Consultant doctors and dentists pay progression system guidance

The new pay progression arrangements

New arrangements will be introduced to the process authorising progression through pay points from 1 April 2025.

It will be the norm for consultants to achieve pay progression and the intention is not to prevent consultants who are achieving expected standards from moving through the pay scale. This process will simply ensure consistency of approach and a minimum standard for progression.

From 1 April 2025, progression to pay points which result in a change of salary will be closed on the payroll system. Once the pay progression meeting has been successfully completed and the doctor has met the criteria, it is the responsibility of the clinical manager to take the necessary action to open the pay point and ensure the consultant moves to the next pay threshold.

The one exception to this is that no pay progression review meeting will be required for progression from Pay Point 2a to Pay Point 2b.

If the clinical manager feels the criteria have not been met this is escalated to the medical director to decide appropriate next steps. If the medical director disagrees and feels the criteria have in fact been met, they will inform the clinical manager to take the necessary action to open the pay point and ensure the consultant reaches the next pay threshold. If the medical director upholds the decision of clinical manager, the pay point will remain closed, and the consultant will not progress to the next pay point. Pay progression is delayed by one year and will be reviewed before the next incremental date.

The medical director may have an alternative title at different organisations, such as chief medical officer. They are identified as being the most senior medical director of the organisation. 

A consultant has the right of appeal against a decision by the medical director that they have not met the criteria in respect of any given pay progression year. In the event of an appeal, it will be the responsibility of the employing organisation to show why this decision was taken.

There will be no loss of pay incurred as a result of a delayed decision on pay progression. 

Should the outcome of the determination of the pay progression criteria be challenged and taken to appeal, the decision of the appeal panel is final. If the panel deems that the consultant has met the pay progression criteria, the consultant will advance to the next pay threshold with payment of back pay to the relevant incremental date. If the panel upholds the medical director’s decision, the consultant will remain on their current pay point but will be eligible for pay progression if they meet the criteria at their next incremental date (that is, no later than 12 months after they were first eligible for pay progression).

Clinical academics

Consultant clinical academics work in higher education institutions (HEIs) in a teaching and/or research role, as well as practising clinically in the NHS. They are jointly employed by HEIs and by partner NHS trusts (or other health bodies), on linked substantive and honorary contracts. 

The pay progression meeting for consultant clinical academics should apply the Follett principles; both the university and NHS employer should work in partnership to complete the pay progression meeting and actions following the meeting outcome.

The guidance describes the process and notifications for organisations that use ESR. Organisations that do not use ESR will not have automated pay progression meeting notifications enabled. Monitoring of pay progression dates for clinical academics will need to take place and meetings will need to be arranged three to six months before the pay progression date and with six-weeks' notice before the meeting. 

If mutually agreed by all, the pay progression meeting may be held immediately after the job planning meeting. The clinical and academic managers will decide if the consultant clinical academic has met the criteria for pay progression. The clinical or academic manager will need to ensure that the relevant pay system has been updated to allow the clinical academic to move to the pay-effecting increment. 

NHS Employers web page Guidance for employing clinical academics provides more information on Follett principles.

Process for pay progression (from 1 April 2025)

Meeting notice period and transitional considerations

Meeting notice period

The meeting should take place six months but no later than three months prior to the consultant’s next pay progression date. The employer will notify the consultant six weeks before the meeting and shall take lead responsibility for arranging the meeting. This allows for sufficient time for any issues to be addressed before the pay progression date and ensures pay roll can take any necessary action to ensure the new pay values are applied on time.

Transitional arrangements

Pay progression notifications from ESR will commence from 1 April 2025. Therefore, those consultants with pay progression dates from 1 April 2025 to 1 May 2025, will not receive notifications before their pay progression date. Consultants with pay progression dates from 1 May 2025, will receive at least one notification. 

Where a pay progression review meeting was not held with sufficient notice, due to the lack of automatic ESR notifications, this should be taken into consideration as part of the pay progression meeting discussion.

Employers are to commence pay progression review meetings before the 1 April 2025 implementation date. Consultants with pay progression dates from 1 April 2025, will need a pay progression meeting three - six months before.

Pay progression process

The pay progression process will be as follows:

• The consultant and the clinical manager will receive notification six months, three months and one month before the consultant’s next pay progression date. The clinical manager will initiate a pay progression review meeting, giving six weeks’ notice, to review whether the requirements for progression have been met. The pay progression meeting may be held immediately after the job planning meeting if it is mutually agreed. 
• The standardised form in Appendix A will be used in electronic or paper format to document this process and should be signed by the clinical manager and the consultant. 
• This will then be used as the basis for confirmation of movement to the next pay point.
• Employers must ensure that the pay progression submission process is completed in a timely fashion to ensure that pay progression can be implemented in time for the doctors pay progression date.

Further details on progression can be found in Schedule 15 of the Terms and Conditions – Consultants (England) 2003.

For illustrative purposes, this flow chart sets out the responsibilities of the employer, consultant, clinical manager, medical director and chief executive. 

Pay progression meeting outcome

There are three outcomes from the pay progression meeting:

Pay progression is achieved/approved.

The consultant has met all of the criteria or has not met one or more criteria due to reasons beyond the consultant's control.

Pay progression is achieved/approved. subject to the completion of remedial action.

The consultant has not met one or more of the criteria and remedial action is agreed upon and can be achieved before the pay progression date. All other criteria have been met or have not been met due to reasons beyond the consultant's control. If the remedial action is completed, the consultant will progress at their pay progression date.

Action following achieved/approved pay progression

it will be the responsibility of the clinical manager to take the necessary action on the NHS pay system to open the pay point when the criteria have been met. This will normally be on the ESR system, where employers do not use ESR it will be their local pay system.

Pay progression has not been met.

The consultant has not met one or more of the criteria and remedial action cannot be completed before the pay progression date.

In the event of pay progression not being met the clinical manager and the consultant will agree an action plan, with timescales, to set out how the consultant can meet the criteria. Another pay progression meeting should be arranged six months but no later than three months before the consultant’s next incremental date. If the consultant has met all the criteria (or has not met criteria, but for reasons beyond their control), they will progress to the next pay point on the incremental date. (i.e. one year after they were initially eligible for pay progression).

Moving employers

If a consultant is due to move employers and the pay progression meeting is due within six months of their last working day, the pay progression meeting shall take place before the consultant moves to their new employer. 

The completed Annex 1 - pay progression review meeting record template will be sent to the new employer. 

Pay progression criteria

The pay progression requirements are set out below:

• made every reasonable effort to meet the time and service commitments in the job plan
• participated satisfactorily in the appraisal process
• participated satisfactorily in reviewing the job plan and the setting of personal objectives; (including any service and quality improvements, or teaching and training) that may have been agreed as personal objectives
• met the personal objectives in the job plan, or where this is not achieved for reasons beyond the consultant’s control, made every reasonable effort to do so
• worked towards any changes agreed in the last job plan review as being necessary to support achievement of the employing organisation’s objectives
• taken up any offer to undertake additional programmed activities that the employing organisation has made to the consultant in accordance with Schedule 6 of these terms and conditions
• met the standards of conduct governing the relationship between private practice and NHS commitments set out in Schedule 9
• engaged and participated with statutory and mandatory training or where this is not achieved for reasons beyond the doctors’ control, made every reasonable effort to do so
• no disciplinary sanctions active on the doctor’s record
• no formal capability processes ongoing.

The expectation is that all consultants will meet the required criteria and will therefore be able to progress on their pay progression date. 

Progression cannot be withheld due to financial or other non-performance related issues. Withholding progression shall not be used as a means to coerce a consultant into agreeing a proposed job plan. The absence of an agreed job plan owing to reasons beyond the consultant's control, or an open job-plan dispute process will not prevent pay progression. Where the job plan has not been agreed, it is the onus of the employer to work with the consultant to agree a job plan as soon as is practicable. The job plan is agreed between the consultant and their clinical manager as per the terms of Schedule 3.

Employers should ensure that all consultants can utilise systems that detail their competency requirements for statutory and mandatory training (via ESR functionality or locally managed system). This will assist with the take-up of training in preparation for pay progression meetings.

Consultants should be given the appropriate time and resource to meet the pay progression criteria.

Where a doctor disputes a decision that they have not met the required criteria to progress to the next pay point, the appeal process at Schedule 4 of the terms and conditions should be followed and will be varied in the following way: For determination of the pay progression criteria, the decision of the appeal panel is final. If the panel deems that the consultant has met the pay progression criteria, the consultant will advance to the next pay threshold with payment of back pay to the relevant incremental date. If the panel upholds the medical director’s decision, the consultant will remain on their current pay point but will be eligible for pay progression if they meet the criteria at their next incremental date (that is, 12 months after they were first eligible for pay progression).

Where a criterion has not been achieved for reasons beyond the consultant’s control, the consultant will not be prevented from progressing onto the next pay point if the other criteria have been met. This includes where remedial action is not possible before the pay progression date for reasons beyond the consultant’s control.

Trusts must make every effort to ensure the pay progression process is fair and in line with relevant equalities legislation as well as with NHS’ Medical Workforce Race Equality Standard (MWRES) and Equality and Diversity and Inclusion improvement plan. Employers should engage in equalities monitoring of pay progression outcomes. 

If a doctor is absent from work for reasons such as parental or sickness leave when pay progression is due, the principle of equal and fair treatment should be followed so that no detriment is suffered as a result.   

In the case of planned long-term paid absence such as maternity, adoption and shared parental leave the pay progression review can be conducted early if this is reasonable and practical, allowing the pay progression to be applied on their pay progression date in their absence. If a pay progression review cannot be conducted prior to the pay progression date, pay progression should be automatically applied in the individual’s absence from the pay progression date.

Employers and doctors will be expected to identify problems affecting the likelihood of pay progression as they emerge to allow time for possible solutions to be found. 

Capability processes

It is recognised that capability and disciplinary process can have a significant impact on the health and wellbeing of doctors who are being investigated. Employers have a duty of care to do everything they can to ensure that such process are conducted in a timely manner and that there are no unnecessary delays. 

In instances where pay progression has been withheld due to an ongoing capability process, this must be kept under regular review. If the process does not find any significant cause for concern, pay progression should be actioned without delay and back pay should be paid where applicable. The pay progression review meeting should take place six months but no later than three months prior to the consultant’s next pay progression date. Such a review must include appropriate details of why pay progression was withheld and outline the reasons why the process has not been concluded. 

Electronic Staff Record (ESR)

The below table demonstrates the structure of the pay scale and codes. The most recent values at each pay point can be found in the Medical and Dental pay circulars on NHS Employers web page.

Pay progression review template