SAS contract reform 2021

This page contains information on the outcome of negotiations to revise the specialty doctor grade and introduce a new specialist grade.

Welsh Government, NHS Wales Employers and BMA Cymru Wales have agreed to provide pay continuity for specialty doctors who choose to move to the new 2021 specialty doctor contract before the end of the window of opportunity on 30 November 2021.

During negotiation, it was a shared aim in designing the transitional pay scale that no doctor would see a reduction in basic pay during the transitional period as a result of choosing to transfer to the new contract. However, following the 2021/22 pay award, we have noted that on a few points on the scale some specialty doctors would experience a nominal reduction in basic pay upon transfer.

In order to ensure that the contract deal remains attractive to as many specialty doctors as possible and that the immediate prospect of nominal loss of basic pay does not provide a barrier to specialty doctors accessing the other benefits of the new contract, including higher career-average pay, it has been agreed that specialty doctors who choose to transfer to the new contract will benefit from either a higher salary on transfer or continuity of their current salary if their current level of pay is higher than the transition salary as set out in the new 2021 contract pay scales.

This will take place both before and after the individual’s 2021/22 pay progression date. To support this a pay modelling tool has been developed and this will reflect these changes and support specialty doctors in their consideration of the new contract during the choice window which is open until 30 November 2021.

NHS Wales Employers has been working with the British Medical Association Cymru Wales (BMA) and Welsh Government since February 2020 alongside colleagues from NHS Employers in England and from Northern Ireland to formally negotiate a revised Specialty Doctor grade and introduce a new Specialist grade.

In January 2021, an agreement was reached which covers a three-year agreement from 1 April 2021 to 31 March 2024 for a reformed Specialty Doctor contract and a new Specialist contract. In March, the British Medical Association Cymru Wales (BMA) members voted in favour of the new contracts and it has now been approved by Welsh Government.

The new contracts will apply to new staff to the SAS grades from 1 April 2021 and to SAS doctors being employed on new contracts from that date forwards. Current SAS doctors employed on national terms and conditions of service will be given the option to transfer to the equivalent revised terms and conditions or remain on current terms and conditions.

Key parts of reform include:

  • The introduction of a new grade named the Specialist grade, which will provide an opportunity for progression for highly experienced specialty doctors. The introduction of the role will help to recruit, motivate and retain senior doctors and contribute to SAS grades being a positive and fulfilling career choice. The creation of these roles will be driven by local employer need to meet service requirements and will be advertised for competitive entry through local recruitment processes.
  • A reformed Specialty Doctor pay structure to move from an 11 point pay scale to a 5 point pay scale. The new pay structure will enable SAS doctors to access the top of the pay scale more quickly than the current system, increasing the career average earnings.
  • A new pay progression system that will link progression to the development of skills, competencies and experience through the processes of job planning, appraisal and mandatory training. Pay progression will no longer be automatic and will only be achieved where the required standards have been met.
  • A number of safeguards and additional provisions to support the health and wellbeing of SAS doctors.
  • A number of changes to modernise the terms and conditions of service to make sure that they are fit for purpose under a changing NHS to support the demands of patient care and to ensure services can be delivered.

The framework agreement sets out both the changes to pay structures and the terms and conditions of service that the 2021 Specialty Doctor and Specialist contract will adopt that employers, British Medical Association Cymru Wales (BMA) and the Welsh Government are agreeing to implement over the period of the agreement and going forward.

  • Read the frequently asked questions (FAQs) on the Specialty Doctor and Specialist grade contracts.

  • The list of resources below relate to the 2021 terms and conditions and model contracts.

    Other resources for the 2021 contract can be found from the links on the main SAS contract reform page.

    Old terms and conditions

    The terms and conditions and guidance for Specialty Doctors on the 2008 contract, Associate Specialists and other closed SAS grades are on the old terms and conditions page.

  • A key element of the SAS contract reform is the introduction of a new grade, called the Specialist grade, which will provide an opportunity for career progression for highly experienced specialty doctors. The introduction of this new grade will help to recruit, motivate and retain senior doctors and contribute to SAS grades being a positive and fulfilling career choice.

