The 2016 contract came into effect on 3 August 2016. The 2016 contract started to be introduced in England for GP trainees and trainees in hospital posts approved for postgraduate medical/dental education in line with a phased implementation timetable from October 2016.
This web page will feature the most frequently asked questions about pay protection as outlined in the 2016 contract and will be updated regularly.
Q1. What are the pay protection arrangements and to which doctors should protection be applied?
The 2016 contract provides an initial period of pay protection for doctors who were in training programmes on 2 August 2016 who remained in those programmes, or progressed directly to their next programme on or after 3 August 2016, and to F1 doctors who began their training programme on 3 August 2016.
There are two sections to the pay protection provisions.
Section one covers foundation doctors, core trainees and doctors in the early stages of run-through training. Doctors covered by section one include:
- All doctors commencing F1 on 3 August 2016.
- All doctors remaining on F1 or remaining on F2 as at 3 August 2016.
- All doctors entering F2 directly from F1 or from other training programmes on 3 August 2016.
- All new entrants to core or run-through speciality training (CT1 / ST1) from F2 or from other training programmes on 3 August 2016.
- All doctors moving into CT2, ST2 or CT3 grades from the grade immediately below or from other training programmes on 3 August 2016.
- All doctors remaining in the CT1, ST1, CT2, ST2 or CT3 grades as at 3 August 2016.
- All doctors progressing directly from core training or from other training programmes to higher training at ST3 point (or for doctors entering higher training in psychiatry or emergency medicine at the ST4 point) on 3 August 2016.
Pay protection for section one trainees will be through calculation of a cash floor. Should earnings under the 2016 contract be lower than this cash floor amount, an additional payment will be made to make up the difference. The cash floor is calculated as:
- the value of incremental point on the day immediately prior to moving to the 2016 TCS, plus
- the value of the GP supplement or banding supplement payable on 31 October 2015 (subject to a maximum of 1A or if the doctor has opted out of WTR, 2A) for the post the doctor was in on the day immediately prior to moving to the 2016 TCS.
Section two covers doctors in higher specialty training and the later stages of run-through training. Doctors in section two include:
- Doctors already at ST3 or above (or ST4 or above for Emergency Medicine or Psychiatry training programmes) on a run-through training programme on 2 August 2016.
- Doctors already in higher specialty training programmes on 2 August 2016.
- Specialist registrars (SpRs) on a pre-2007 training programme.
Doctors in section two will continue to be paid a basic salary based on the current 2002 New Deal pay scales (MN37), annual increments and a banding payment. A banding questionnaire is included with the TCS as Annex B for the purposes of calculating the banding supplement payable.
Full eligibility for pay protection is set out in Schedule 14 of the TCS.
Q2. How long will pay protection apply?
The 2016 contract provides for transitional pay protection to apply for four years of continuous employment from the point at which a doctor moves to the new contract, or until they exit training, or 3 August 2022, whichever is the sooner.
If during the period of transition a doctor is absent from work on maternity leave, adoption leave, shared parental leave, or long-term sick leave (more than three consecutive months), this period can be extended by the length of that absence up to a maximum of two years, or until 3 August 2022, or until they exit training, whichever is the sooner.
Doctors training less than full time (LTFT) will have their period of transitional pay protection extended to reflect the full time equivalent entitlement. For example, a trainee working at 80 percent FTE will receive pay protection for five years, or until 3 August 2022 or until (s)he exits training, whichever is the sooner.
Q3. Will doctors currently absent due to maternity, shared parental, adoption or long term sick leave or an approved OOP be eligible for pay protection when they return to training?
Yes, provided that the doctor still holds a national training number (NTN) or were part way through their foundation or core training programme when their out of programme (OOP) was agreed or absence started, pay protection will apply.
For the purposes of Section One pay protection, the protected level of pay for doctors absent at the point of transition shall be:
1. the incremental pay point the doctor would have reached had they not been absent, plus
2. the value of the banding supplement paid on 31 October 2015 for the rota the doctor would have been working on had they not been absent at the point of transition, subject to a maximum of 50 per cent (or 80 per cent for those opted out of the working time regulations.
