LEDs in England - Your rights to fair pay and reasonable work scheduling

LEDs in England - Your rights to fair pay and reasonable work scheduling

Locally employed doctors (LEDs) play an instrumental role delivering healthcare within the NHS. Yet these doctors can often face difficulty receiving what they are due from their employers.

Employed under various titles (such as Trust Grade, Clinical Fellow, Trust Doctor etc), LEDs are not provided with national contracts but instead given local variations of such contracts. These terms and conditions can vary significantly from those of their SAS and resident doctor colleagues. This can both undermine the working conditions of LEDs, and cause confusion regarding what they are expected to do.

Given the recent announcements on pay, it is imperative that LEDs understand what they are owed and that they receive this.

Considering the current state of the NHS – the workforce shortages, the backlog, and the potential for extended industrial action – it is important that LEDs are not devalued and used as an inexpensive way to plug up gaps created by systemic issues or strikes.

While the BMA continues to explore how we can improve the working lives of LEDs – both locally and nationally – we wanted to take a moment now to reach out and make sure you’ve got the tools and information you need to get make sure your rights are respected.

Accordingly, we ask LEDs two questions: are you being paid what you are owed by your employer, and are you being over-worked?

Check you are getting your pay uplift

2024/25 pay uplift – England

Following BMA campaigning, the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) has accepted that LEDs fall under its remit. As of 2022, the pay review body has begun making recommendations for this previously excluded groups of doctors.

The 2024 DDRB report explicitly states that all LEDs should receive a pay uplift:

We recommend that locally employed doctors receive the same uplift as the national contract that their employment arrangement mirrors, otherwise a 6 per cent uplift.

The Government has stated they will accept the DDRB’s 2024-25 recommendations.

This means that in England:

• LEDs on terms mirroring the 2016 resident doctors contract or the 2002 resident doctors contract should receive a 6% pay uplift, plus £1,000 consolidated for 2024/25
• All other LEDs should receive a 6% pay uplift for 2024/25

This pay uplift should also be backdated to April 2024.

We are conscious that some LEDs may not have a clause in their contracts guaranteeing a pay uplift in line with DDRB recommendations. If you find yourself in this situation, we encourage you to:

• Still approach your employer in due course (if your contract mirrors resident doctors pay scales, you may wish to wait to see further developments regarding the recent pay offer). We will shortly be sharing a template letter you can use for this purpose.
• Push to have this clause instated in your contract. The BMA can support you with this.

Pay deals in England 2024

SAS doctors: The recent SAS pay deal, agreed between the BMA and UK Government, secured increases to the pay scales of all SAS doctors in England, with additional pay back-dated to January 2024. The DDRB recommended uplift has been applied on top of this.

SAS doctors should see the pay deal reflected in their August pay slips, and the subsequent DDRB uplift in their autumn pay slips.

If your contract mirrors SAS pay scales, you should accordingly see the benefits of the recent deal in August 2024.

Resident doctors: At present, resident doctors in England are considering a pay offer from the UK Government. If accepted, this will lead to new, increased pay scales, that go beyond the DDRB recommended uplift, which would benefit LEDs with mirrored pay scales. We will report back with further developments as they arise.

LEDs should possess either work schedules or job plans. These are documents that clearly outline your work commitments, as agreed by an employee and their employer.

In England:

• LEDs on terms that mirror the 2016 resident doctors’ contract should have access to a work schedule
• LEDs on terms that mirror SAS contracts should have access to a job plan
• LEDs on terms that mirror none of the above contracts should still have access to one or the other depending on which grade you are – members can check which by contacting the BMA 

Regardless of the above, anyone legally classed as an employee or worker has the legal right (Employment Rights Act 1996) to a 'written statement of employment particulars'. The employer must provide the principal statement on the first day of employment and the wider written statement within 2 months of the start of employment. If you haven't yet got a contract ask your HR department and contact the BMA for support.

You can use your job plan, work schedule or contract detailing employment particulars to determine if you are working beyond your agreed hours/PAs.

Working your agreed hours/PAs

You are not contractually obliged to work beyond the commitments set out in your work schedule or job plan.

If you wish to complete extra hours/PAs, you should be appropriately compensated for doing so. More information – including rate cards used by resident and SAS doctors for extra-contractual work - can be located in the resources section.

If you’re already a BMA member

We will shortly be issuing a template letter you can use to contact your employer about receiving the DDRB recommended uplift for 2024/25.

The BMA also works with LNC chairs to raise the matter of LED pay uplifts with Trusts across England.

If by autumn you have still not seen a change in your pay slip, or your employer is questioning your eligibility for an uplift contact our advisors, and the BMA will help address this. 

If:

• Your contract has no provision for a work schedule or job plan;
• You should have access to a work schedule or job plan but if you are struggling to establish one with your employer; or
• You employer is pressuring you to work beyond what has been agreed

You can again contact our advisors, who will help resolve the issue.

If you are not a member, join your trade union

Being a member of the BMA gives you access to employment advice throughout your career – whether you continue working as an LED or move into another grade.

As your trade union, we

• Understand the challenges facing LEDs and fight locally and nationally for better working conditions, helping LEDs move from temporary to permanent contracts and negotiating better pay deals
• Provide our contract checking service and specialist advisors, who understand the unique working context of LEDs, and can help address issues that arise in your workplace
• Have created a checklist for LEDs, helping to ensure your working arrangements are fit for purpose
• Provide Trust-based LED representatives to fight for your rights locally
• Offer financial and legal guidance, as well as pensions advice
• Understand the desire for career progression and development and, accordingly, provide mentoring and guidance from experienced professionals, as well as access to BMJ learning, where you can learn clinical practice and job planning skills along with hundreds of CPD learning modules covering every aspect of your professional development.

Need help? Contact us

How to find out if you are a Locally Employed Doctor (LED)

LEDs are often employed under various titles, which can include terms such as Trust Grade, FY3, Clinical Fellow, and Trust doctor as well as others. Check your contract or job offer to see what the title of your post is.

If you're not sure whether you are an LED, please contact us and we can advise you.

Your contract of employment

LEDs are not provided with nationally agreed contracts but instead given local variations of such contracts. These terms and conditions can vary significantly from those of their SAS and resident doctor colleagues on national terms and conditions. This can both undermine the working conditions of LEDs, and cause confusion regarding what they are expected to do.

This is why we would strongly recommend that LEDs:

• use our LED checklist to ensure that you can fully consider your options and help verify that your working arrangements are fit for purpose
• obtain a contract of employment from your prospective employer at the earliest opportunity and send it to us for review before you sign it.