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:

• weekend clinics and extra lists 
• additional shifts 
• waiting list initiatives. 

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. 

During doctors' recent industrial action, the British Medical Association (BMA) published recommended minimum rate cards for doctors to use or consider when considering agreeing to extra-contractual work requests. As part of the pay deals for doctors and dentists in training, SAS, and consultants, the BMA agreed to withdraw their rate cards in England with immediate effect following acceptance of each pay offer.  

As part of the deals for SAS and consultant doctors agreed by the government, 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.  

Employers are advised to consult with the relevant local trade union representatives via established JLNC or equivalent before publishing new rates for extra-contractual work.