Q4. Will a doctor who was not in an approved training programme (e.g. taking a break in training between core and higher specialty programmes or between foundation and specialty training) qualify for pay protection when they return to training after 3 August 2016?
No, the 2016 contract provides transitional pay protection for F1 doctors joining in August 2016 and for doctors in training programmes on 2 August 2016 remaining in their programme or progressing directly to their next training programme. There are some exceptions:
a. A doctor who has accepted a place in a training programme in a 2015 recruitment round, or earlier, and has agreed with Health Education England (HEE) to defer the entry date at that time will qualify for pay protection when entering that programme on the agreed date.
b. A doctor who has accepted a place on a training programme during a 2016 recruitment round (prior to 30 June) and has agreed with HEE a deferral of the start date will qualify for pay protection when entering that programme on the agreed date.
c. A doctor who has accepted an appointment to start a period of research or organised leadership programme (e.g. the FMLM scheme) prior to 31 March 2016 without having secured a place on a GP or specialty training programme, and who would otherwise qualify for pay protection on return to training under the 2016 terms and conditions of service. To be eligible for pay protection in this circumstance, the doctor must enter a nationally recognised specialty training programme at the first available opportunity, in line with the national specialty training recruitment timetable, following the successful completion of that academic or leadership work. This provision will only be extended to those who have made the decision to take up such academic of leadership programme activity prior to 31 March 2016. Doctors should be asked to provide evidence of the date upon which they accepted this academic or leadership work to prove their eligibility for pay protection.
Q5. What pay protection will apply for a doctor who switches training programme or returns to training from being a SAS doctor (or other nationally recognised grade)?
If during the period of transition, doctors in training choose to switch training programmes, without a break in training of more than three months, subject to qualification periods, they will benefit from transitional Section One cash floor pay protection until the end of their transition period. See Schedule 14 para 4 of the 2016 terms and conditions (TCS).
Additionally, and also subject to qualification periods outlined in the TCS, the 2016 contract permanently provides for pay protection at the level of basic pay, where doctors either re-enter training from another nationally recognised grade or switch from a specialty training programme directly into an agreed hard to fill training programme. Currently these are general practice, psychiatry and the higher stages of emergency medicine (ST4+). See Schedule 2 of the TCS.
Q6. What will happen to doctors from other nationally recognised career grades who have applied to return training this year?
They will have made those applications based on an assumption that para 132 of the 2002 contract will apply and that pay protection will apply. We recognise that some doctors may have made the decision to apply to return to training prior to when the full terms and conditions of service (TCS) were available.
The 2016 contract provides permanent pay protection for some doctors re-entering training into the recognised hard to fill specialties (Schedule 2 paragraphs 49-52). However, where doctors in the nationally recognised career grades have already successfully applied to re-enter training in the 2016 recruitment rounds, and they meet the eligibility criteria set out in paragraph 50, the pay protection outlined in paragraph 51 will apply irrespective of their training programme (except for re-entry to the foundation programme). The extension of this provision to doctors entering programmes in any training programme (except foundation programme) will only apply to those who applied in 2016 recruitment rounds as it will protect the pay expectations they had when making that application. Doctors who successfully applied for training in previous years who have deferred their entry to training will be covered under other transitional arrangements for pay protection.
Q7. Will the payment of band 3 supplements that were payable on 31 October 2015 be protected during transition?
No. The highest level to which protection can be applied under the proposed contract will be Band 2A (80 per cent) for those who have opted out of working time regulations, or Band 1A for those who have not opted out. As a consequence of the proposed contractual safeguards on working patterns that would have previously triggered band 3 payments are no longer permitted under the 2016 contract.
Q8. Can a doctor choose to receive pay under Schedule 2 of the 2016 contract during the transition period rather than Schedule 14 (Section Two) pay protection based on the New Deal pay system?
No. In order for the 2016 contract to deliver cost neutrality, one of the fundamental requirements for the introduction of the new offer, the costs have been modelled by including Section two pay protection values for trainees in the higher stages of training. Any divergence from this plan may result in higher costs.
