DoH plays a leading role in modernising the pay and conditions of Hospital Medical and Dental staff.


The current contractual arrangements for doctors in hospitals and public health training have been in force since 2000, with the introduction of the New Deal Contract.

With effect from 2009 the responsibility for ensuring that doctors and dentists in training work within the legislative requirements of WTR and the contractual requirements of New Deal moved to Health and Social Care Board.

New Contract for doctors and dentists in training

On 20 June NHS Employers published draft heads of terms (HoT) which have been jointly agreed with the British Medical Association (BMA) to achieve a new contract for doctors and dentists in training.  

Both parties will now consider the draft heads of terms over the summer and seek the necessary mandates, from the Junior Doctors Committee (JDC) and the UK health departments respectively, in order to proceed to formal negotiations in the autumn.

This follows exploratory talks between the BMA and employers, including representatives from the devolved nations, after concerns that the 13-year-old contract is no longer working as well as it could for NHS employers, doctors and dentists in training and patients.

The HoT set out a framework for negotiation on a design of a new contract and covers the areas of working hours, pay, quality of life and training.

Circulars & Supporting Documentation

Review of the Junior Doctors Contract

The report was produced by NHS Employers in collaboration with the four health departments and reviews the viability of the current contract for doctors in training.

NHS Employers (England) in conjunction with the devolved administrations carried out the scoping exercise in response to a request from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The review of the contract took into account the views of a wide range of employers in the NHS, as well as the BMA, the BDA and the BMA Junior Doctors Committee.

Key points

All of the stakeholders agreed that a contract for doctors in training should work towards achieving five key aims:

  • better patient care and outcomes
  • doctors in training feeling valued and engaged affordable
  • produces the next generation of medical professionals
  • improves relationships (employers with juniors, juniors with deaneries and deaneries with employers)

There was also an agreement that the current contract is not achieving these aims.

Employers told us that there are particularly problematic elements of the current contract which include the effect it has on the employment relationship; the rigidity of shift patterns; pay protection (both banding and career grade salary protection); monitoring; and the re-banding process.


Stakeholders agreed that new arrangements should, among other requirements:

  • reward appropriately - ensuring that the overall reward package remains competitive and attractive and rewards doctors in training fairly, equitably and  consistently in accordance with their value to organisational service delivery
  • be affordable for employers
  • incentivise appropriate overtime and patterns of working hours while being consistent with the EWTD
  • link pay progression to progress through the training programme and the achievement, and effective application of, competences rather than be based on time served in employment
  • comply with employment legislation
  • seek to be more straightforward to apply and administer than the existing contractual arrangements
  • harmonise education, training and service delivery needs
  • recognise the need for doctors in training to attain competences through training and that achievement of these is dependent on participation in service delivery

Next steps

We are very pleased that the Department of Health has now published this report. We hope that a remit to negotiate will be given quickly and we look forward to taking this work forward in the new year.

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