SAS contract 2021 FAQs
21 January 2025
These FAQs have been agreed and updated with the British Medical Association (BMA).
These frequently asked questions (FAQs) on the specialty doctor and specialist grade contracts have been updated in agreement with the British Medical Association (BMA).
*Where the term ‘specialist’ is used in this web page, it is used to denote doctors and dentists employed on the specialist grade (England) 2021 contract.
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1.1 What happens to incremental dates when transferring from the 2008 to 2021 contracts? Will these change?
No, everyone will retain their existing incremental dates, but this will now be called the pay progression date. For new entrants to the NHS, their pay progression date will be the date that they commenced employment in the grade.
1.2 Where should we place doctors who are appointed to a role from abroad on the new pay scales?
As was already the case under the 2008 specialty doctor contract, employers may set basic salary at a higher pay point than the bottom of the pay scale to recognise non-NHS experience in the specialty at an equivalent level. It will be for employers to determine whether an applicant’s experience is equivalent to that of the specialty doctor or specialist roles, in line with existing national guidance for the roles.
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2.1 Is it expected that staff will successfully progress through their pay progression points?
Yes. Employers should plan and budget on the basis that all SAS doctors are expected to progress on time. The exception will be where an individual has not met the criteria for progressing to the next pay point, and there are no mitigating factors sufficient to justify this. Schedule 15 covers situations where progression may be delayed. Employers have a responsibility to ensure that doctors have the support needed to enable them to meet the requirements for incremental and career progression.
2.2 If automatic annual progression in ESR is being turned off, is it possible to turn it back on again locally?
No, from 1 April 2023, automatic progression ended for all SAS doctors on the 2021 contracts and employers will have to follow a process to ‘switch on’ pay progression for individuals.
2.3 What happens if someone is off on sick leave or maternity leave when their pay progression is due?
The law prevents anyone from being treated less favourably in certain circumstances, for example if they are on maternity leave. Schedule 15 sets out the process to follow when a SAS doctor is absent from work when their pay progression is due.
2.4 How long should it take to progress from the bottom to the top of the specialty doctor or specialist pay scales?
The minimum length of time it should take to progress from the bottom to the top of the Speciality Doctor pay scale is 12 years, subject to individuals meeting progression criteria. For the specialist grade, this is six years subject to meeting progression criteria.
2.5 Can organisations let SAS doctors get to top of the pay scale more quickly than the minimum periods set out?
No, allowing people to progress more quickly would undermine the principles of the pay system and place additional unfunded costs on to the employer.
2.6 How will the pay progression system work when SAS doctors move employers?
A SAS doctor’s pay progression date will remain the same and move with them to the new employer. If a doctor moves to a new employer shortly before pay progression is due, the new employer will be expected to carry out the review required, within three months of the date that the doctor begins work for the new employer. If progression is granted, pay shall be backdated to the pay progression date. ESR will ensure relevant information is recorded on to the system and included in Inter-authority transfer (IAT) information.
2.7 Does an informal process or investigation into capability or conduct count as a reason to defer pay progression?
No, the progression criteria explicitly references formal capability processes and disciplinary sanctions, setting out the circumstances in which these can be reasons for deferring pay progression. These note that the specifics of such processes are set out in local policy, though such policies will need to take account of the provisions of the Maintaining High Professional Standards framework to which doctors and dentists in the NHS continue to be subject.
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3.1 Should the 60 per cent in hours and 40 per cent out of hours be calculated in hours or PAs?
Schedule 4, paragraph 11 of the SAS terms and conditions states:
The majority (that is, no less than 60 per cent) of work should normally take place in standard working hours being 7am to 9pm Monday to Friday, rather than in out of hours (OOH) which is 9:01pm to 6:59am Monday to Friday and all day Saturday and Sunday, unless otherwise mutually agreed.
Where existing job plans contain in excess of 40 per cent of work in OOH, the employer and doctor will work towards decreasing the percentage each year until a limit of 40 per cent is reached, unless otherwise mutually agreed.
The 60/40 per cent split should be calculated accordingly to ensure that it meets all contractual safeguards and will be determined locally. Examples are provided below for illustrative purposes.
Job planning is based on a partnership approach and confirmation of working hours should be mutually agreed upon at the job planning meeting and then reviewed at annual or interim meetings.