Q9. How much will pay protection cost and how is it funded?
As we are protecting junior doctors’ current pay in cash terms (except for those on band 3 rotas), protection costs will decrease over the period of transition (up to 2 August 2022) as trainees on Section One protection progress through the nodal pay points and their basic pay increases and catches up with their cash floor. The costs of protection are a relatively small part of the overall medical pay bill and are largely funded within the pay envelope due to fluctuations in the numbers of starters and leavers. Any residual cost will be small, short-lived and well within the scale of any annual fluctuations in the pay bill. The money used to fund planned pay protection costs (those within the cost envelope) will be recycled back into the pay envelope as the need for pay protection diminishes.
Q10. What will happen for doctors with previous NHS service who re-enter training from a post that was not in a nationally recognised grade e.g. trust grade, clinical fellow etc? Will they have any of their pay protected on transition to the new contract?
We recognise that some doctors may have made the decision to apply to return to training from trust doctor posts, or other types of medical posts that are not nationally recognised, expecting their previous NHS service to be recognised in determining their future pay. These doctors are not afforded pay protection in Schedule 2 of the 2016 contract.
However, such doctors who applied to re-enter training prior to the publication of the 2016 TCS on 6 July 2016 and are due to commence that post before 10 February 2017 (unless deferral of entry has been agreed) will, by exception, also be considered for the pay protection arrangements outlined in Schedule 14.
The incremental point paid to that doctor after commencing that training programme under 2002 TCS shall be used for the determination of pay protection on transition to the 2016 contract. Where such doctors commence their training programme directly on the 2016 TCS, the 2002 terms shall be used to determine what the appropriate incremental point would have been on the day immediately prior to transition, had they already been in post.
Q11. Will banding supplements be protected if hours and banding change within a rotation?
If hours change during a placement, the provisions of Schedule 2 paragraphs 60-62 will apply. If pay increases due to a work schedule review, pay will increase from the date the change is implemented (other than in exceptional circumstances). Where the work schedule review is required by your employer and, as a consequence pay will decrease, total pay will be protected until the doctor moves to their next placement. Where changes to the work schedule are requested by the doctor, any pay decreases will be reflected in total pay from the point the change is implemented.
Q12. For the purposes of pay protection in Schedule 2 paragraph 50, what are the agreed hard to fill training programmes?
The agreed hard-to-fill training programmes will be set out in the Medical and Dental Pay and Conditions Circular. Pay and Conditions Circular (M&D) 2/2016 identifies applicable training programmes as higher training in emergency medicine (ST4+), general practice, and psychiatry.
Q13. What are the 2016 contract arrangements for annual leave and bank holidays?
Annual leave under the new proposal will be stated in days, rather than weeks. In addition, statutory days will be incorporated in to the annual leave allowance. This means that leave allowance on first appointment will be 27 days, increasing to 32 days after five years’ service. Annual leave for LTFT trainees will be pro-rata. Leave arrangements can be calculated in hours for non-standard working patterns. Existing arrangements for the definition of a ‘day’, giving notice for annual leave, time off in lieu for bank holiday working and payment for untaken leave remain unchanged.
Q14. I notice that F1s starting in August will now be pay protected when they move onto the 2016 contract?
Yes, due to the transition date for F1s being moved from August to December 2016, new F1 doctors this year will start work on the 2002 contract and will therefore be entitled to Section One pay protection – the cash floor method.
The cash floor is based on the basic pay that the doctor was on the day before they transition to new contract, so in most cases for F1s this will be £22,862, plus the 31 October 2015 banding of the rota they are working on the day before they transition.
Some F1s will earn more than their cash floor amount when transitioning to the new contract because under the new arrangements F1 basic pay is significantly higher. Some F1s will need pay protection if the banding value included in the cash floor calculation is high. Upon moving to F2 it becomes very unlikely that any F1 will continue to need pay protection, however employers should remember that the doctor should not earn less than their cash floor until their period of pay protection expires.
Q15. How will pay protection work practically?
Transitional pay protection has two elements – those in the early stages of their training will be entitled to a cash floor that their total salary cannot fall below; those in the higher stages of their training will continue to be paid on their 2002 contract pay scale with annual increments and banding for the duration of their transitional period.
