Enhanced appraisals under the resident doctors' deal
The government's offer to the BMA UK Resident Doctors Committee (UKRDC), agreed in June 2026, introduces a strengthened, standardised appraisal requirement for locally employed doctors (LEDs), whose contracts mirror the 2016 Terms and Conditions of Service (TCS), which is linked to progression and pay. Employers will need to ensure appraisal processes are consistent, well‑documented and aligned with national expectations.
The enhanced appraisal will become the mechanism through which eligible LEDs can demonstrate attainment of competencies and access pay progression. The process will assess if an LED is able to perform the competencies required to work at a higher level in a specialist field.
The proposal is intended not only to determine pay progression, but also to provide a structured mechanism for recognising the development of skills and experience gained while working as a locally employed doctor. The appraisal process is expected to help doctors demonstrate progression in their capabilities, identify development needs and gain recognition for competencies acquired outside formal training pathways.
While national guidance is still being developed, employers should begin reviewing their current appraisal arrangements, supervisor capacity and governance processes to prepare for implementation. This page summarises what trusts need to know now, with a focus on operational readiness rather than policy.
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What is changing
As part of the resident doctor deal, pay progression for LEDs will become linked to the demonstration of relevant competencies through an enhanced annual appraisal process.
The offer states that:
- By October 2026, NHS England will design an enhanced annual appraisal for locally employed doctors that will be conducted by trusts, to allow doctors to demonstrate attainment of relevant competencies to achieve pay progression from August 2026. This appraisal process will apply to all LEDs on contracts that mirror the 2016 Terms and Conditions of Service for NHS Doctors and Dentists in Training.
- UKRDC will be involved and consulted during the design and implementation phases of the new enhanced appraisal process.
- This process will assess if an LED is able to perform the competencies required to work at a higher level in a specialist field.
- Experience and competencies gained outside of formal training can be recognised in the enhanced annual appraisal. This will be the means through which LEDs are able to access the opportunity for annualised pay progression.
- This process applies to less-than-full-time (LTFT) LEDs – who can unlock the same opportunity for annualised pay progression at their enhanced annual appraisal, subject to demonstrating the relevant competencies.
- Furthermore, on re-entry to formal training, LEDs may have their competencies recognised towards training by requesting a review of their competencies at an early ARCP within the first three months, after beginning training. This means that completion of that stage of formal training could be quicker on re-entry.
- To ensure enhanced appraisals are fair and consistent for LEDs, competencies will be signed off by a supervisor or a doctor with relevant clinical experience.
- With enhanced appraisals, trusts will be supporting LEDs to illustrate how they are demonstrating the development of their skills, with their pay progressing accordingly, and resultantly rewarding LEDs for the competencies that they have developed.
- The enhanced appraisal for resident doctors will become the default mechanism to assist LEDs to identify gaps in their competencies and their development needs. It will also be the mechanism for determining pay progression. The enhanced appraisal will be developed by October 2026 and a new standardised contract for LEDs will be fully implemented by April 2027.
Preparatory action for employers to consider
- Although NHS England is currently leading discussions to develop the enhanced appraisal framework, employers should expect the process to operate as an annual appraisal that supports competency-based pay progression for eligible locally employed doctors.
- Employers should also prepare for a nationally consistent approach to appraisal for LEDs, supported by national guidance and standardised requirements. Supervisors and appraisers allocated this work are likely to require appropriate training and support to ensure assessments are undertaken consistently and fairly across organisations and specialties.
- Trusts should expect to maintain robust records of appraisal activity, competency evidence and progression decisions, with clear governance and audit arrangements in place. Given the link between appraisal outcomes and pay progression, organisations may wish to review whether existing appraisal processes provide sufficient assurance, documentation and consistency.
- No specific funding has been identified for the additional employer activity associated with implementing enhanced appraisals. Employers may therefore wish to consider the potential resource implications, including appraiser and supervisor capacity, administrative support, training requirements and job planning.
- Employers should also anticipate that appraisal arrangements for LEDs may be more structured than some existing local processes, reflecting their role in evidencing competency development and supporting progression decisions. Current expectations are that the enhanced appraisal process will support pay progression from August 2026, with NHS England developing the framework by October 2026 and implementation activity commencing thereafter.
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