5 Identify the applicable route

Establish the rules before preparing the application

Two doctors with similar experience may face different progression processes because they work in different nations, hold different contracts or seek different kinds of decision. A colleague's successful route can be informative without being transferable to you.

Begin with four facts: your nation, your employment contract, your current role and the decision you are seeking. Record what you know and what needs confirmation. Do not infer your contract solely from the year you joined an employer; obtain the actual documents or workforce confirmation where necessary.

Next establish whether you are preparing for recruitment to a post, asking about creation of a role or using an applicable regrading process. These are not interchangeable descriptions. Pay progression within a grade is a further separate matter. A conversation may cover more than one, but the resulting actions should remain distinct.

The summaries below are a dated orientation checked on 20 October 2026. They deliberately avoid reproducing whole policies. Use the linked operative documents and forms for a real application, particularly where an individual calculation or deadline matters.

A concise national orientation

These headlines do not replace registration, capability and other applicable conditions. They do not resolve part-time calculations, overlapping work or the treatment of every individual employment history. Keep the factual timeline from chapter 2 and ask for the basis of any disputed calculation.

England

The March 2026 ministerial answer described recruitment to employer-created posts rather than plans at that time for a national regrading policy equivalent to Wales or Scotland. Current BMA guidance also describes employer-created vacancies and the need to demonstrate the relevant capabilities. The NHS Employers resource published in October 2026 addresses workforce need, post design, recruitment and embedding the role. [S06, S07, S32]

For planning, connect your preparation to a defined role. Obtain the person specification for an available post, or clarify who would consider a proposed role. A development agreement can prepare you for opportunities without constituting an offer. If the employer describes a local progression arrangement, obtain its written terms and clarify how it relates to recruitment and your contract.

Do not assume that work already undertaken is irrelevant merely because recruitment is involved. It can help explain the service contribution and your capability. The question is how that evidence enters the applicable process, not whether it should be ignored.

Wales

The May 2025 policy covers NHS Wales Specialty Doctors on 2008 and 2021 contracts. Its entry conditions include registration and licence, twelve years of work since primary qualification, six relevant specialty years and the capability requirements. Relevant equivalent experience from other grades and overseas is accepted. Work wholly or partially at Specialist clinical responsibility is sufficient evidence of service need under the policy. [S08]

Manager non-support requires written reasons within five working days and does not prevent submission. Applications go through the central NHS Wales route. A rejection requires an interview invitation; acceptance need not. Budget alone is insufficient grounds for refusal. Section 6.4 also addresses a doctor meeting the criteria where no current requirement exists, providing for support to identify a suitable post. [S08, S09]

Present actual responsibilities clearly and ask how the policy applies to them. A discussion confined to whether a vacancy is advertised may not answer a regrading request. Keep the policy test, your evidence and the formal assessment distinct. Chapter 18 covers responding to the outcome.

Scotland

Scotland's policy took effect in August 2025 and was issued in December 2025. It covers Specialty Doctors and Dentists on the specified current and earlier contracts. Its experience conditions are ten years since primary qualification and six relevant specialty years, accepting equivalent experience from other grades and overseas. It also requires registration, licence and the framework criteria. [S10]

Existing Specialist responsibility undertaken wholly or substantially and recorded in the job plan can demonstrate service need. Relevant work beyond the plan requires immediate job-plan review. Applications go to the employer's medical workforce team; manager non-support does not prevent submission. An outcome is required within 35 working days, and rejection requires a prior discussion invitation. Budget alone is not sufficient grounds for refusal. The transitional backdating window ended in January 2026. [S10, S11]

Keep the Scottish formulation distinct from the Welsh one. Describe the work rather than invent a percentage definition of substantially. Where public summaries conflict, use the operative policy and obtain clarification of any disputed application to your circumstances.

Northern Ireland

The Department of Health publishes the contract and appointment resources. NIMDTA describes Specialist posts as employer-created in response to workforce need, with the generic capabilities relevant to entry. The resources listed here describe Specialist appointments. Do not assume that the Welsh or Scottish regrading policies apply in Northern Ireland; confirm whether an applicable local progression process exists. [S12, S13, S33]

Ask your HSC employer for the current route and the relevant documents. If a local process is described, clarify its authority, criteria and decision maker. Do not prepare a Welsh-style regrading submission on the assumption that the same provisions apply.