    Stakeholders across the system have contributed to defining the scope of practice of the role, including the roles and responsibilities, how the role differs from existing medical roles and the benefits the new role will offer to doctors, employers and patients.  

    The creation of these roles will be driven by local employer need to meet service requirements and will be advertised for competitive entry through local recruitment processes. It is not a regrading process for existing specialty doctors.

    A generic capabilities framework for the specialist grade has been developed in partnership between the Academy of Medical Royal Colleges, the British Medical Association and NHS Employers. It outlines the core capabilities and skills expected across all specialties for safe working practices at this senior level. The terms and conditions for the Specialist grade state that doctors will need to evidence they meet these criteria in order to successfully enter the grade. 

    Supporting documents

    Generic capabilities framework

    This document outlines the capabilities that a doctor will need to evidence in order to enter the grade and will 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.

    Template person specification

    Download this to help you develop a clear description of the requirements for an individual role.

    Notes on person specification template

    This list contains illustrative examples of specialty-specific criteria and guidance for reference. It shows ways in which the template person specification may be amended or extended to be made suitable for different specialties.

    Concordat between the Academy of Medical Royal Colleges and NHS Employers on the appointment of Specialist medical staff.

    Specialist grade appointment guidance 

    This document provides additional guidance to support employers transitioning doctors from the Associate Specialist grade into the Specialist grade and with the collation of evidence against the capabilities framework. It contains: 

    • clarity on the process for Associate Specialists transitioning into the Specialist grade and how employers can best manage this process
    • an easy-to-use template, along with accompanying guidance, on how doctors can evidence that they meet the criteria in the capabilities framework.
  • Guidance and resources for employers to use to help with implementation of the 2021 Specialty Doctor and Specialist grade contracts.

    Contract documentation

    Guidance for implementation

    • Key changes at a glance - this document provides an overview of the key changes in the 2021 contracts
    • Employer checklist (to follow) - this document provides a list of the key actions employers will need to take to implement the 2021 contracts.
    • Implementation guidance (to follow) - full guidance for employers implementing the new 2021 contracts including transitional arrangements and guidance on the new Specialist grade.
    • Choice exercise flowchart - use this flow chart to follow the step by step process for existing SAS doctors wanting to transition to the new 2021 contracts.
    • Template letter for choice exercise and checklist - this document provides a checklist for employers undertaking the choice exercise for SAS doctors in their trust, including a template letter to send to their SAS doctors.
    • FAQs (to follow) - read the frequently asked questions relating to SAS contract reform 2021.

    Specialist grade guidance

    • Specialist grade generic capabilities framework - this document outlines the capabilities that a doctor will need to evidence in order to enter the grade. 
    • Specialist grade template person specification - download this document to help you develop a clear description of the requirements for an individual Specialist role. 
    • Concordat on the appointment of Specialist grades - read the concordat by NHS Employers, British Medical Association and the Academy of Medical Royal Colleges which have worked together to ensure that the highest standard of professional medical practice in NHS employing organisations are maintained in the appointment of Specialist grades.
    • Notes on person specification template - this list contains illustrative examples of specialty-specific criteria and guidance for reference. It shows ways in which the template person specification may be amended or extended to be made suitable for different specialties.
    • Specialist grade appointment guidance – this document provides additional guidance to support the transition of Associate Specialists into the Specialist grade, including an easy-to-use template for doctors to evidence that they meet the criteria in the capabilities framework. 

SAS contract reform 2021 webinar

On Tuesday 23 March NHS Employers held a webinar to talk employers through a high-level summary of the proposed agreement between NHS Employers and the BMA for SAS doctors in England, Wales and Northern Ireland. The webinar covered:

  • a high-level summary of the agreement
  • timeline for implementation
  • next steps that employers need to take to prepare for the implementation of the new contracts.
  • Q&A session

View the webinar recording below and download the slides.

Specialist grade webinar

On Tuesday 2 March, NHS Employers held a webinar to talk employers through the new Specialist grade that has been introduced as part of the proposed agreement for SAS contract reform. The webinar covered:

  • generic responsibilities of a doctor in the grade
  • entry criteria
  • how to appoint to the role
  • why employers should consider creating roles in their own organisation
  • Q&A session 

View the webinar recording below and download the slides.