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Understanding the Consultant contract

20180835 Know your rights consultant campaign 16x9

About the campaign

Know your rights, know your contract, and protect your working life.

The BMA is here to help you get the best out of your contract. Find key information to support you, and ensure you get a fair deal from your employer. If you have any further questions, call 0300 123 1233 or email [email protected].

This page will continue to be updated as the campaign progresses – be sure to check back every fortnight for each theme in focus.


Know your rights on...

  • Job planning

    ‘My weekly activities no longer match what’s set out in my job plan. Can I do anything about it?’

    • You do not need to wait for an annual review to address concerns with your job plan. You or your employer can request an interim review if duties or needs have changed, or if you are concerned about whether your objectives can be met.
    • You should not be pressured into agreeing a job plan that is not clinically justified or compliant with your contract. Job planning should be a collaborative process, and your agreement is an absolute requirement.
    • Benefit: Download the BMA's Dr Diary app to help evidence your time for your job plan review. Dr Diary is the new job planning tool for NHS consultants which helps to address your job planning challenges.

    Get informed

    BMA overview of consultant job planning
    What are job plans?
    BMA/NHS Employers joint guidance on job planning (England only)
    BMA job planning checklist
    BMA model job plans (England, Scotland and Northern Ireland)
    Step-by-step job planning (Northern Ireland)

    Consultant terms and conditions of service – Schedule 3: ‘Job planning’ (England, Scotland and Northern Ireland); Amendment Chapter 1: ‘Job Planning’ (Wales)

  • Leave

    ‘If I take a week of leave, does that cover all my PAs (programmed activities)/sessions for that week?’

    • All consultants receive proportionately the same amount of annual leave. However, in your contract, annual leave is defined in terms of weeks and days – and ‘a week’ means different things for different people depending on the number of days or hours they work. If you work a weekly average of 11 PAs, for example, then one week of leave covers 11 PAs.

    • If you work a more variable or irregular job plan, with differences from one week to the next, it may be useful to calculate your annual leave entitlement based on PAs/sessions. Read our guidance on consultant leave and different ways of calculating entitlement. While the examples are tailored to the contracts for England and Northern Ireland, they highlight that there are different ways of thinking about your annual leave.

    • All consultants are entitled to 30 days study leave over the course of three years (often averaged as 10 days a year). This leave can be used to cover a range of activity, including attendance at courses, conferences or programmes, undertaking research, or teaching and training. Remember to ensure that your employer agrees in advance that expenses for study and professional leave are met. In Wales, local agreements can be made within health boards/ trusts to extend the amount of study leave. This does not include time off for trade union activities and duties which should be recognised separately.

    • Benefit: to help evidence your time and calculate your annual leave, use Dr Diary, the app that supports job planning. After reading the guidance, if you need further support, please contact us on 0300 123 1233 or email [email protected].

    Get informed

    BMA overview of annual leave
    BMA guidance on public holidays
    BMA guidance on professional, study and professional leave

    Consultant terms and conditions of service – Schedule 18: ‘Leave and public holidays’ (England & Northern Ireland); Schedule 7: ‘Leave Arrangements’ (Scotland); Paragraphs 205-217 (Wales)

  • Pensions

    Update on BMA pension calculator

    The BMA have entered into an agreement with Dr Tony Goldstone to develop a calculator for BMA members that covers all pension schemes and all branches of practice across all four nations. The BMA will support this development with additional input from specialist tax advisors, actuaries and IT support to deliver a comprehensive tool to support members in calculating their pension growth and annual allowance charges.

    With a growing number of consultants raising concerns over the impact of pension changes and the levels of annual and lifetime allowances, this will be an important step in BMA supporting our members to understand fully the implications to them.

    This calculator will also facilitate the ongoing work by the BMA in its efforts to lobby the government to change the rules around calculation of the tax due on annual allowance breaches.

    Further details will be released in due course.

    ‘Will changes in my work pattern impact on my pension and the Annual Allowance?’

    • Pension growth depends on the accrual rate of the scheme you contribute to (1995 Section, 2008 Section and 2015 Career Average Revalued Earnings Scheme) and whether you have transitioned to the 2015 CARE scheme and have retained a ‘final salary link’. Where transition members have retained a final salary link 1995 and 2008 section benefits will be calculated with reference to current pay.
    • 10 PAs (programmed activities)/sessions is full-time in pension terms and working less than this results in slower service accrual for members of the 1995 and 2008 sections. Members of the 2015 CARE scheme have benefits based on actual pensionable pay and working less than 10 PAs/sessions results in less pension accruing.
    • As reducing hours will result in less pension growth (if this takes you below 10 PAs or results in the loss of other additional pensionable payments) it may also affect the calculation of the tapering of the Annual Allowance (depending on your overall taxable income position).
    • Benefit: Our dedicated pensions service provides free guidance on your NHS pension and other occupational pension schemes. Call our pensions team on 0300 123 1233.