Progression criteria and employer decisions

Progression requires assessment through the applicable route. That does not mean an employer has unrestricted discretion once a national regrading policy's conditions are satisfied. Distinguish a proposed new post from an application concerning duties already performed, and apply the policy's provisions on service need and outcome. Chapter 18 explains how to separate a disputed assessment from an unfunded development proposal. [S08, S10]

Experience and capability remain separate

Experience conditions establish part of the entry framework. They do not tell the whole story about what you can do now. Equally, a strong account of current practice does not permit an applicant to ignore a formal condition.

When a calculation is uncertain, make the question precise. Identify the period, working pattern, specialty and document needed. Ask whether the issue is the length of experience, its relevance or the evidence supporting it. A vague response that experience “does not count” needs clarification before you can act on it.

Relevant overseas work should be described accurately, including duties and context. Do not claim that a title is equivalent to a UK grade without a basis, or accept an unexplained assumption that only UK work is relevant. The operative conditions and evidence should govern the answer.

Record prior posts and current working patterns in a factual timeline. Mark any disputed period for workforce clarification while continuing to map capability evidence. This avoids declaring unconfirmed eligibility without unnecessarily suspending preparation that remains useful.

Local requirements and their authority

An employer may have forms, document-handling arrangements or contacts that make the process workable. Ask for them early. A local requirement should be described as local, with its basis clear where it affects a consequential decision.

Not every extra request is unreasonable. A panel may need clarification to understand your work. The question is whether the request serves a legitimate assessment purpose and is consistent with the applicable process. Conversely, an informal custom should not be presented as a national rule merely because it has been used before.

Keep a dated copy or reference to the documents used. If a requirement changes during preparation, ask which version applies and what action is needed. The aim is a fair and understandable process, not an argument about every administrative detail.

Your route navigator

The route navigator in the resources section records nation, contract, intended route, authoritative source, workforce contact and unresolved questions. It should be short enough to use at a meeting. Link it to your T01 starting position and T02 scope profile.

The most useful final line is often a question: “Please confirm whether this is recruitment to a vacancy or an application under the named regrading policy, and identify the current form and decision route.” That is much more actionable than asking generally how to progress.

A request that makes the route clear

Use a short factual request when the route remains uncertain. For example: “I am employed as a Specialty Doctor under the stated contract and would like to clarify the process for considering Specialist progression. The attached profile describes my current responsibilities. Please confirm the applicable recruitment or regrading route, the current criteria and forms, and the person responsible for explaining the next step.” Add the nation and the actual contract details before sending it.

If the answer refers to an advertised vacancy, ask whether that answers the decision you requested. If it refers to regrading, obtain the policy and application instructions. If no route is identified, ask whether the outstanding question concerns policy, creation of a post or assessment of existing responsibility. These distinctions help you decide what preparation is worthwhile.

Keep the response with the dated documents used. An informal explanation can be helpful, but a consequential disputed point needs to be checked against the operative source. If advice and policy appear inconsistent, state the difference precisely and ask for clarification. You do not need to attribute motives to identify a discrepancy.

When a national summary is insufficient

The experience headlines in the table are useful for orientation, but an individual timeline can raise questions they cannot answer. A period may combine specialties, involve overlapping appointments or use a title unfamiliar to the receiving organisation. Separate the factual issue from interpretation. First establish what work occurred and when; then identify the provision being applied to it.

Ask for a written explanation of a disputed calculation, including the periods included and excluded and the reason. This gives you something specific to check with workforce colleagues or a professional adviser. Continue useful capability preparation while the calculation is clarified, but avoid presenting a provisional total as confirmed eligibility.

The same discipline applies to service need. A service-development proposal and an assessment of work already undertaken may require different evidence. Your contribution is to make the work visible. The applicable policy determines how that evidence enters the formal decision.

What the service needs to arrange

Provide access to the relevant documents and a named person who can explain the process. Distinguish advice from a formal decision. Where the doctor's understanding is wrong, identify the correct provision and its practical consequence. Where the service's position is uncertain, obtain clarification rather than turn uncertainty into a refusal.