Article

Old terms and conditions of service for medical and dental staff

This is an archive of the terms and conditions for all the closed medical and dental grades in the NHS. These grades are now closed to new entrants.

10 January 2022

This is an archive of the terms and conditions for all the closed medical and dental grades in the NHS, including SAS doctors. These grades are now closed to new entrants. 

General Whitley Council Conditions of Service

These arrangements have been closed since the introduction of the Agenda for Change system in 2004 but certain sections are still incorporated into some of the medical and dental terms and conditions of service. Where this is the case, those terms and conditions will explicitly set out which sections of this document apply.

Access the General Whitley Council Conditions of Service (PDF).

Closed grades

Specialty doctor 2008

  • Grade [grade code] 

    Specialty doctor 2008 [MC46]

    These terms and conditions are now closed to new entrants. Any new entrants to this grade should be employed on the 2021 Terms and Conditions of Service (TCS).

    Associated documents

    Terms and conditions of service

    Terms and conditions of service for specialty doctors - England (2008) (Version 4, April 2018) (PDF)

    Model contract

    Contract of employment for specialty doctors and associate specialists (Version 4, October 2020) (Word)

    Record of amendments

    Record of amendments to the terms and conditions of service for specialty doctors (April 2018) (PDF) - changes are highlighted in the main document with superscript numbers

    Record of amendments to the contract of employment for specialty doctors and associate specialists (August 2019) (PDF) - changes are highlighted in the main document with superscript numbers

    Other model documents

    Model increment sign off form (PDF) - Model sign off form for pay increments

    Model threshold sign off form (PDF) - Model sign off from for pay thresholds

    Model offer letter (Word) - Model offer letter for new SAS contractual arrangements (where transferring from a closed SAS grade)

    Model person specification (Word) - Standard person specification extracted from the document Employing and supporting specialty doctors: a guide to good practice (PDF)

    SAS guidance on pay progression - schedule 15 paragraph 6

    This guidance specifically relates to schedule 15 (Pay Progression through Incremental Points and Thresholds), paragraph 6, of the Terms and Conditions – Associate Specialist (England) 2008 and Terms and Conditions of Service – Specialty Doctor (England) 2008.

    Schedule 15 paragraph 6 describes the process for passing through threshold one on the salary scale, stating that doctors will pass through this threshold unless they have demonstrably failed to comply with certain criteria, one of which is undertaking 360-degree appraisal/feedback (in the year preceding threshold one).

    As 360-degree appraisal/feedback is a requirement of revalidation, it may be possible that this has taken place, but more than one year ago. The pay progression process should be fair and clear, as straightforward as possible to implement and neither the process nor the gathering and demonstrating of evidence should be onerous.

    With this in mind, it has been agreed that employers have the discretion to take into account 360-degree appraisal/feedback undertaken more than one year ago, for the purpose of satisfying the criteria for progression through threshold one.

    This does not mean that these doctors do not need to have participated satisfactorily in the annual appraisal process, this remains separate criteria for progressing through threshold one. This guidance simply allows employers to use discretion when considering 360-degree appraisal/feedback that has not taken place within the preceding year.

    The same principle applies to progression through threshold two, as set out in schedule 15 paragraph 7a.

    FAQs

    These frequently asked questions (PDF) (published in July 2009 and updated last in March 2018) on the SAS contracts have been updated in agreement with the British Medical Association (BMA).

Associate specialist 2008

  • Grade [grade code]

    Associate specialist 2008 [MC41]

    This grade is closed to new entrants.

    Associated documents

    Terms and conditions of service

    Terms and conditions of service for associate specialists - England (2008) (version 3, April 2018) (PDF)

    Model contract

    Contract of employment for specialty doctors and associate specialists (Version 4, October 2020) (Word)

    Record of Amendments

    Record of amendments to the terms and conditions of service for associate specialists (April 2018) (PFD) The changes are highlighted in the main document with superscript numbers. See also the additional supporting guidance on the related pages.

    Record of amendments to the contract of employment for specialty doctors and associate specialists (August 2019) (PDF) - changes are highlighted in the main document with superscript numbers. 

