Article

2018 contract - Ambulance FAQs

Questions and answers relating to ambulance staff payments for unsocial hours.

17 December 2025

This article answers frequently asked questions (FAQs) relating to ambulance staff following the implementation of the 2018 three-year pay deal.

The following FAQs were initially published to provide relevant information for ambulance staff following the three-year pay deal in 2018. They have been updated in December 2025 to retain any remaining information. 

The original implementation FAQs can be found on this web page in our archive pay library.

Overview of 2018 contract changes for ambulance staff

New starters to the ambulance service (effective from 1 September 2018) will have their unsocial hours payments paid via section 2 of the NHS Terms and Conditions of Service (TCS) Handbook

Any existing staff members who commenced employment within their ambulance trust before September 2018 and who move roles requiring a new contract of employment to be issued will be moved from annex 5 to section 2 (if they are not already on section 2).

Staff employed via, or moving to, section 2 also saw changes to the way in which occupational sickness absence pay is calculated in line with other NHS staff. 

At implementation, existing staff who were not changing roles were offered the chance to move voluntarily to section 2.

Local agreements within the ambulance sector may be in place providing more details on relevant scenarios.  

2018 contract - Ambulance specific questions

  • The move to section 2 would mean the way your unsocial hours payments are calculated would change and you would not receive your unsocial hours pay when you are off work sick, unless your sickness absence is work related. It should not mean changes to other related terms and conditions such as overtime, standby and payment for shift overruns.

  • In line with the section 2 system, unsocial hours payments will only be payable during sickness absence for those absent due to injuries, diseases or other health conditions sustained or contracted in the discharge of their duties of employment, and who are not in receipt of injury allowance.

    Under the section 2 system of unsocial hours payments, these payments are included in pay during annual leave. Agenda for Change is clear that you should receive what you would have been paid if you had been at work. This is based on the previous three months at work or any other reference period that may be locally agreed.

  • Agenda for Change, section 14 and section 22 describe how employers should establish whether an absence is wholly or mainly attributable to your work. Guidance for staff and employers on injury allowance are available for section 22.

  • Yes. There were no changes to occupational sickness absence payments for existing staff who remain on annex 5.

  • Unpaid meal breaks are not included in the calculation of unsocial hours, but agreements relating to paid meal breaks are.

  • No. There is a single harmonised rate of time-and–a-half for all overtime, with the exception of work on general public holidays, which will be paid at double time.

  • No. Staff are able to choose to move to section 2. Sometimes people need to move to flexible working as a way to balance work life and personal or family commitments. If you are applying for a move to flexible working you will retain your choice to move to Section 2.

  • No. Ambulance services are constantly changing to ensure the levels of operational cover match demand. Changes of roster and bases which are as a result of these changes do not constitute a voluntary change of contract so you would not move to section 2 unless you exercised your individual choice.

  • A reasonable adjustment helps an employee to retain employment and reduce disadvantage of staff with disabilities, or physical or mental health conditions. For that reason it will not automatically mean a move to section 2.

  • Whether a role constitutes a suitable alternative offer of employment will depend on the circumstances involved. A restructure is not a voluntary change of role therefore the person would retain their choice.

  • No, a secondment is temporary working arrangement and does not constitute a change of contract or change of role.

  • Career breaks have the effect of pausing the contract of employment for an agreed period of time. Providing the contract is restarted within the agreed timeframe you will return on your existing terms as at the point of the career break.

  • The effect of TUPE will be to transfer the staff with their terms and conditions of service at the point of the transfer. If staff are on annex 5 then they will remain on this through the transfer.

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