Locally employed doctors (LEDs) are doctors who are on local contracts rather than nationally negotiated contracts. They have a range of different titles (Trust Grade, Clinical Fellow, Trust Doctor etc), with different terms and conditions (TCS), and can work at different levels of seniority.

LED contracts sometimes mirror national TCS (both SAS contracts and resident doctor contracts), either completely (e.g. offering the exact same pay and protections) or with a range of variation from national TCS. Employers have not, historically, been required to 'match' standards. 

While LED and resident doctor in training contracts can appear similar, no LED is on a national training programme.  

Without the contractual protections of their colleagues employed on national TCS, LEDs are more vulnerable to exploitation, reliant on the discretion of their employer, rather than nationally negotiated contracts. 

Many LEDs have also been placed on fixed-term (temporary) contracts, including contracts of less than a year’s length. This can place LEDs in a position of re-applying for their own roles, and prevents long-term job security. 

The BMA is fighting for LEDs to have better working conditions and pay. Changes brought about in 2026 by the BMA UK SAS committee (SASC) and the UK resident doctors committee (RDC) have sought to improve working conditions for eligible members of this group and address the specific risks they face, by providing them with the opportunity to move onto different sets of TCS.  

What are the new opportunities for LEDs?

As part of its 2026 pay deal with UK Government, RDC negotiated the following for LEDs:

• substantive (permanent) contracts of employment to end the widespread practice of fixed-term contracts in England whilst working as an LED,
• the option to transition to 2016 terms TCS (ensuring access to nationally agreed exception reporting, work schedules and safe working rules), and
• a new enhanced appraisals process each year, enabling LEDs to progress up the resident doctor pay scale.

The UK SAS committee negotiated specific arrangements for LEDs who have the appropriate clinical experience to transition to SAS contracts. This nationally negotiated framework, the Eligibility and Permanency Framework (EPF), is available to all qualifying LEDs. It allows the transition to a SAS contract which offers:

• longer term job security,
• pay progression through the SAS pay scale,
• access to professional SAS entitlements (such as mutually agreed job plans, weekly SPA (supporting programmed activity) time).

These new opportunities are intended to give LEDs:

• greater job security,
• stronger contractual protections,
• more control over their future career, 
• and challenge unfair treatment.

They will provide more choice, while still providing the option for LEDs to remain on their current contracts.

This page aims to empower LEDs to make informed decisions. It will be kept updated as the changes are implemented and more detail becomes available, but contact the BMA or a local LNC rep if you need assistance regarding your contract. We want to make sure all LEDs can make decisions based on the latest advice.

Improving job security: the 2026 England resident doctors pay deal

Agreed on 29 June, the 2026 resident doctors pay deal included several specific provisos for LEDs. The expected timeframes for these include: 

• From August 2026: Eligible LEDs be moved to permanent contracts, unless legitimate reasons apply (such as short-term cover for maternity leave etc)
• By September 2026: Eligible LEDs will be given the option to move to contracts with repurposed 2016 TCS
• By October 2026: An enhanced annual appraisal for LEDs on the 2016 contract will be agreed, to be implemented in early 2027
• By April 2027: A new set of national terms and conditions (TCS), repurposing 2016 TCS to remove references to training will be available to eligible LEDs.

The BMA is currently in discussions with DHSC (the Department of Health and Social Care), NHS Employers and NHS England to progress the implementation of these reforms. In principle, however, they mean eligible LEDs will be offered the same protections as colleagues employed on national contracts. It also means future LEDs will not be subject to the 'wild west' of local contracts.

Find out more about the resident doctor pay deal

Recognition for experienced LEDs: the Eligibility and Permanency Framework

Created as a result of the 2024 England SAS pay deal, the Eligibility and Permanency Framework (EPF) provides a process for LEDs who meet certain criteria to apply to move onto a permanent SAS contract. Announced in May 2026, it was developed by the pay deal’s implementation group consisting of NHS Employers, the SAS committee, NHS England and DHSC.

The initial EPF 'choice window' will open from 1 September 2026, during which LEDs who already meet the criteria can apply to move contracts. After March 2027, the EPF process should be followed during LEDs’ annual appraisals.