Example 1 - Calculating in hours.
36-hour job plan with 12 hours worked within the hours of 9:01pm to 6:59am Monday to Friday and all day Saturday and Sunday (out of hours) and 24 hours worked within the hours of 7am to 9pm Monday to Friday.
To calculate the out-of-hours percentage, divide the out-of-hours total by the total number of hours worked and then multiply by 100.
12/36*100=33.3% As this is lower than or equal to 40% this meets the safeguard requirement.
Example 2 - Calculating in programmed activities (PAs).
10 PA job plan with 4 PAs worked within the hours of 9:01pm to 6:59am Monday to Friday and all-day Saturday and Sunday (out of hours) and 6 PAs worked within the hours of 7am to 9pm Monday to Friday.
To calculate the out of hours percentage, divide the out-of-hours PAs by the total number of PAs and then multiply by 100.
4/10*100=40% As this is lower than or equal to 40% this meets the safeguard requirement.
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4.1 Will it be for employers to fund the new specialist posts themselves or will this be funded centrally?
Employers will be expected to use their overall allocations to fund new specialist posts themselves. The modelling for the SAS deal took into consideration the expected creation of new specialist grade posts in organisations using workforce data from the past 10 years and a survey of employers describing their intended use of the new grade.
4.2 What is the entry criteria to the new specialist grade?
The entry criteria for a doctor/dentist requires:
- full registration and a licence to practice with the General Medical/Dental Council.
- a minimum of 12 years medical/dental work (either continuous period or in aggregate) completed since obtaining a primary medical/dental qualification, of which a minimum of six years should have been in a relevant specialty in the specialty doctor and/or closed SAS grades. Equivalent years’ experience in a relevant specialty from other medical/dental grades including from overseas will also be accepted.
- To meet the criteria set out in the Specialist generic capabilities framework.
4.3 What is the specialist grade generic capabilities framework and how should it be used?
The specialist generic capabilities framework has been developed in partnership between the Academy of Medical Royal Colleges, the British Medical Association and NHS Employers. All the capabilities listed in the Framework are taken from the General Medical Council’s Generic Professional Capabilities Framework. It outlines the core capabilities and skills expected across all specialties for safe working practices at this senior level. Doctors/ dentists will need to evidence they meet these criteria in order to successfully enter the grade.
The framework is intended to support employers to create individual person specifications, which will be tailored to the specific requirements of the role. As the overarching framework is generic in content, any specialty-specific, practical or surgical skills that are required will need to be defined in the person specification. A template person specification to help employers develop a clear description of the requirements for an individual role has also been produced.The appointment process for the specialist grade will not be incorporated into the TCS; support on how to appoint to these roles will be provided in guidance. This will include engagement with the medical and dental Royal Colleges.
4.4 How is the entry criteria structured in the generic capabilities framework?
The entry criteria is detailed in the generic capability framework under the following themes:
- professional values and behaviours, skills and knowledge
- leadership and teamworking
- patient safety and quality improvement
- safeguarding vulnerable group
- education and training.
4.5 How are the medical Royal Colleges and the faculties supporting this process?
The Academy of Medical Royal Colleges, the British Medical Association and NHS Employers have agreed to work together on the appointment of staff to ensure that the highest standards of professional medical practice in NHS employing organisations are maintained in the interests of patients and the quality of care provided by those organisations. The parties agree that independent professional medical advice has an important role to play in the ability of NHS employing organisations to make the best possible appointments to the newly formed Specialist grade.
The appointments process should include external input from the relevant Royal College, the details of which are set out in a formal concordat jointly agreed between the parties. The concordat confirms the process for developing Specialist person specifications and the recruitment and involvement of Royal College/Faculty assessors in the appointment process.4.6 How is a person specification for a new specialist grade created?
The clinical lead from the employing organisation should draw up the person specification using the person specification template provided, identifying more specialty-specific capabilities that may be required and the evidence needed to support these through a review of the relevant part(s) of the college or faculty curricula. Where the clinical lead judges that further input is required, they should look to work with the college or faculty’s regional adviser (or equivalent) in developing this person specification and reviewing the curricula. The clinical lead should inform the employer position on the relevant sections of the curricula and the appropriate levels of competence that would need to be reached, considering the advice offered by the college or faculty’s regional adviser (or equivalent) where this has been sought.
