2025/26 DDRB recommendation and progress on non-pay deal agreement

For the 2025/2026 pay year, the DDRB recommended a pay uplift of 4% for doctors in Northern Ireland. Unfortunately, this recommendation does not sufficiently address the years of pay erosion for SAS doctors nor meet our expectations of a clear and timely path to pay restoration.

In addition to the annual pay uplift, BMA’s Northern Ireland SAS committee (NISASC) secured a  number of non-pay asks as part of the pay agreement secured in December 2024. Unfortunately, despite continued lobbying of the Department of Health, delivery of the non-pay elements of the pay deal has been delayed.

Full details of the offer.

NISASC is currently considering its next steps in response to both the 2025/26 recommended pay uplift for doctors, which is not enough to address years of pay erosion for SAS doctors, and over continuing delays in implementing this pay uplift in Northern Ireland.

“We are also deeply disappointed and frustrated by delayed implementation of agreed non-pay asks as part of the deal,” said NISASC chair Leanne Davison.

“We are continuing to engage with Department of Health on these delays which we have told them must be addressed as a matter of urgency. Delivery of these commitments is essential to ensuring that SAS doctors receive the recognition and support they deserve. Should the Department of Health fail to deliver these agreed actions in a timely fashion, we will have no hesitation in escalating our response.

“Members will be fully updated as matters progress. In the meantime, I would ask that you remain engaged, informed and prepared to support collective action if necessary.”

For years, SAS doctors here have been working harder and longer, with more complex cases in a much more challenging environment, whilst a crisis builds in the health service.  Despite the significant additional pressures, since 2008/09 our basic pay has experienced real terms (RPI) pay cut of 26.3%.

Coupled with this has been a sustained period of political instability in Northern Ireland which has meant decisions to address workforce gaps, and stabilising and transforming the health service have not been taken, adding to the pressures doctors face. 

While we have engaged in good faith with the Doctors and Dentists Pay Review Body (DDRB) for the last 17 years, the recommendations it has made around pay have not always been implemented by government. The actual application of the pay award in Northern Ireland has generally been extremely slow, and it has taken months for it to be paid. This is unacceptable and out-with what happens in the other nations. 

Following the restoration of the Northern Ireland Assembly in February 2024, the Health Minister said that he intended to apply a pay uplift of 6%, as recommended by the DDRB for the 2023/2024 financial year. This was not paid until June 2024. 

In May 2024, SAS doctors in Northern Ireland voted overwhelmingly in favour of taking a formal ballot for strike action over pay. The strength of feeling among SAS doctors in Northern Ireland coupled with a pay deal achieved for SAS doctors in England and Wales, meant that a pay deal was reached and accepted here without the need for a formal ballot.

Read the full details of the pay offer

However, this pay deal, and the DDRB-recommended pay uplift of 6% for 2024/25, was not fully implemented in pay packets until March 2025.

After engaging with the Health minister and the department since April of this year, the minister confirmed that although he was minded to accept this year’s DDRB-recommended pay uplift of 4%, he has not secured the funds he says are needed to do so in line with the rest of the UK.
Aside from this, the DDRB recommendation of a 4% uplift does not align with our aim of full pay restoration. 

Pay deterioration for SAS doctors in Northern Ireland 

The tables below clearly illustrate pay deterioration faced by SAS doctors in Northern Ireland as successive pay uplifts have not kept up with inflation. Each step in the table shows the value of the pay point for both contracts, what that value was in 2008, what is now, and what it would be if uplifts had reflected RPI levels of inflation. Those who have reached the top of the 2008 Specialty Doctor contract are now almost £35,000 worse off because of the failure of successive pay uplifts to take account of inflation. Those on Associate Specialist contracts are almost £40,000 worse off.

Specialty Doctor (2008) (Northern Ireland) 

Associate specialist (2008) (Northern Ireland)

Figure 1 - SAS difference in pay uplifts vs inflation 

The table below shows the impact of sub-inflationary pay uplifts over the last 16 years on SAS pay in Northern Ireland. 

Pay erosion for SAS Doctors (closed contract) from 2008/09 to 2025/26

Pay erosion for SAS Doctors (open contract) from 2008/09 to 2025/26

SAS vacancies in Northern Ireland

Whist the number of SAS doctors in Northern Ireland is growing, so too are the number of vacant posts. This suggests that growth is not sufficient to keep up with service demands.  

According to data obtained via BMA Northern Ireland freedom of information requests, as of September 2021, vacant SAS posts in Northern Ireland as a proportion of the overall establishment (vacancy rate) was 25.4%. In September 2023, the vacancy rate was 31.8%.   

However, when looking exclusively at the number of SAS vacancies reported by the Department of Health, the rate is significantly less – just 8.3% in 2021 and 7.71% in 2023.   

This suggests that the Department of Health are significantly underreporting the true extent of SAS vacancies in Northern Ireland due to the narrow scope of its definition of a vacancy. This inevitably leads to an inability to make effective workforce plans and enables huge staffing pressures to go unchecked.    

Now more than ever we need to restore pay back to the level it should be at in order to retain and attract to the SAS workforce and protect the integrity of our profession. 

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