Improving pay for SAS doctors in England

Update: Pay uplift 2025

The Government has announced that its 2024/25 pay uplift for SAS doctors will be only 4%.

In the evidence we had earlier submitted to the DDRB, we spoke about the impact of pay erosion on SAS doctors since 2008/09. We asked them to commit to a pay uplift of 12.81% for all SAS doctors for the next three pay rounds, to restore pay to (RPI) real-terms 2008/09 levels by 2027.

Our case, it would appear, was largely ignored.

We are immediately entering dispute with the Government. 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 are now reintroducing the rate card.

We have written to the Government, explaining why we have taken these action, and calling for them to enter direct negotiations with us.

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. They don’t have the brand recognition of some of their colleagues. 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 and are determined to ensure that they are finally seen for the invaluable workforce that they are and treated accordingly.

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.

SAS doctor's change in basic pay in real terms since 2008/09 using RPI inflation: graph demonstrates a -25.7% change by 2023/24 and improving only to 24.3% in 2024/25

Plain time and the specialist pathway

In our submission to the DDRB, we also asked for support for our call to reverse 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.

Neither of these are within the gift of the DDRB but 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

As mentioned above, we are entering a dispute with the Government and reissuing our rate card in England. Hopefully, Government will respond to our call for negotiations, and we can make some progress through talks.

Find out more about how to use the rate card.

We will, however, keep SAS doctors in England updated on any developments in this area.
In the meantime, you can make sure you are prepared for any possible future action, by:

updating your details
speaking to your colleagues
joining the BMA.

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