Government offer to SAS doctors in England

Find out more about the Government's offer to SAS doctors  

The offer

There are three central components to the Government offer to SAS doctors in England: 

  • Pay scale realignment 
  • A catalyst pot to fund the creation of specialist roles 
  • A project reviewing the locally employed doctor (LED) workforce and their contracts. 

In addition to this, there are proposals on other activity to support SAS doctors’ career progression. All of these components are detailed below.  

Pay scale realignment 

The Department of Health and Social Care (DHSC) has offered investment to increase the basic pay provided by both the 2021 specialty doctor and specialist pay scales.  

Everyone on these scales will receive an increase to their basic pay between 6.1% and 9.22%.  

View the table which details the current 2021 pay scales, the revised pay scale on offer, and the difference between the two.  

Specialist catalyst pot 

DHSC has offered to provide a catalyst pot of £5m for the financial year 2024/25 to support employers with the creation and implementation of specialist roles, helping specialty doctors to progress in their careers.  

The funding would be distributed to integrated care boards (ICBs), with each ICB being told the value of their allocation and how many roles they would be expected to create.  

The newly established roles would then become part of the organisation’s routine funding arrangements.  

This pot could be used to cover the difference in pay between a specialty doctor and specialist role, as there would not be a requirement to back-fill an individual’s role if they move from from a specialty doctor role to a specialist role. 

National guidance will be developed on how to use the funding, along with the criteria that Trusts will need to evidence to be able to access the pot. A joint intention statement will also be agreed between the BMA, DHSC and NHS Employers, which will make clear that the intention of this pot is to create opportunities for specialty doctors to progress in their careers. To this effect, the specialist roles created using this funding will be open to only internal applicants for the first recruitment round, increasing the likelihood of specialty doctor career progression.  

LED project 

If the offer is accepted, DHSC, NHS England, NHS Employers and the BMA will carry out a joint piece of work focusing on LEDs. The shared objectives of this work are to: 

  • Better understand the make-up of the LED workforce (including their contractual terms and needs) 
  • Enable LEDs to move to permanent SAS contracts where this is in everyone’s best interests 

While the final scope of the work is to be agreed, it is expected to include: 

  • The development of a process by which all LEDs who have been fulfilling a role that is comparable to the roles, duties and responsibilities of a SAS doctor for 24 months or more should be offered the option to move to a SAS contract.
  • The process would also cover how LEDs who do not fulfil the criteria to move to national SAS contracts but are on fixed term contracts for 24 months or more can be provided with the option to be made permanent. Once the specifics of the proposal have been agreed, this would require a further decision prior to implementation.   
  • An agreement to promote the statutory right of LEDs with four or more years of continuous service on successive fixed-term contracts to be made permanent. 

This work would begin by March 2024 and conclude by December 2024. The implementation stage is then expected to be concluded within six months.  

On introduction, any new process should become embedded as part of standard operations for employers. As the process embeds, the impact on the number of locally employed versus national contracts can be monitored through JNC SAS.  

Other activities around career progression

In addition to the above, the BMA, DHSC, NHS Employers and NHS England would jointly take forward the following actions to support the career development and progression of SAS doctors. 

1. To promote that job planning should take place so that SAS doctors are able to work optimally, with access to the appropriate opportunities. This is in recognition that job planning is important to recognising the status of SAS doctors.  

2. To develop advice and guidance specifically to support career progression for SAS doctors.  

3. To explore what national levers are available to encourage, establish and embed specialist roles to provide career development opportunities for SAS doctors. This would include the following: 

a. The creation of guidance setting out our expectation to employers, ahead of the start of the 2024-25 Financial Year, recommending that: 

i. Vacant associate specialist roles are converted into specialist role vacancies. 

ii. Specialist roles are advertised internally within Trusts first to give local specialty doctors more opportunities to progress within their Trust.

iii. SAS advocates have an opportunity to review relevant vacancies and make the case for them to become specialist roles. 

b. A piece of research into why more specialist roles are not being created and establishing a project board with the BMA to consider the recommendations and how these could be implemented. The aim would be for this to conclude by Summer 2024. 


SAS doctors have been asked for few concessions in exchange for the above. If members accept the offer, the dispute will be settled, and in exchange we would agree to: 

  • Withdraw the BMA rate card for extra-contractual work for SAS doctors in England. (Note that the BMA reserves the right to re-introduce the BMA rate card for SAS doctors in England if there is a future industrial dispute. Where ICBs and other groups of employers collaborate on arrangements for securing extra contractual SAS work, this should be done in consultation with those employers’ Joint Local Negotiating Committees.) 
  • Not to re-ballot members unless there is a significant change which results in a new and separate dispute arising that cannot be resolved through negotiation. 

It is important to note that even if the BMA rate card is withdrawn, SAS doctors are fully entitled to value their time and ask to be remunerated appropriately for extra-contractual work.


The above offer is being put to a referendum which opened on Monday 29 January and closes at 5pm on Wednesday 28 February. Eligible SAS BMA members in England have been sent an email link to vote on whether to accept or reject the offer. If you cannot find or didn’t receive a voting email from Civica then take a look at our support page on how to find it and request a new one. 

Until members have voted in the referendum, there will be no announcement of industrial action for SAS doctors in England.

If the membership votes to accept the offer, we will have reached a deal. The dispute with Government will be resolved and no industrial action will be required.  

We would move to agree to the necessary changes for this proposal to be implemented in April 2024, and any additional pay will be backdated from 1 January 2024.  

If the membership votes to reject the offer, we will explain to the Government we have not reached a deal and decide next steps.  

In that event, the BMA may seek to re-enter back into negotiations. However, it is possible Government would refuse, and unlikely that any re-negotiations at this stage would result in a better offer being put to members, without some form of escalation. In such a scenario, industrial action may be required to bring the Government back to the table or gain the leverage to seek any improvements to the offer.

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