    Get informed

    Overview of pensions
    More information on annual allowance and tapering
    Consultant pensions survey (England)
    Pension rules force consultants to retire early
    The 'perfect storm' of pensions rules hitting consultants in Scotland

    Consultant terms and conditions of service – Schedule 17: ‘Pension arrangements’ (England & Northern Ireland); Schedule 15: ‘Pension Arrangements’ (Scotland); Amendment Chapter 14: 'Miscellany' (Wales)

  • Pay

    ‘How do I know if I’m being paid correctly?’

    • Consultant pay is made up of a number of different components and it can be quite complex. It is essential that you are able to understand every part of your payslip to ensure that you are being appropriately remunerated for all aspects of your work. We are producing a guide so that you can ensure that your work is being properly recognised and paid.
    • There are 8 pay points in total on the consultant pay scale: five pay points at one-year intervals followed by three further pay points at five-year intervals. There are no further increments beyond the 20th year of service. Consultants progress through the pay scale by meeting certain criteria, including compliance with the private practice code of conduct and satisfactory participation in job planning. Remember: you do not need to have agreed a job plan to have met the criteria, you only need to have engaged with the job planning process in good faith. You should never agreed to a job plan that you do not think contractually or clinically justified just to progress through the pay scale.
    • Doctors’ pay scales are subject to an annual cost of living uplift. This means that the UK and devolved nation governments can increase them, and in the past have done so in line with the recommendations of the Review Body on Doctors' and Dentists' Remuneration (DDRB) – a notionally independent body who produce annual reports on pay. However, in recent years, governments have either set strict limits on the recommendations that the DDRB can make or have simply ignored their recommendations altogether, for example in England and Scotland. We have significant concerns about both the process and the independence of the DDRB. Read about what action we are taking.
    • If you think you’re not being paid correctly, please get in touch with an advisor 0300 123 1233 or email [email protected].

    Get informed

    Consultant payslip guide
    Understand your payslip (Scotland)
    Pay scales for England, Wales, Scotland & Northern Ireland 
    Consultant award schemes 
    Private practice code of conduct (England)
    Private practice code of conduct, Appendix 8 (Scotland)
    Structure of the consultant contract in Scotland
    Find out about gender pay gap reporting, and the work the BMA is doing to address Gender Pay Gap in medicine

    Consultant terms and conditions of service –  Schedules 13-16 (England & Northern Ireland); Section 2 'Rates of Pay' (Scotland); Amendment chapter 4 'Pay and Pay Progression' (Wales)

  • Covering colleagues

    ‘My employer wants me to cover gaps in the rota for consultant colleagues. What should I do?’

    • In England, consultants are expected to deputise for absent consultant or associate specialist colleagues, as far as is practicable. There is no strict definition of ‘practicable’ but you will need to consider your personal circumstances. If, for example, you have caring responsibilities, you would be justified in saying that it is not practicable for you to provide unforeseen cover that conflicts with these responsibilities.
    • Providing cover should only ever be a temporary measure, not a long-term solution to workforce planning issues. It should not be necessary for longer than 48 hours (or up to 72 hours if it includes a weekend or public holiday) – after which your employer should be in a position to employ a locum or reschedule the clinical work. Check for local agreements on such cover and ensure there are pay or time off in lieu arrangements.
    • In Scotland, gaps for no more than a few weeks may be covered by an irregular leave policy detailing short-term internal locum cover arrangements depending upon rota frequency (where agreed) – check with the LNC or HR department if there is such a policy. Consultants should not be expected to provide cover without agreement and should be appropriately and promptly remunerated. Gaps beyond the scope of any irregular leave policy (or any gaps if there is no policy) are the responsibility of the NHS Board management and not the clinicians who provide the service. Clinicians may be approached by their board to help in such a situation but each clinician has a responsibility to consider such a request carefully in light of their own health and the impact of stretching themselves ever thinner on service safety and sustainability.


    ‘My employer wants me to cover gaps in the rota for trainee colleagues. What should I do?’ 

    • You are not contractually obliged to cover for junior doctor colleagues if the absences are known about in advance, such as in cases of long-term sickness or identified rota gaps. However, there will be times when you may be asked to provide emergency cover for junior doctor colleagues due to unforeseen absences. This is often called ‘acting down’, but you are still working as a consultant so you will be paid at a consultant level. In Wales, there is provision for enhanced payment rates where in exceptional circumstances a consultant is requested and agrees to be immediately available e.g. to cover an absence of a trainee at short notice.