It is up to LEDs to choose whether they want to use the EPF to apply for a SAS contract. But doctors who are delivering patient care at the level of a SAS doctor, and wish to transition to a SAS contract, should be actively supported to do so by their employer.

LEDs on permanent contracts (including as a result of the resident doctors deal) will remain eligible to apply to the EPF if and when they meet the criteria.

To be eligible, LEDs need to:

• be currently employed for 24 months (or more) on a local contract (or contracts) with the same employer;
• have spent these 24 months (or more) in a role that is comparable to the roles, responsibilities and duties of a SAS doctor;
• have completed at least four years post-graduate training with two in the relevant specialty (or equivalent if less than full time).

Note that the latter can include overseas training or experience gained outside a formal UK training programme, where you can demonstrate equivalent specialty competencies and scope of practice through documented clinical roles, supervised practice or recognised international qualifications.

Find out more about the EPF

Choosing between a repurposed 2016 RD contract and SAS contract

Some LEDs may be able to choose between moving to a permanent repurposed 2016 RD contract and applying to a permanent SAS contract.

When making this choice, doctors will need to consider their personal circumstances (including their short- and long-term career aspirations) and how these measure against differences in pay and TCS between the two types of contract. For example, rules around safe working, pay progression mechanisms, hours you would be expected to work, etc.

You may also wish to consider:

• If you choose to move to a SAS contract, you can use evidence of past experience at SAS level (including comparable work performed under a local contract or overseas) to argue for a higher entry point onto the SAS pay scale.
• Moving onto a repurposed RD contract does not place a doctor in a UK training programme - if a doctor wishes to return to training, they will need to apply to a national training post separately.
• Although both the move to repurposed resident doctor contracts and applications through the EPF are expected to begin from September, choosing to move onto a repurposed 2016 resident doctor contract should not prevent you from applying for a SAS contract through the EPF at a later date. Employers should continue to ensure doctors are aware of the opportunity under the EPF in this case.
• You will have the option to remain on your current contract and not make any move, if that’s what you’d prefer (see below). 

If you have any questions about your contract options, contact the BMA or speak to your local LED representative. 

Choosing to remain on your current contract

LEDs may choose not to move and stay on their current contracts.

As these contracts come down to employer discretion, their specific terms can differ widely. They may mirror open (e.g. 2016 England resident doctor/2021 England specialty doctor) or closed (e.g. 2002 England resident doctor/2008 England associate specialist) nationally agreed contracts; they may closely match national terms or differ significantly from them. 

Accordingly, it is difficult to give universal advice that would cover all local contracts. As an LED, you should bear the following in mind:

Pay uplifts

Following BMA campaigning, the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) has accepted that LEDs fall under its remit (and have been making recommendations for this group of doctors since 2022). The 2026 DDRB report called for a 3.5% uplift for all LEDs (as well as doctors on national SAS and resident doctor contracts), backdated to 1 April 2026. The UK Government accepted the DDRB’s headline pay recommendations for doctors in England. LEDs on contracts mirroring the 2016 resident doctors TCS should also receive the pay uplifts agreed in the 2026 England resident doctors pay deal.  

Contractual right to pay uplifts

The BMA position is that all doctors should receive pay uplifts as agreed nationally. It is possible your employer will argue that the uplift is not stipulated in your contract (if your TCS do not closely match those in a nationally employed contract). You should check if this is the case. Even if it is, you can still make the case for pay – approach your employer and push to have a clause included in your contract.

Work schedules and job plans

You should be entitled to either a work schedule or job plan that details all professional activity undertaken. Even if there is no mention of a work schedule or plan in your contract, 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 two months of the start of employment. Both clinical activities as well as other supporting professional activities, particularly those necessary for appraisal and revalidation, should be included in such a work schedule, job plan or written statement.

Working hours

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

If for any reason you have not yet been provided with an actual contract, this should be raised with your employer – you can use this template email request to do so.

You should contact the BMA or your Local Negotiation Committee (LNC) directly if:

• you suspect you have not been given the correct pay uplift (e.g. you have not seen a change to your pay slip by autumn 2026)
• you are struggling to access a work schedule or job plan
• your employer is pressuring you to work beyond your agreed hours  
• you require further assistance in securing a contract from your employer.

BMA: the trade union for LEDs 

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