    Other model documents

    Model increment sign off form (PDF) - Model sign off form for pay increments

    Model threshold sign off form (PDF) - Model sign off from for pay thresholds

    Model offer letter (Word) - Model offer letter for new SAS contractual arrangements (where transferring from a closed SAS grade)

    Model person specification (Word) - Standard person specification extracted from the document Employing and supporting specialty doctors: a guide to good practice (PDF)

    SAS guidance on pay progression - schedule 15 paragraph 6

    This guidance specifically relates to schedule 15 (Pay Progression through Incremental Points and Thresholds), paragraph 6, of the Terms and Conditions – Associate Specialist (England) 2008 and Terms and Conditions of Service – Specialty Doctor (England) 2008.

    Schedule 15 paragraph 6 describes the process for passing through threshold one on the salary scale, stating that doctors will pass through this threshold unless they have demonstrably failed to comply with certain criteria, one of which is undertaking 360-degree appraisal/feedback (in the year preceding threshold one).

    As 360-degree appraisal/feedback is a requirement of revalidation, it may be possible that this has taken place, but more than one year ago. The pay progression process should be fair and clear, as straightforward as possible to implement and neither the process nor the gathering and demonstrating of evidence should be onerous.

    With this in mind, it has been agreed that employers have the discretion to take into account 360-degree appraisal/feedback undertaken more than one year ago, for the purpose of satisfying the criteria for progression through threshold one.

    This does not mean that these doctors do not need to have participated satisfactorily in the annual appraisal process, this remains separate criteria for progressing through threshold one. This guidance simply allows employers to use discretion when considering 360-degree appraisal/feedback that has not taken place within the preceding year.

    The same principle applies to progression through threshold two, as set out in schedule 15 paragraph 7a.

    FAQs

    These frequently asked questions (PDF) (published in July 2009 and updated last in March 2018) on the SAS contracts have been updated in agreement with the British Medical Association (BMA).

Associate specialist pre-2008

  • Grade [grade code]

    Associate specialist pre-2008 [MC01]

    This grade is closed to new entrants.

    Associated documents

    Terms and conditions of service

    Terms and conditions of service NHS Medical and Dental Staff (England) 2002 (Version 10, March 2013) (PDF)

    Additional information

    In 1981 the Department of Health and Social Security issued PM (81) 16 (PDF) which contains a recommended form of contract for associate specialists. In November 1991 the NHS Management Executive issued guidelines relating to terms and conditions of service for doctors in the associate specialist grade HSG (91) 18 (PDF). In addition, the Executive announced the delegation of procedures for appointment to the associate specialist in the medical specialties EL (91) 150 (PDF). In 1995 employers were notified of new arrangements for the payment of Discretionary Points to associate specialists AL (MD) 7/95 (PDF). The NHS Executive also produced EL (97) 25 (PDF), a working draft to develop a quality framework for HCHS medical and dental staffing. Annex 2 of this document contains guidance on appointments to the associate specialist grade.

Staff grades

  • Grade [grade code]

    Staff grade [MH01]

    Staff grade [MH03]

    Staff grade [MH05]

    These grades are closed to new entrants.

    Associated documents

    Terms and conditions of service

    Terms and conditions of service NHS Medical and Dental Staff (England) 2002 (Version 10, March 2013) (PDF)

    Additional information

    In 1988 the Department of Health and Social Security issued a circular giving guidance on arrangements for the employment of hospital medical and dental staff on the then new staff grade HC (88) 58 (PDF) and annexes (Word). From October 1997 new terms and conditions of service for the staff grade were outlined by the NHS Executive AL (MD) 4/97 (PDF).

Senior clinical medical officer (SCMO)

Clinical medical officer (CMO)

Hospital practitioner

  • Grade [grade code]

    Hospital practitioner [MD01]

    Hospital practitioner [MD02]

    Hospital practitioner [MD11]

    Hospital practitioner [MD21]

    Hospital practitioner [MD31]

    Hospital practitioner [MD41]

    The hospital practitioner grade is closed to new entrants.

    Associated documents

    Terms and conditions of service

    Terms and conditions of service NHS Medical and Dental Staff (England) 2002 (Version 10, March 2013) (PDF)

    Additional information

    In 1979 the Department of Health and Social Security issued guidelines setting out arrangements for the employment of hospital practitioners HC 7916 (PDF). In 1993 the NHS Executive issued summary guidance amending these arrangements HSG (93) 50 (PDF).

Clinical assistant (part-time medical/dental officer)

Consultant pre-2003

  • Grade [grade code]

    Consultant pre-2003 [MC21]

    Consultant pre-2003 [KC11]

    Consultant pre-2003 [LC01]

    Consultant pre-2003 [LC10]

    These terms and conditions are closed to new entrants. New appointments to the consultant grade should be made on the 2003 TCS.

    Associated documents

    Terms and conditions of service

    Consultants who were appointed before 31 October 2003 and who have opted not to transfer to the 2003 contract will remain employed on the Terms and Conditions of Service NHS Medical and Dental Staff (England) 2002, below. 

    Terms and Conditions of Service NHS Medical and Dental Staff (England) 2002 (version 10, March 2013) This handbook sets out the Terms and Conditions of Service for hospital medical and dental staff and doctors in public health medicine and the community health service. It supersedes the handbook issued in 1994, and incorporates all amendments agreed between the Secretary of State and the medical and dental professions as at 31 March 2013.

    Record of amendments

    Record of amendments to the TCS (31 March 2008 to date) (PDF)

Doctors and dentists in training pre-2016

  • Grade [grade code]

    Foundation doctor year 1 [MN13]

    Foundation doctor year 2 [MN15]

    Specialty registrar (core training) [MN39]

    Specialty registrar (FT) [MN35]

    Specialty registrar (full) [MN37]

    Senior house officer [MN21]

    Dental core training [MN21]

    Dental core training [KA01]

    Dental core training [LF21]

    Specialist registrar [MN25]

    Specialist registrar [KA31]

    Specialist registrar [LF25]

    These terms and conditions are closed. All doctors or dentists in training in England (other than dental foundation trainees, who are employed on different arrangements) should now be employed on the 2016 TCS. However, the 2002 TCS documentation remains available for reference.

    Associated documents

    Terms and conditions of service

    Terms and Conditions of Service NHS Medical and Dental Staff (England) 2002 (version 10, March 2013) (PDF). This handbook sets out the Terms and Conditions of Service for hospital medical and dental staff and doctors in public health medicine and the community health service. It supersedes the handbook issued in 1994, and incorporates all amendments agreed between the Secretary of State and the medical and dental professions as at 31 March 2013.

    Model contract

    Model contract (Word) for hospital medical and dental staff in training - September 2008. This superseded annex C of AL(MD)1/2001.

    Record of amendments

    Record of amendments to the TCS (31 March 2008 to date) (PDF)

    Record of amendments to the contract (PDF)

    Other documents

    AL(MD)1/2001 & Annex A (PDF) - Letter authorising changes to the national pay and Terms and Conditions of Service

    AL(MD)1/2001 Annex B (PDF) - Amendments to the Terms and Conditions of Service

    PM(81)30 (PDF) - General guidance including recognition of service outside the NHS

    Junior doctor banding questionnaire

    When the junior doctor contract was introduced in 2000 a banding questionnaire with an accompanying glossary was used in order to assess the correct banding supplement payable under the new system. This document remained applicable to full time trainees under the 2002 junior doctor contract and employers were encouraged to refer to the document when assessing banding supplements. View the banding questionnaire (PDF) document.

    Less-than-full-time (LTFT) training arrangements

    A different approach to LTFT was introduced in June 2005. This approach recognised the need to integrate an increasingly important mode of training into mainstream medicine and endeavoured to make LTFT more affordable for employers. It combined better support for LTFT trainees with an equitable pay structure to make employing LTFT doctors more accessible and more attractive to employers.

    Dental trainees

    Dental core training

    Prior to 2016, dental core trainees (previously known as Dental SHOs) were employed on the 2002 TCS as per the documentation above. Alongside this, separate arrangements were in place to ensure that total pay did not decrease on entry to core training. These arrangements are no longer in place for any dental trainees, but if needed for historic pay queries, please contact our team who can talk through the detail of these arrangements.

    Dental core trainees should now be employed on the 2016 TCS.