The following frequently asked questions give further information for employers on the staff and associate specialist
contract.
Where are we now?
Which staff are affected?
Who is included in this group?
Why aren't trust grade doctors included?
What are the key elements of the contract?
How does this link to DDRB and the pay review body process?
What happens next?
When will the contract be introduced?
How will doctors move onto the new contract?
How will employers be supported through the implementation process?
What are the benefits for employers?
How will the new contract benefit doctors?
What are the benefits for the service?
What happens if SAS doctors vote not to accept the contract?
Is this a UK contract?
Is the contract fully funded?
Where can I find out more information?
Where are we now?
In April 2005 NHS Employers received a mandate from the Department of Health to conduct a review of the pay and
terms and conditions for staff and associate specialists (also known as non-consultant career grade doctors).
Negotiations with the BMA continued until late 2006 when a joint proposal was submitted to the UK Health
Departments.
Following approval by the Public Sector Pay Committee, subject to adoption of changed transitional arrangements, the
Government has agreed the new contract for staff and associate specialist doctors (SAS) negotiated between NHS
Employers and the BMA. The BMA SAS Committee has agreed to put the proposals out to a ballot of their members
subject to clarification of some points by the Department of Health.
The expectation is that the contract would be implemented from 1 April 2008.
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Which staff are affected?
SAS (staff and associate specialist) doctors also known as NCCG (non consultant career grade) doctors are employed
doctors working on national terms and conditions who are neither junior doctors (doctors in training) nor consultants.
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Who is included in this group?
The group includes:staff grade doctors
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associate specialists
non-practising GP clinical assistantshospital practitioners
clinical medical officers
senior clinical medical officers
It does not include trust grade doctors, as these doctors work on locally set terms and conditions. Nor does it
include GPs working in community hospitals.
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Why aren't trust grade doctors included?
The review only includes those doctors employed on national terms and conditions that are negotiated with
the BMA.
However, it was a shared aim of the joint negotiating group to reduce the reliance on local contracts by
negotiating a sufficiently attractive national contract for adoption in place of trust grade doctors working at staff
and associate specialist level.
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What are the key elements of the contract?
The key elements are as follows:
• Introduction of a single grade for all SAS doctors as recommended in the Modernising Medical Careers
report ‘Choice and Opportunity – Modernising Medical Careers for Non Consultant Career Grade doctors’.
• Closure of current associate specialist grade to new entrants, with contract improvements for existing
associate specialists who remain in the grade. AS grade has historically not provided a rewarding career
pathway.
• A basic salary for the new grades will be £33,839-63240 for specialty doctors and £51,235-81079 for
associate specialists on the transitional salary scale, (at 2007/08 pay rates).
• Removing the optional and discretionary points system, which has not always recognised the contribution
made by SAS doctors and are felt by many to be neither fair, nor transparent. These points are incorporated
into the salary scales for both new grade and closed associate specialist grades.
• A similar contract to consultants with a working week based on 10 programmed activities (each PA lasts 4
hours) and an annual job plan review, appraisal and set objectives.
• At least one programmed activity a week should be set aside for activities that are not direct clinical care.
• Improved rewards for working out of hours to encourage doctors to work more flexibly. Out of hours work to
be given at a rate of time and a third (the same as consultants) and doctors who need to be on call should
receive a percentage uplift to their basic salary depending upon the frequency of their on call rota.
• There will be a “window of opportunity” for staff grades nearing eligibility to apply for regarding to associate
specialist grade before it is closed
• The transitional arrangements phase the increased payments for staff grade doctors with half their expected
pay increase in year one (1 April 2008) and half in year two (1 April 2009). The same arrangements will be
applied to associate specialists who originally would not have received any uplift until April 2009.
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How does this link to DDRB and the pay review body process?
This is about pay reform and not linked to the annual pay review process, in which the independent review
bodies make recommendations to Government on yearly pay uplifts to account for cost of living increases.
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What happens next?
There will be a ballot and if there is a positive outcome then we will run roadshows to support implementation.
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When will the contract be introduced?
The BMA SAS Committee has agreed to put the proposals out to a ballot of their members subject to
clarification of some points by the Department of Health. The Health Departments will agree on an
implementation date, although the expectation is that the contract would be implemented from 1 April 2008, if
the ballot outcome has approved the contact by this date.
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How will doctors move onto the new contract?
Once we have a start date for the contract and if we get a positive ballot doctors will be invited by their
employer to make ‘an expression of interest’ in the contract. Employer and doctor will then sit down, agree a
job plan and the doctor will be offered the contract on this basis. The doctor will then choose whether to
accept the offer.
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How will employers be supported through the implementation process?
NHS Employers will be running road shows to propose sensible implementation arrangements, especially to
ensure the job planning process is robust. We believe that this will provide employers with realistic
expectations of the costs and benefits of the contract as well as the resource commitment.
Following implementation, the Joint Negotiating Committee will continue to meet to oversee the
implementation and monitor the application of the terms and conditions of service.
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What are the benefits for employers?
• Employers will have improved ability to manage doctors’ time in ways that best meet local service needs and
priorities.
• There will be greater clarity of objectives and more effective systems for engaging doctors in joint action to
improve performance and modernise patient care.
• Employers will also have the opportunity to integrate doctors more within multi-disciplinary teams and bring
this group of doctors into line with reward systems operating for other senior doctors.
• The contract provides a clear and coherent pay and career structure for this important group of staff.
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How will the new contract benefit doctors?
• Both NHS Employers and the BMA wanted to agree a new contract for SAS doctors that properly recognises
and rewards them for the work they do in the NHS.
• We also wanted to design a contract that will give SAS doctors a rewarding career and enable them to
progress through points to the top of the grade on a salary scale that is linked to training and development.
• The new contract provides continued professional development for doctors, contributing to the quality of
patient care, and give doctors more involvement in planning their work.
• The new contract will also include an annual appraisal, job planning and objective setting. All this should help
provide a portfolio of evidence for those doctors who want to go back into training to become a consultant, but
provide a good career for those who wish to remain in the new grade.
• The contract provides consistency with other grades and it is hoped that it will improve morale and
motivation.
• In the current financial climate the contract represents a good deal for SAS doctors.
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What are the benefits for the service?
• NHS Employers wanted the contract to help employers to improve patient services.
• We believe the new contract will enable trusts to provide or redesign services to more easily meet patients’
needs.
• There will be greater opportunities and incentives to arrange care in the evenings and at weekends leading
to improvement in patient access.
• Strengthened job planning will make it possible to ensure that the work of individual doctors is fully aligned to
the objectives of the organisation to ensure improvements for patients.
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What happens if SAS doctors vote not to accept the contract?
We sincerely hope that SAS doctors will vote to accept the contract because it represents a good deal for
individual doctors. If, however, SAS doctors were to reject the contract NHS Employers has no mandate to
enter into any further negotiations. The Government would have to decide what it is wished to do but it is
difficult to envisage there being any new national mandate or negotiations. In these circumstances some trusts
might choose to implement the contract but others would not.
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Is this a UK contract?
Yes, the proposals were agreed by NHS Employers and representatives of the health administrations in
Scotland, Wales and Northern Ireland.
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Is the contract fully funded?
NHS Employers was given a funding envelope to work with and has modelled the costs accordingly.
Resources to implement the contract are taken into account in funding allocations to the NHS.
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Where can I find out more information?
A number of key documents are available on our website including the contract and the terms and conditions,
and more documents will be added over the coming weeks.
If you have any questions please email: doctorsanddentists@nhsemployers.org
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