The Complete Guide To NHS Pay For Doctors

Published on: 30 Aug 2022

The Complete Guide To NHS Pay For Doctors

An NHS doctor’s salary is more complicated than it might at first appear and varies according to grade, years in role, and where in the UK the job is based. NHS pay is reviewed annually by the Review Body on Doctors' and Dentists' Remuneration (DDRB), who make recommendations to the government; new rates apply from the 1st of April. This guide provides a comprehensive overview of the latest pay scales for NHS doctors in the UK.

 

Junior Doctor Pay Scale

Pay arrangements vary between home countries in the UK. Whilst England began implementing a new junior doctor contract in 2016, Scotland, Wales, and Northern Ireland continue to apply the old 2002 contract (1). However, there are still some doctors in England who are working on the 2002 contract; this may be the case with lead employer arrangements or doctors with a long-term contract based on 2002 terms which is yet to expire (2).

 

Basic Pay

In Scotland, Wales, and Northern Ireland, basic pay increases by small increments at the end of each year of training (3). The new 2016 contract in England removed incremental annual pay rises; instead, your salary increases by larger amounts at so-called nodal points. These refer to the point in your training when you move up a grade, e.g. the first day you commence work as a specialty registrar (core training) after FY2 (Table 1). In October 2020, a 5th nodal point was added for trainees at ST6 and above (4).

Grade

Stage of Training

Nodal Point

Salary (£)

England

Scotland

Wales

Northern Ireland

Foundation Doctor Year 1

FY1

1

29,384

26,462

25,563

23,553

Foundation Doctor Year 2

FY2

2

34,012

32,822

31,708

31,708

Specialty Registrar (StR)

(Core Training)

CT1

3

40,257

34,901

33,883

33,883

CT2

37,037

35,955

35,955

CT3

4

51,017

40,020

38,851

38,851

Specialty Registrar (StR)

(Run-Through Training or Higher Training)

 

Specialist Registrar (SpR)

ST1 / SpR1

3

40,257

34,901

33,883

33,883

ST2 / SpR2

37,037

35,955

35,955

ST3 / SpR3

4

51,017

40,020

38,851

38,851

ST4 / SpR4

41,823

40,603

40,603

ST5 / SpR5

43,998

42,712

42,712

ST6 / SpR6

5

58,398

46,173

44,826

44,826

ST7 / SpR7

48,351

46,938

46,938

ST8 / SpR8

50.526

49,051

49,051

Table 1 Junior Doctor Basic Pay in England (2016 contract; rates apply from April 1st 2021), Scotland (2002 contract; rates for 2021-22), Wales (2002 contract; rates for 2021-22), and Northern Ireland (2002 contract; rates for 2021-22) (4, 5).

 

Furthermore, under the 2002 contract, if it takes more years than usual to complete a grade, your salary would still rise by annual increments, as set by a separate pay scale within each grade. For instance, if it took you 3 years to complete your FY2 in Scotland, your basic pay in your 2nd year would increase from £32,822 to £34,969, and £37,116 in your 3rd year.  Then, upon commencement of core or specialty training, you would not be placed on the minimum point for that grade as this would result in a reduction in salary. Instead, you would be placed on the next most favourable point, ie £40,020 (5).

 

Other Allowances: Scotland, Wales, and Northern Ireland

The 2002 contract utilises a banding system whereby junior doctors receive a base salary and are remunerated depending on their band, which reflects a number of factors: the number of additional hours worked; the degree to which these hours are unsociable; the on-call commitment; and the workload. (Table 2) (5).

Band

Average Amount & Nature of Hours

x Basic Pay

3

>56 hours/week or not achieving the required rest

2.0

2A

48 - 56 hours/week, most antisocially

1.8

2B

48 - 56 hours/week, least antisocially

1.5

1A

40 - 48 hours/week, most antisocially

1.5

1B

40 - 48 hours/week, moderately antisocially

1.4

1C

40 - 48 hours/week, least antisocially

1.2

No band

No more than 40 hours/week on average

Basic pay

Table 2 Banding System in Scotland, Wales, and Northern Ireland (2002 contract) (5).

 

Other Allowances: England

Under the 2016 contract, a junior doctor’s pay depends on a multitude of factors (4,6):

  1. Additional Hours

This is the average number of hours worked in addition to a 40-hour week. These are remunerated at the basic pay rate respective to your nodal point (ie 1/40th of your basic pay for each additional hour worked).

  1. Enhanced Hours

These are hours worked at "unsociable" times as defined by the 2016 terms and conditions of service (eg between 21.00 and 07.00 on any weekday) and are subject to an enhancement of 37% of the hourly basic pay rate.

  1. Weekend Allowance

A doctor rostered to work at the weekend (defined as one or more shifts/duty periods beginning on a Saturday or a Sunday) at a minimum frequency of 1 in 8 across the length of the rota cycle will be paid an allowance. These are set as a percentage of full-time basic salary in accordance with your nodal point (Table 3).

