Improving pay for SAS doctors in England

2025 indicative ballot

On 21 July we will open an indicative ballot on industrial action. We want members to tell us if they are willing to take action over the erosion of their pay, and the lack of recognition of SAS doctors’ value.

The Government’s pay uplift for SAS doctors in England announced in late May is only 4% - failing to heed our calls for a meaningful path towards pay restoration and a recognition of our true value. SAS doctor pay erosion remains at 24%.

We have been in dispute with the Government since the pay award, and have reintroduced the rate card. Unfortunately, the Government has ignored our calls for negotiations, forcing us to take this next escalatory step. We urge SAS doctors to vote YES in the indicative ballot when the time comes.

This is not something we take lightly but we cannot let last year’s commitment slide. Our faith in the pay review process has been betrayed; the Government set limits in its remit letter to shackle the pay review body (DDRB) and both ignored our terms of reference. Government must know that they cannot make commitments to doctors and fall at the first hurdle.

We remain committed to recognising the value of all SAS doctors – whatever their grade or contract status – ensuring Government recognises their value, too.

Recognising SAS doctors

Doctors across the NHS have experienced real terms pay erosion compared with since 2008/09 levels. Working in an over-stretched system, medical professionals are certainly not working less than they did in the early 2000s, but they are being effectively paid less for it. This has led to a feeling of being devalued.

The impact of this, and other issues, are compounded for SAS doctors due to one key issue: a lack of recognition.

Despite the role they play in the NHS and the tireless work they provide in patient care and improving services, SAS doctors can often be left to feel like a forgotten workforce. Many people do not recognise the names of the SAS grades. And their contribution to the NHS is either unknown or misunderstood by the public, Government, and even fellow health service workers.

There are specialty doctors working autonomously, who, unable to enter the specialist grade, go unrecognised.
There are experienced SAS doctors who, too often, cannot access leadership roles.
SAS doctors' efforts and experience can be dismissed, or otherwise ignored, simply due to their grade.

In the BMA survey of SAS doctors in England during autumn 2024, we asked what they wanted the BMA to focus on. Their top priorities were:

improving pay
creating more specialist roles
improving access to the Portfolio Pathway
involvement in leadership roles.

This shows that SAS doctors understand their worth, and believe it is high time others saw it, too.

In 2025 we are still pushing for SAS doctors to receive the recognition they deserve. We are determined to ensure that they are finally seen for the invaluable workforce that they are and treated accordingly.

We are calling for the following:

significant increases to pay to restore the lost value of SAS doctors
a reversal to the extension of plain time in the England 2021 SAS terms and conditions, following the precedent set in Wales
reforms to expand the specialist grade, such as the single pay spine that will allow specialty doctors to progress to the senior position through meeting competencies
concrete means of support for SAS doctors considering the Portfolio Pathway and entering senior leadership positions.

20250233 SAS IA graphics_pay erosion graphic

Plain time and the specialist pathway

We are also calling for a reversal of the extension of plain time in 2021 terms and conditions, as well as support for the development of a process, ideally a single pay spine to better strengthen the specialty doctor to specialist pathway.

These are key issues, which we continue to lobby on, alongside a pay uplift that would help enhance the recognition of SAS doctors.

Recent development regarding the specialist grade

While we continue to push for reform, there have been several developments, following the pay deal, aimed to expand the use of the specialist grade:

the creation of guidance on opportunities to implement the specialist role (aimed at employers), co-signed by the BMA and NHS Employers
the creation of the specialist hub, again aimed at employers, co-signed by the BMA and NHS Employers
the completion of a research project looking at the benefits of the specialist role, and the barriers to accessing it. BMA, NHS England, NHS Employers and DHSC will look at the finding of the report and consider what steps can be taken next.

What you can do

We are now in dispute with the Government. We have reissued our rate card and are preparing to open an indicative ballot on 21 July.

An indicative ballot allows us to further evidence the strength of SAS doctors’ feeling, and show the Government you care about your pay. A strong mandate on this ballot will give us extra leverage in any discussions we may have with Government. This may help us reach a resolution without opening a statutory ballot or taking strike action. The strong response we got to our indicative ballot back in 2023 helped provide us with the mandate we needed for negotiations.

We are asking you to give this to us once more. You can act now by:

Background: The 2024 England pay deal

Pay

In 2024, following months of negotiation, the BMA and Government agreed a pay deal for SAS doctors in England. The deal was made after we lodged a formal dispute, a successful ballot for industrial action, and following months of negotiations. It was also made without taking a single day of strike action. The deal has led to real improvements for SAS doctors and has gone some way to address over a decade of real terms pay erosion. The deal:

realigned 2021 specialty doctor and specialist pay scales, lifting basic pay for everyone on the 2021 (open) terms and conditions
provided a consolidated £1400 pay uplift to each pay point on the closed contracts (on top of the 6% awarded by the DDRB for 2023/24)
as well as provided several non-pay commitments.

Following the deal, the BMA have continued to work with NHS Employers, NHS England and DHSC on the implementation of all aspects of the deal. One major outcome from this included the creation of revised contract transfer guidance, which includes a clause calling for backpay for those whose transfer takes longer than 35 days (through no fault of the doctor in question).

Read the contract transfer guidance

The revised offer to SAS doctors in England

Your questions answered

Webinar on revised offer