Junior doctors

Joint Statement

NHS Employers agreed a joint statement with the British Medical Association (BMA) on the application of the 2016 terms and conditions of service contract limits for the duration of the COVID-19 pandemic. 

The statement outlined that where an employer is unable to meet its obligations under the definitions of appropriate levels of cover within the limits of the 2016 terms and conditions of service, you may agree to suspend contractual provisions in discussion with the trainees and, where possible, the guardian of safe working hours.As the contract provisions are in place to ensure the health and safety of trainees, we advised that departures from the contract limits should be as limited as possible and for as short a time as necessary. The statement was amended on 8 April, the focus of the agreed amendments is to provide additional clarity that better reflects the intention of the parties and ongoing review arrangements.

On 3 July the BMA confirmed its withdrawal from the joint statement. As per the terms of the agreed joint statement a one month’s notice will now be applied. This will have the effect of terminating any agreed contractual flexibilities at local level and reverting the contractual position to that set out in the Terms and Conditions of Service.

Read NHS Employer's response to the withdrawal of this agreement.

Weekends exceeding one in two

NHS Employers and the British Medical Association (BMA) have issued guidance for employers for when emergency rotas, exceeding the one in two weekend frequency limits, have been necessary to respond to the challenges presented by the COVID-19 pandemic.

In the absence of any government solution, employers should consider the recommendations made in the guidance, but recognise that there is no-one-size-fits-all solution. Ultimately this is a matter for local determination including remuneration rates and how these are applied.

Local conversations do need to ensure a fair and reasonable approach has been applied to ensure trainees have been appropriately rewarded for working on emergency rotas exceeding one in two weekend frequency limits.

Management of untaken annual leave

In recent months, doctors and dentists in training have worked incredibly hard to support the COVID-19 response and in some cases may as a result not have been able to take as much annual leave as would usually have been planned, with insufficient ability to use any excess annual leave up before the end of their rotation.

To support employers and their doctors and dentists in training, we have agreed with the British Medical Association temporary and exceptional guidance for the August rotation on how untaken annual leave should be managed in different scenarios.

Key principles

  • Where reasonable and practicable annual leave entitlement is taken prior to finishing their existing placement.
  • Where reaching agreement on planning annual leave is not possible, some annual leave may be allocated by the employer to ensure that they are able to take their full annual leave entitlement while maintaining safe coverage of services.
  • Where carry over is not requested, or only a portion of annual leave is carried over payment of the remaining entitlement should be made at the end of this rotation.
  • Where a request is made to carry over some of the untaken annual leave, this is to be facilitated; this will require the agreement of the current and new employer.
  • There should be a parity of approaches adopted regardless of employment arrangements.

Where agreement is reached for the carryover of annual leave, we have provided a template which can be adapted locally.

Please see the medical and dental workforce issues section for further information. 

If you have any queries, or requests for additional guidance that will help you support your workforce to deliver patient care, please send them to

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