Improving pay for SAS doctors in England

The ballot for industrial action by SAS doctors in England has now closed. Thank you to all members who returned your ballots. Although a strong majority (90%) of those who took part voted in favour of strike action, strict legislation mandates postal voting and a minimum turnout for statutory ballots to be binding. While the law is due to change later in the year, it currently still applies, meaning our ballot did not meet the threshold in this instance. The results were:

Number of individuals who were entitled to vote in the ballot: 6,369
Number of votes cast in the ballot: 2,738
Votes cast in the ballot as a % of individuals who were entitled to vote: 42.99%
Number of spoilt or otherwise invalid voting papers returned: 3

Result of voting:

Yes: 2,461 – 89.98%
No: 274 – 10.02%

We remain in dispute, and will continue campaigning to improve the working lives of SAS doctors. There are still conversations to be had with the Government, and work to be done to address the issues faced by our members.

SAS doctors deserve better. Their tireless work needs to be rewarded with fair pay, real career progression, and proper recognition – so that they can continue to give their best for their patients and the NHS.

SAS doctors have been taken for granted

SAS doctors are an essential part of the NHS workforce – without them, it would unravel. Yet their pay, recognition and opportunities for progression do not reflect the value of these highly skilled doctors.

The Government’s pay uplift for SAS doctors in England for 2025/26 was only 4%. Worse, the Government accepted the pay review body’s (DDRB) recommended pay ‘uplift’ of just 3.5% for doctors in England for 2026/27 - leaving pay erosion at over 23% in real terms since 2008. Working in an over-stretched system, medical professionals are certainly not working less than they did in the early 2000s, but they are being effectively paid less for it. This has led to a feeling of being devalued.

The issue is compounded for SAS doctors by a lack of recognition. Despite the role they play in the NHS and the tireless work they provide in patient care and improving services, SAS doctors can often be left to feel like a forgotten workforce. Their expertise and skills are woefully undervalued. Their efforts and experience can be dismissed, or otherwise ignored, simply due to their grade. Their career progression is also stunted by the lack of specialist posts, and a struggle to access development opportunities, including leadership roles.

In September 2025, our indicative ballot showed 82% of SAS doctor respondents would be willing to take action. We were then finally able to meet the Secretary of State and start discussions with the Government regarding our dispute.

However, despite months of engagement in good faith with officials, we are still seeing insufficient evidence that the Government is taking SAS doctors’ issues seriously, let alone taking action to resolve them. The announcement of a pay ‘uplift’ of just 3.5% for 2026/27 made this crystal clear: SAS doctors are once again being taken for granted.

What we are fighting for

We are pushing for SAS doctors to be paid fairly, and receive the recognition they deserve. We are determined to ensure that they are finally seen for the invaluable workforce that they are and treated accordingly.

We are calling for:

Fair pay

SAS pay erosion still stands at 23% and the 3.5% ‘pay award’ for 2026/27 deviates from the path toward pay restoration, showing that we are once again being taken for granted. We want to see SAS doctors’ pay restored to its 2008 levels and to stop the devaluation of our profession.

True career progression

2021 negotiations between the BMA and Government led to the introduction of the specialist grade – allowing SAS doctors with years of skills and experience to be recognised as senior doctors, and in turn improving the capacity and performance of the medical workforce.

However, many SAS doctors are still not being given the opportunity to progress to specialist posts and there has been no progress toward setting up a mechanism for specialist progression in England – despite mechanisms being established in Scotland and Wales.

As a result, SAS doctors in England are currently struggling to access the few posts that have been created, and have to compete with other grades to access them. The SAS committee have been advocating for the creation of more specialist posts, but as long as specialist posts are created purely at the employer’s discretion, these efforts can only go so far without structural change at a national level. We want the experience of specialty doctors to be recognised with automatic progress to the specialist role, creating a single pay spine in the SAS contract.

We are also campaigning for SAS doctors to have other development opportunities to use their full potential. We want to see increased SPA time to allow SAS doctors to pursue development opportunities, and enhanced access to leadership roles – with regular data collection to analyse how many SAS doctors are in leadership roles.

Proper recognition

SAS doctors’ time should be properly valued – we are calling for all SAS doctors’ PAs and OOH work to be fairly remunerated. In and out of hours, no SAS doctor should be disadvantaged when it comes to pay – whether it’s compared to other contracts or to their consultant counterparts. We also want to see a reversal of the extension of plain time for SAS doctors on the 2021 contract, meaning work done between 7pm and 9pm on weekdays should be considered out of hours.

We believe being a SAS doctor should and can be a choice that is just as rewarding and valued as other medical career paths. We believe SAS annual leave should match that of consultants – especially for SAS doctors with more than seven years' experience, who often are given less entitlement than their senior consultant colleagues.

What you can do

We remain in dispute with the Government and continue to campaign to ensure SAS doctors are valued appropriately - through our pay, career progression opportunities, and the recognition of our work. You can stay updated on developments and support the campaign by: