Medical contract reform

Group of hospital staff

12 / 7 / 2016 Midnight

NHS Employers has been working with the British Medical Association (BMA) for a number of years to negotiate new contracts for both junior doctors and consultants.  

This web page provides background to the negotiations and progress made to date. 

Contract reform for doctors in training
Contract reform for consultants


Since 2013, NHS Employers has been negotiating a new contract for doctors in training with the BMA. As a result, both sides agreed a joint statement.

Following the BMA's decision to end the negotiation process on 16 October 2014, NHS Employers was asked to submit evidence to the Doctors' and Dentists' Review Body (DDRB). You can read a summary and download the full evidence document here.

We published questions and answers on the contract talks, you can find these on our web page. 

Contract reform for doctors in training

In 2009, NHS Employers (NHSE), in collaboration with UK health departments, carried out a scoping exercise that reviewed the viability of the current contract for doctors in training. The report took into account the views of a wide range of employers in the NHS, as well as the British Medical Association's (BMA) junior doctors committee (JDC) and the British Dental Association (BDA).

The Department of Health published the scoping report in December 2012. Following this, NHSE and stakeholders held exploratory talks with the BMA to jointly agree a heads of terms (HoT) document. The HoT document sets out the joint vision for what a new contract may feature and will be used as the basis of future negotiations.

The document was submitted to the UK Health Departments and the BMA JDC in order to obtain a mandate for negotiation. Both parties considered the draft HoT document over summer 2013, to seek the necessary mandates from the JDC and UK Health Departments respectively, in order to proceed to formal negotiations from autumn 2013.

This follows exploratory talks between the BMA and employers, including representatives from the devolved nations, after concerns that the 13-year-old contract is no longer working as well as it could for NHS employers, doctors and dentists in training and patients.

The HoT set out a framework for negotiation on the design of a new contract and covered working hours, pay, quality of life and training.

After extensive periods of negotiation, in May 2016, NHS Employers, the BMA, and the government reached an agreement on a new contract, under the auspices of ACAS. The BMA held a referendum of relevant members on whether to accept the new agreed terms, but BMA members voted against accepting the terms, 58 per cent to 42 per cent. 

NHS Employers has made resources available on the new contract on the junior doctors webpage

Contract reform for consultants

NHS Employers received a mandate from the Department of Health to reform the consultants’ contract in October 2013. These negotiations with the British Medical Association (BMA) were around possible changes to the 2003 consultant contract.

The heads of terms and subsequent negotiations were a result of exploratory discussions between the BMA and employers following publication of a report by the Doctors' and Dentists' Review Body(DDRB), which recommended substantial changes to the Clinical Excellence Awards scheme as well as changes to the consultant pay scale which would link pay progression more closely to current performance than to time served. These discussions also reflected the current debate on seven-day services and how the consultant contract could in future facilitate the provision of seven-day services for the benefit of patients, while at the same time remaining fair to consultants.

In December 2014, we submitted evidence to the DDRB and in July 2015, the DDRB made a number of observations on the consultants' contract.

In September 2015, the BMA agreed to re-enter formal negotiations on the reform of the consultants' contract. These talks have been constructive but have not yet concluded. NHS Employers is working with the BMA consultant committee with the aim of publishing a new contract in due course.

Latest Tweets

Why Register?

Great reasons to register with NHS Employers

  • A personalised website
    Manage your profile and select topics of interest to you
  • Access your dashboard
    Bookmark useful content to help you quickly find what you're looking for
  • Get involved
    Contribute to our Talking Points discussions, comment on and rate our webpages
  • Keep up to date
    Receive the latest newsletters and media summaries

Sounds great, what next?

Register Now

Not now, I will register later

Log In