Frequency

Percentage

1 in 2 weekends

15.0%

Less than 1 in 2 weekends and greater than or equal to 1 in 3 weekends

10.0%

Less than 1 in 3 weekends and greater than or equal to 1 in 4 weekends

7.5%

Less than 1 in 4 weekends and greater than or equal to 1 in 5 weekends

6.0%

Less than 1 in 5 weekends and greater than or equal to 1 in 6 weekends

5.0%

Less than 1 in 6 weekends and greater than or equal to 1 in 7 weekends

4.0%

Less than 1 in 7 weekends and greater than or equal to 1 in 8 weekends

3.0%

Less than 1 in 8 weekends

No allowance

Table 3 Weekend Allowances (2016 contract) (4).

 

  1. On-Call Allowance

This is paid at a flat rate and is not determined by frequency. See the table below for figures (4).

Nodal Point

Value (£)

1

2,351

2

2,721

3

3,221

4

4,082

5

4,672

Table 4 On-Call Allowance (2016 contract). Rates apply from April 1st 2022 (4,6).

 

Furthermore, additional bonuses (flexible pay premia) are paid to trainees under certain conditions, such as those on hard-to-fill training programmes (Table 5) (5).

Name of premium

Applicable Training Programme

Eligibility

Full-time annual value (£)

Hard-to-fill training programmes

General Practice

ST1 – ST4 during placements only

9,144

Psychiatry Core Training

Psychiatry Core Trainees

3,718

Psychiatry Higher Training

3-year higher training

4-year higher training

2,789

Emergency Medicine

ST4 and above only

Dependent on length of training

3-year

7,435

Dual qualification – OMFS

Oral and Maxillofacial Surgery

ST3 and above only

4-year

5,577

5-year

4,461

6-year

3,718

7-year

3,187

8-year

2,789

Histopathology

Histopathology

ST1 and above only

4,461

Academia Upon return to training following successful completion of a higher degree

Table 5 Flexible Pay Premia in England (2016 contract). Rates from April 1st 2022 (4).

 

Consultant Pay Scale

Basic Pay

The vast majority of consultants in England work under the 2003 national consultant contract. Only a small number appointed before 1 November 2003 still retain the pre-2003 contract. The other home countries have their own consultant contracts in place. The 2003 contract is based on a full-time work commitment of 10 programmed activities (PAs) per week, each having a time-tabled value of four hours (1). Basic pay thresholds in England and their equivalents in the rest of the home countries are shown below.

Threshold

Years completed as consultant

Basic Salary (£)

England

Scotland

Wales

Northern Ireland

1

0

84,559

87,534

82,356

82,500

2

1

87,207

89,383

84,979

85,084

3

2

89,855

92,043

89,366

87,668

4

3

92,503

94,705

94,459

90,250

5

4

95,144

97,359

100,278

92,826

5

6

7

8

6

9

101,432

103,679

103,596

98,964

10

11

12

13

7

14

107,721

109,999

106,920

105,100

15

16

17

18

8

19+

114,003

116,313

111,230

Table 6 Basic Pay Threshold in England (2003 contract) and equivalent in Scotland (2004 contract), Wales (2003 contract), and Northern Ireland (2004 contract). Rates for 2022 (5).

 

The annual rate for an additional PA is 10% of basic salary, where basic salary includes the pay thresholds and any local clinical excellence awards held (7).

 

Local and National Clinical Excellence Schemes

In England and Wales, academic consultants and GPs who contribute most to the delivery of safe and high-quality care and the improvement of NHS services are eligible for a Clinical Excellence Award (CEA). In Wales, consultants can also receive commitment awards, whereas in Scotland, they can apply for discretionary points. 

The scheme operates at a local and national level. The lower value local awards (levels 1-9) are made by Employer Based Awards Committees (EBACs). The higher value national awards (9-12) will be reviewed by the Advisory Committee on Clinical Excellence Awards (ACCEA). A level 9 award may be assessed by either depending on the achievement (8). Refer to Table 6 for figures.

Awarded by EBACs

Level

Value (£)

1

3,016

2

6,032

3

9,048

4

12,064

5

15,080

6

18,096

7

24,128

8

30,160

9

36,192

Awarded by ACCEA

9 (Bronze)

36,192

10 (Silver)

47,582

11 (Gold)

59,477

12 (Platinum)

77,320

Table 7 Clinical Excellence Awards. Rates for 2019-20 (7).

 

Specialist and Associate Specialist (SAS) Doctor Pay Scale

SAS pay arrangements are based on the 2008 contract in all four home countries (Table 8) (1).

Associate Specialist

Scale

England

Scotland

Wales

Northern  Ireland

Min

59,436

60,632

59,727

57,985

1

64,215

65,506

64,528

62,647

2

68,991

70,378

69,382

67,306

3

75,299

76,814

75,666

73,461

4

80,767

82,391

81,161

78,794

5

83,035

84,705

83,439

81,007

6

85,995

87,725

86,415

83,896

7

88,955

89,837

89,390

86,784

8

91,915

92,770

92,363

89,671

9

94,875

95,701

95,339

92,558

10

97,838

98,635

98,315

95,450

Specialty Doctor

Scale

England

Scotland

Wales

Northern Ireland

Min

42,393

43,246

42,601

41,357

1

46,017

46,944

46,243

44,895

2

50,730

51,751

50,979

49,491

3

53,255

54,327

53,516

51,955

4

56,894

58,039

57,171

55,505

5

60,519

61,737

60,815

59,042

6

64,225

65,517

64,538

62,658

7

67,933

69,299

68,264

66,274

8

71,640

73,081

71,991

69,891

9

75,346

76,862

75,715

73,507

10

79,054

80,643

79,440

77,124

Table 8 SAS Doctor Pay Scales (2008 contract). Rates for 2022-23 (5).