Where there is an accepted national standard or statutory requirement for a specialty-specific competence (for example, child protection), this should be stipulated in the person specification and will need to be demonstrated by candidates to the appropriate level.
4.7 Determining which capabilities are ‘key’ for the post and those that are ‘required but not key’
As all the capabilities listed in the Framework are taken from the General Medical Council’s Generic Professional Capabilities (GPCs) Framework, they are required of all doctors. We expect most capabilities listed will be key for the posts, but some may not be as relevant in certain roles, e.g. where there is no active involvement in formal research or teaching and training. Rather than using the language ‘essential’ or ‘desirable’ in the template person specification, all capabilities should therefore be categorised by the employer as ‘key for the role’ or ‘required but not key’. For those which are ‘required but not key’, the same depth or level of expertise may not be needed.
Capabilities listed should not be removed by employers in developing individual person specification. However, some may need to be amended or contain additions to reflect specialty-specific skills. If, in certain instances, an employer considers a capability ‘not applicable’ they should indicate this and, in the interests of transparency, explain their decision.
4.8 How should employers use the person specification template for a new specialist grade post?
The capabilities framework for the new specialist grade have been created using the General Medical Council’s (GMC) Generic professional capabilities framework. The GMC’s framework sets out the essential generic capabilities needed for safe, effective and high quality medical care in the UK and is required of all doctors.
The expectation is that the majority of capabilities listed in the framework for the new specialist grade would be considered key for the role, but it is the employer’s responsibility to ensure that the depth of knowledge and expertise required is appropriately reflected in the person specification, which will be based on the specific requirements of the post being created.
In addition to consulting the relevant college/faculty curriculum to support the development of the person specification, employers should refer to the ‘notes on person specification template - examples of specialty-specific criteria and guidance for reference’. This supporting document provides illustrative examples indicating where specific capabilities may need to be amended or strengthened for particular specialties.4.9 When considering the capabilities in respect of professional values and behaviour, skills and knowledge there is a requirement to clinically evaluate and manage patients (ref 1.3). What is meant by the term ‘appropriate management plan’?
This refers to the plan for treatment of the patient and depending on the nature and responsibilities of the role, can include decisions about discharge and discharge planning, referral and follow ups as appropriate.
4.10 What is the rationale for a minimum of 12-years medical/dental work (since obtaining a primary medical/dental qualification, of which a minimum of six years should have been in a relevant specialty in the specialty doctor and/or closed SAS grades) to be set as entry criteria to the new grade?
Employers needed to ensure that progression from the resident doctor grade to the consultant grade remains an attractive career pathway. Setting the criteria to below 12 years to enter the new specialist Grade would most likely create unwelcome incentives that could encourage resident doctors into that grade rather than progressing to a consultant grade. Employers also wanted to ensure that the specialty doctor is viewed as a destination grade with attractive pay scales. Reducing the entry requirement to below 12 years would mean that the specialist grade would be a financially attractive option part way through the specialty doctor grade. Additionally, entry into a consultant post requires a minimum of 10 years of experience through the training pathway. Completion of the training pathway (CCT secured) is not a requirement to enter the specialty doctor or specialist grades, so it is reasonable to extend the entry criteria in recognition of the different training pathways undertaken.
4.11 If an assessor is not available, how should an employer ensure that their appointment processes are robust enough to secure suitable appointments to the grade?
Input from the Royal Colleges is beneficial for all parties and should be included early in the recruitment process to secure the appropriate input and time commitment. Where no assessor is available local arrangements should be made to secure the appointment of suitable candidates.
4.12 What happens if the appointed assessor has concerns about how the employer has applied the capabilities framework to inform the development of the person specification?
Any concerns on the grounds of patient safety will need to be directed to the employer for local resolution. Since the role of the Royal Colleges is to provide advice, their views may sometimes differ from those of the employing organisation, but we find that discussion should enable a mutually satisfactory agreement, facilitating a good appointment.
4.13 Will a substantive specialty doctor be at risk if a specialist post is created at their current employer, and their application for the post is not successful?
This will not be the case. As set out in FAQ 4.1 above, employers will be expected to use their overall allocations to fund new specialist posts themselves.
