Doctors' extra-contractual work

The list below is an example of what types of work could be classed as extra-contractual, the list is not exhaustive: 

Extra-contractual work can be arranged by mutual agreement between the doctor and employer. The pay rate for extra-contractual work can vary across employers and could depend on factors such as the doctor's grade or when the shift occurs.  

Employers set extra-contractual rates and will generally do so in discussion with the appropriate trade union representatives via joint local negotiating committees (JLNCs). This supports partnership working and allows all parties to discuss and share views on any potential changes to locally agreed extra-contractual rates. Working in partnership is key to maintaining transparent and effective working relationships.  

As part of the pay deals for SAS and consultant doctors agreed by the government in 2024, it was agreed that in instances where integrated care boards (ICBs) and other groups of employers collaborate on arrangements to set new rates for securing extra-contractual work for doctors, this should be done in consultation with employers’ JLNCs. Employers can take the same approach when setting resident doctors’ extra-contractual rates, and we would recommend this approach, especially where rates for all grades of doctors are reviewed.