We are asking the electronic staff record (ESR) organisation to create a field so that the cash floor amount, once calculated, can be input on to the doctor’s record on ESR. This will ensure that the cash floor value is transferred in the inter authority transfer (IAT) process when the doctor rotates. We are also asking ESR to create a field showing the doctor’s individual transition end date, so that it is clear to employers when pay protection should cease.
Q16. I notice the method of calculating the cash floor has changed slightly compared to the March edition of the TCS?
The cash floor is now calculated using the basic pay the day before the doctor transitions, plus the 31 October 2015 banding of the rota they are working on the day before they transition. Finding out the doctor’s pay point the day before they transition should be simple for employers who are used to finding out this information anyway. We would recommend that if you have any outstanding banding appeals concerning the banding of a rota at 31 October 2015, you need to resolve them as quickly as possible.
If a doctor has rotated from another employer, the new employer may need to contact the former employer to find out what the banding supplement of the rota they were working on was at 31 October 2015. To make this process easier we would recommend that all employers create a document containing the bandings of all rotas at 31 October 2015, and the posts that worked on these rotas. This will make it easier to provide this information when requested.
Q17. Schedule 14 paragraph 16b requires us to use the rota the doctor 'would have been working on' had the doctor not been absent prior to transition. How do we know which rota this is?
Schedule 14 paragraph 16 specifically deals with situations where, on the day prior to transition, doctors are absent on maternity, paternity, adoption, or shared parental leave, on long term sick leave, or on an approved OOP.
To work out the cash floor in these cases, you need to know the value of the banding supplement, as at 31 October 2015, for the rota on which the doctor would have been working had they not been absent. Where this cannot be easily determined, the most sensible approach would be to use the rota which the doctor works upon return, as in most cases, it is likely that, but for the period of absence, this is the rota on which they would have otherwise been working, as the doctor would have moved onto this rota some time earlier alongside his/her peers.
In such cases then, it would be the banding, as at 31 October 2015, for the rota on which the doctor is employed immediately on transition, that should be used for this purpose. We have created a template for employers to use with doctors in training on cash floor and transition.
Q18. The banding of the rota has changed since 31 October 2015. Does this mean the rota 'did not exist' on 31 October 2015, in which case the cash floor should be based on the banding at the time of appointment?
It depends on the circumstances, the 31 October 2015 banding is not automatically superseded by banding changes.
Where a rota existed on 31 October 2015 but has subsequently undergone minor alterations, and this has resulted in a banding change, the 31 October 2015 banding will apply. Many rotas will need to undergo minor amendments to comply with the new 2016 arrangements, for example, which may result in a higher or lower banding than on 31 October 2015 due to the new working hour limits. This would not supersede the 31 October 2015 banding for cash floor purposes.
However, it might be considered that the current rota 'did not exist' on 31 October 2015 in the following circumstances:
- where these posts did not exist on 31 October 2015
- where the doctor(s) were working daytime only on 31 October 2015, and have only been put on an out of hours rota after that point
- where there has been such a substantial change that the doctors are effectively doing an entirely different working pattern – for instance, if they have changed from a single specialty rota to a cross cover rota, or from a full shift only to a pattern including non-resident on-call (or vice versa), or a significant increase in the frequency of weekends worked.
Q19. If a doctor on Section 2 pay protection is working in a GP practice, what banding should they get?
As these doctors continue to be paid as if they were on the previous pay system, they should receive the 45 per cent GP supplement while they are in their practice placement. There is no need to try and assess the banding supplement for these doctors during their placement. When the doctor rotates back into a hospital setting, they will then receive a banding based on their rota, just like all other doctors on Section 2 pay protection.
Q20. Where a doctor in training has a gap in training arising because the end date of one training programme does not match up to the start date of their first post/placement on the next training programme (either because the doctor is training less than full time and therefore out of sync with the programme, or because of a simple mismatch between the start and end date of training programmes e.g between core and higher training), does the doctor continue to be eligible for pay protection? - NEW added 15 February.