 

Other Doctors

GP

There is no pay scale for GPs. The pay ranges as set by the DDRB are outlined below. Note that although the pay range in England goes up to 93,965, there is no upper limit. Your salary reflects your level of responsibility, qualifications and experience (5).

Nation

Minimum (£)

Maximum (£)

England

62,269

93,965

Scotland

61,346

91,564

Wales

63,803

96,278

Northern Ireland

63,170

95,325

Table 9 DDRP GP Pay Ranges. Rates for 2022-23 (5).

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Medical Academic

Those returning to clinical practice after successfully completing a higher degree are paid an academic pay premium of 4,204 per annum on the 2016 contract (5). The pay scales for clinical lecturers (2009 contract) are summarised in table 9.

Scale

England

Scotland

Wales

Northern Ireland

1

35,254

37,037

35,350

35,955

2

37,000

40,020

37,101

38,849

3

38,746

41,823

38,850

40,601

4

40,492

43,998

40,601

42,712

5

42,598

46,173

42,713

44,825

6

44,705

48,351

44,825

46,938

7

46,812

50,526

46,939

49,049

8

48,918

52,701

49,050

51,161

9

51,025

54,879

51,162

53,273

10

56,502

60,631

56,652

58,858

11

61,042

65,505

61,201

63,592

12

65,584

70,377

65,759

68,321

Table 10 Clinical Lecturer Pay Scale (2009 contract). Rates for 2022-23 England; 2021-22 Scotland, Wales, Northern Ireland (5).

 

Armed Forces

The Armed Forces' Pay Review Body provides independent advice to the prime minister and the secretary of state for defence on the remuneration and charges for members of the naval, military and air forces of the crown. Below is a comparison of median salaries between NHS and Medical Defence Service (DMS) consultants and junior doctors in England (5). DMS staff is also eligible for armed forced doctor pension scheme; the figures in Table 10 are shown with and without adjustment for pensions in (5).

Grade

DMS

DMS (10% pensions adj.)

NHS full-time

Consultant

107,578

118,336

117,750

Junior Doctor

Foundation Doctor Year 1

38,111

41,923

34,250

Foundation Doctor Year 2

50,347

55,382

42,250

Specialty Registrar

56,071

61,679

62,250

Table 11 Comparison of Median DMS and NHS Salaries. Rates for 2018 (5).

 

Occupational Physicians

Occupational physicians in the NHS are paid according to the pay scales for specialty trainees and consultants. Of course most occupational physicians will be employed outside the NHS and the BMA recommends that salaries are negotiated based on typical salary ranges for full-time hospital doctors working in the NHS (5). These are shown in Table 12.

Seniority

Possible length of progress

Pay Range

Trainee Occupational Physician

< 5 years

£36,461 to £46,208

Occupational Physician

< 5 years

£76,761 to £86,369

Senior Occupational Physician

< 10 years

£86,369 to £139,682

Table 12 Occupational Physician Pay Ranges (5).

 

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References:

1. Contracts [Internet]. British Medical Association. [cited 25 July 2022] Available from: https://www.bma.org.uk/pay-and-contracts/contracts

2. 2016 Junior Contract Implementation [Internet]. NHS Employers. [cited 25 July 2022] Available from: https://www.nhsemployers.org/publications/faqs-2016-doctors-training-contract

3. 2002 Terms and Conditions of Service [Internet]. NHS Employers. [cited 25 July 2022]. Available from: https://www.nhsemployers.org/sites/default/files/2021-06/Terms-and-Conditions-of-Service-2002-NHS-Medical-dental-staff.pdf

4. Pay and Conditions Circular [Internet]. NHS Employers. [cited 25 July 2022]. Available from: https://peoplefirst.nhsbt.nhs.uk/NHSBT-DOCUMENT-LIBRARY/PayBenefitsandPensions/Document-Medical-Consultant-Pay-Circular.pdf

5. Pay [Internet]. British Medical Association. [cited 25 July 2022]. Available from: https://www.bma.org.uk/pay-and-contracts/pay

6. Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 [Internet]. NHS Employers. [cited 25 July 2022] Available from: https://www.nhsemployers.org/publications/doctors-and-dentists-training-terms-and-conditions-england-2016

7. Terms and Conditions – Consultants (England) 2003 [Internet]. NHS Employers. [cited 25 July 2022] Available from: https://www.nhsemployers.org/articles/consultant-contract-2003

8. Clinical Excellence Scheme [Internet]. British Medical Association. [cited 25 july 2022]. Available from: https://www.bma.org.uk/pay-and-contracts/pay/consultant-award-schemes/consultant-award-schemes-and-clinical-excellence-awards-cea