reformed contract. We opened with higher rates than those seen, including different night rates, whilst employers pushed for rates more similar to those seen in Agenda for Change and the 2016 contract in England.
The rates in the proposed contract represent an acceptable compromise with the additional advantage of making the pay system relatively simple. The money released that would have gone into higher rates went into basic pay. Our modelling shows that further altering the rates would not necessarily improve the distribution of pay across rotas. Rather, increasing basic pay seems to be the best way of doing this.
Can’t find an answer to your question?
Email us at [email protected] and we’ll be happy to answer your question.