Yes. Where a trainee exits one training programme, having secured entry to another training programme but is unable to take up a place on that second training programme due to a mismatch between the start and end dates of the two programmes, the break in training will not affect the doctor’s entitlement to transitional protection. In such circumstances, it is envisaged that the provisions of schedule 14, paragraph 8 should apply. This provision does not apply where a doctor voluntarily leaves on programme prior to completion in order to take up a different programme. In those circumstances, the provisions of schedule 2, paragraphs 46-48 would apply, but a break in service, other than for reasons set out in paragraphs 47 and 48, would remove the entitlement to transitional protection.
Q21. A special pay protection provision was agreed for F2 doctors in unbanded posts who took up the 2016 contract on moving to another F2 post. Does this also apply to unbanded F2s moving into ST1/CT1 posts?
No. As per Schedule 14, paragraph 11c, this provision is specific to F2s transitioning part way through their F2 year (7 December 2016 or 5 April 2017) The amendment to the cash floor is from 5th April 2017 without backdating. The distribution of the nodal points agreed with the BMA during the ACAS negotiations in May 2016, meant that these particular trainees were more likely than other grades to see an impact on their pay compared to what they might otherwise have expected. This is intended to bring these F2 doctors more into line with the transitional arrangements for their peers.
It does not apply to trainees who remained on the 2002 terms throughout their F2 year and who transition to the 2016 terms when they take up an ST1/CT1 post.
Q22. Schedule 14, paragraph 37 indicates that a previous career grade salary (which was protected under the 2002 TCS) should be taken into account when calculating the doctor’s earnings in line with paragraph 25. How do we calculate any additional payments in the new post?
The agreed intention of Schedule 14 is that for doctors qualifying for section two, pay should continue in line with the 2002 TCS for the period in which such transitional protection applies, apart from the agreed modifications to banding.
This means, for doctors in receipt of career grade protection who transition to the new TCS, if pay protection applies in a particular post they would have their total pay in that post calculated as if they were doing that work under the terms of the previous career grade contract.
So if a doctor is receiving pay protection on a point of the specialty doctor scale, their total pay in the new post would be calculated as if they were doing that work under the specialty doctor arrangements. This might include additional programmed activities, premium time and/or on call availability allowance.
Q23: Schedule 14, paragraph 22 indicates that a previous career grade salary, which has been protected under paragraph 132 of the 2002 TCS, should be taken into account when calculating the cash floor. How does this work?
The intention of this paragraph is that where a doctor is in receipt of career grade pay protection, the cash floor should not fall below the protected career grade basic salary. The paragraph is clear that only basic pay can be considered, not any additional payments.
Where a trainee due to transition is in receipt of career grade pay protection under paragraph 132a of the 2002 TCS, the employer should still undertake the standard cash floor calculation in paragraph 11, using the trainee basic salary which would apply if there was no career grade pay protection. If, however, the career grade basic salary is higher than this cash floor calculation, then the career grade basic salary should become the cash floor.
For instance, if a specialty trainee has career grade pay protection from a specialty doctor post on £66,734, and their cash floor on training grade pay is calculated as £47,647 plus 1B banding = £66,034, then their cash floor should be set at the higher level of £66,734.
However, if their protected career grade basic salary was £60,168, then the higher cash floor of £66,034 calculated on training grade pay would apply.
Q24: What pay protection do dental trainees receive? Is it section one or section two of the transitional arrangements?
The nomenclature used to describe dental training differs from that used for medical trainees.
This is set out in the pay and conditions circular, dentists on the Dental Core Training programme become higher trainees at the Dental Specialty year 1 (DST1) level. This should be recognised when determining the pay protection. So for example, a dental trainee who was a ST2 in August 2016, would qualify for section two transitional arrangements, as per schedule 14 of the TCS .Trainees already in the higher stages of training, who are transferring to the 2016 contract should be eligible for section two pay protection. This means that all dental trainees at DST1 and above at the dates set out in the TCS should be eligible for section two pay protection.
Any dentists in training not at DST1+ level (ie. still a DCT) on 2 August would be eligible for section one pay protection.