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Restoring pay for SAS doctors in England

SAS doctors have seen their real-terms pay fall by more than a quarter over the last 15 years. We're calling for this to change.

Have you voted in the statutory ballot?

Following talks with the Government, a credible offer has not been presented and we are therefore moving forward with a formal ballot on industrial action.  


The ballot is open from 6 November until 18 December.


SAS ballot closes


*Tip: post your ballot by 11 December to ensure that it arrives in time.

We remain willing and ready to talk with the Government but we cannot simply ignore the disappointing lack of progress. Strike action is still not inevitable, they have the power to prevent it. But we must have a mandate for strike action at our disposal.  


We urge all SAS doctors to vote YES to be fairly paid and fully valued. 



Statutory ballot webinars

Our webinars are open to all SAS doctors in England (BMA members and non-members).

Why the BMA is balloting SAS doctors: Our campaign for you to be fairly paid and fully valued

Webinar: Do you have questions about the statutory ballot and industrial action? Attend one of our free webinars. The online events will include a short presentation on the background of the ballot, and a Q&A where participants can put their questions to BMA SAS committee members.

The webinars will take place on:

SAS doctors explain why they are voting YES

What has happened to SAS doctor pay

Pay erosion

Since 2008/09, SAS doctors in England have been forced to put up with a 30.0% fall in real terms pay. For those on the new contracts, adjusted to reflect the promised multi-year deal investment, the real terms pay cut is 31%. This is the equivalent of working more than 3.5 months of the year for free.

SAS doctors pay is reviewed each year by the DDRB, an ‘independent’ body who makes recommendations to the government on pay uplifts for doctors. The Government introduced its own criteria for how the DDRB reviews pay, and the limited uplifts which are recommended by the DDRB are often ignored by Ministers, leading to pay erosion.

With rising inflation and doctors working harder than ever to address the growing backlog, SAS doctors are increasingly feeling undervalued and unrecognised.

Exclusion of SAS doctors on 2021 contracts

Last year, the Government made a divisive decision for the second year in a row to exclude SAS doctors in England on the new 2021 contracts from receiving the sub-inflationary 4.5% awarded to the wider profession.

This was despite the DDRB themselves warning that a decision to not apply an award to groups subject to a pay deal will have ‘a significant effect on motivation, affecting retention, productivity, and ultimately patient care.’

This appalling treatment by the Government not only shows a complete disregard for the crucial role SAS doctors play in keeping the NHS running in the face of chronic underfunding, but also risks making the new contracts that the government negotiated completely unattractive for SAS doctors to transfer to them.

Data from NHS Employers in England shows that transfer numbers to the new contracts remain well-below projections, with a significant proportion of SAS doctors not transferring to the new contracts since their introduction in 2021.

Our March 2022 survey of SAS doctors showed that they were not transferring onto the new contract because they believed their long-term financial position was better with their old contract and wanted to avoid a drop in pay.

We also surveyed SAS doctors in England in November 2022 on pay and found that 82% of SAS doctors feel this year’s pay award is ‘inadequate’ or ‘completely unacceptable’, and 84% feel the exclusion of any uplift to new contracts has ‘decreased/significantly decreased morale.

What we are doing about it

BMA SAS rate card

As a first step to improve SAS doctor pay, we published a rate card for extra-contractual work undertaken by SAS doctors in England to ensure that those who choose to do this work are paid fairly and that their expertise is properly valued. 


We have continued to meet quarterly with NHS Employers and Department of Health and Social Care through JNC(SAS), with meetings focusing primarily on issues arising from the new 2021 contracts in England, Wales, and Northern Ireland. We have used this forum to highlight and try to address the negative effects of the decision to award the new contract nothing beyond the multi-year pay deal for two successive years, on the transfer rates to the new contract.

We also continue to work on other guidance and webinars relating to SAS advocates, SAS week, job planning and more.

Watch our webinars

Striking on a visa

This webinar explains the impact of visa constraints on taking industrial action.

Watch the visas and industrial action webinar

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BMA: representing SAS doctors

We're here to stand up for SAS doctors' rights, support you in the workplace and champion the medical profession. 

Join the BMA