Discussions about the creation of specialist roles should be about the need to redesign the workforce according to service needs, not about employing fewer specialty doctors. For example, if there is a locum consultant post, this could be disestablished and a permanent specialist role established.
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5.1 How do the transitional arrangements work?
The process of transition for existing SAS doctors currently on national contracts is set out in Schedule 20 of the 2021 speciality doctor and specialist contracts.
5.2 If a doctor transfers to one of the 2021 contracts what happens to their incremental date?
The incremental date will not change, but it will now be called their pay progression date.
5.3 Will doctors on local or trust grade contracts be able to move to the 2021 SAS contracts?
The negotiations did not cover those doctors who are on local or trust grade contracts and the costs of transferring these doctors have not been factored in the modelling. We hope that the new contract package will be sufficiently attractive for employers to offer to those on local contracts. However, there is no obligation for employers to offer this contract to those not already on national contracts and there is no obligation for any individual to accept the new contracts.
5.4 Can an associate specialist move to the specialist contract after the six-month window of opportunity?
For associate specialists wishing to transfer to the specialist contract after 30 September 2021, Schedule 20, Paragraph 7 of the specialist terms and conditions applies. This states that they will not be eligible to transfer via the provisions in the schedule. Instead, any transfer to the specialist terms and conditions will be at the discretion of employers and salary will be determined subject to paragraphs 4-8 in Schedule 12. In these circumstances, the doctor will not be eligible for backdating of contractual terms and salary to 1 April 2021.
5.5 Can a specialty doctor move to the 2021 specialty doctor contract after the six-month window of opportunity?
The choice window ended on 30 September 2021 and at that time, few doctors had expressed an interest to move to the new contract. This response by doctors was compounded by a 3 per cent pay uplift being applied to the 2008 contracts in 2022, as it removed the financial incentive to transfer for the majority of doctors. It was then agreed by the joint negotiating committee for specialty and specialist doctors (JNC SAS) that from 9 June 2022, doctors employed on the 2008 specialty doctor grade or on closed SAS grades in England and Northern Ireland will have the contractual right to transfer to the 2021 specialty doctor contract during any time in their employment. This is set out in Schedule 20, Paragraph 14 of the specialty doctor terms and conditions of service. The salary of a doctor transferring to these terms and conditions will be determined subject to paragraphs 4-8 in Schedule 12 and the doctor will not be eligible for any backdating of salary.
This was put in place to ensure that both doctors and employers are able to benefit from the new contractual provisions. Should doctors change employer, the 2008 contract will no longer be available; therefore, the 2021 contract will apply from the date of commencement to the new employer.
5.6 How will contracts for clinical medical officers (CMOs), senior clinical medical officers (SCMO’s), hospital practitioners (HPs) and clinical assistants (CAs) be rebased to the 2021 specialty doctor contract?
Full-time CMOs/SCMOs work 37 hours per week so if they are wanting to transfer to the 2021 specialty doctor contract, their contracts will need to be rebased to 40 hours.
From 9 June 2022, as set out in Schedule 20, paragraph 6, the salary of a doctor transferring to the 2021 terms and conditions will be determined subject to paragraphs 4-8 in Schedule 12.
If the doctor chooses to remain on a 37-hour contract their pay will be calculated at 37 hours instead of 40 (0.93 WTE) and they will be offered a proportionate number of programmed activities (PAs), and their salary will be pro-rata to that of a full-time doctor. -
6.1 If an employer is offering a secondment opportunity to a SAS doctor, for example to allow them to gain further experience to support them in CESR processes, under what contractual arrangements should they be employed?
It will be for an employer to decide on what the terms the secondment is being offered. The simplest option, to facilitate their clinical activity and to ensure that there are no concerns about indemnity or clinical governance, is to offer an honorary contract that is aligned with the terms of the 2021 specialty doctor or specialist contracts.
6.2 What will happen with SAS doctors’ development fund from 2024/25 onwards?
NHS England has confirmed that the level of funding made available in 2023/24 will be included in baselines for setting future allocations, but there is no specific requirement for this to be allocated to SAS doctor development.
Employers do have the option to use this funding to continue to invest in supporting professional development of SAS doctors, and we would encourage this.
Further information can be found within our SAS doctor development funding guidance.