    Get informed

    Covering colleagues guidance for consultants
    Guidance for consultants on raising concerns
    Medical rota gaps report and practical solutions
    BMA Scotland guidance for consultants in Scotland under pressure in the face of medical staff shortages

    Consultant terms and conditions of service – Schedule 2: ‘Associated duties and responsibilities’ (England & Northern Ireland); Schedule 7: ‘Leave Arrangements’ (Scotland); Paragraph 106 (Wales)

  • Shift and resident working

    ‘My employer wants me to do resident on-call, but I don’t want to. What can I do?’

    • Consultants in Scotland, England and Northern Ireland are not contractually obliged to work resident on-call – they can only be resident during an on-call period by mutual agreement. In Wales, consultants will not normally be resident on call and work in evenings or weekends will only be undertaken with the voluntary agreement of the consultant and the employer. Where a consultant does agree to be resident in unsocial hours, the rate should be agreed with the Local Negotiating Committee and will usually be substantially higher than standard or premium time rates.
    • Shift-based models are increasingly seen in some services – e.g. paediatrics, emergency departments, intensive care and obstetrics. When a service needs to rearrange responsibilities, the best way is to seek agreement on job planning arrangements, ensuring consultants who take on such work are properly supported by both facilities and staff.
    • Consultants who work lengthy periods consecutively in premium time are likely to use up most of their weekly PAs very quickly. Employers should therefore consider whether shift and resident working is a practical long-term solution.
    • Benefit: In order to help to determine whether you can take on this additional work, evidence your time, using Dr Diary, the app that supports job planning. After reading the guidance, if you need further support, please contact us on 0300 123 1233 or email [email protected].

    Get informed

    BMA consultant shift and resident working guidance (England, Wales & Northern Ireland)
    BMA guidance on resident on call work and consultant out of hours working (Scotland)

    Consultant terms and conditions of service – Schedule 8: ‘On-call rotas’ and Schedule 29: ‘Balancing Work and Personal Life’ (England and Northern Ireland); Schedule 4, paragraph 9 (Scotland); Amendment Chapter 2: Working week; Chapter 3: ‘On call and emergency work’ (Wales).

  • Reducing your hours and commitments

    ‘I’d like to work less than full time, or work more flexibly. What are my options?’

    • There is no absolute right to work part time or to vary your hours of work, but your employer is obliged to consider your request seriously and to justify their agreement or rejection of it. Contact your clinical director to let them know you wish to work part time/change your hours, and ask for a job plan to be drawn up that allows you to do this.
    • Employers must develop policies on flexible working, job sharing, part-time working and related areas. There should be a clear process for employees to apply for flexible working arrangements – ask your employer for a copy of this information.
    • It is also worth noting that there is no obligation on any consultant to work more than a standard 10 PA (40 hour) contract. We know that many consultants will routinely work in excess of this. If you currently work beyond the standard contracted hours, you are entitled to give up any additional/extra PAs or sessions with three months’ notice.
    • Due to changes to the pension scheme and current tax arrangements, you may wish to explore whether it is in your personal and financial interests to continue work more than 10 PAs or, indeed, whether to seek a reduction to part-time working.
    • While there is no absolute right to go part-time, in practice workforce demands and the need for the skills of senior clinicians provide consultants with a great deal of leverage, allowing them to either negotiate a reduction or seek a part-time role with another employer.
    • If you think you’re currently undertaking too much work, it may be worth checking to ensure that you’re not in breach of Working Time Regulations (WTRs).
    • Benefit: if you are requesting to work more flexibly, due to stress, don’t forget that the BMA has range of wellbeing support services to support you. Give BMA counselling or our peer to peer service a call on 0300 123 1233. If you are preparing for a reduced role, our learning and development module could be helpful.

    Get informed

    Guidance on Part-time and flexible working for consultants 
    While this guidance is based on an agreement that was introduced alongside the 2003 consultant contract in England, it contains a number of important principles that we believe should apply to all consultants.

    Consultant terms and conditions of service – Schedule 28: ‘Flexible Working Arrangements’ and Schedule 29: ‘Balancing Work and Personal Life’ (England); Schedules 27 and 28 (Northern Ireland); Appendices 15 and 16 (Scotland); Amendment Chapter 10: ‘Equal Opportunities’ (Wales)

  • Need more help? Contact us

    If you have any further questions, call 0300 123 1233 or email [email protected].