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Employment and orientation

Working in NHS Scotland

Separate the UK-wide professional framework from Scotland’s own employer, contract, pay, tax and development arrangements.

01 · System

NHS Scotland has its own national framework

The Scottish Government sets health policy and is accountable for NHS Scotland. Territorial boards provide and plan local services, while special boards deliver functions such as education, public health, ambulance, blood, information and national services. A doctor may work across board sites or networks, so the job description and local pathway matter as much as the named base.

First rule

Check that every employment document says Scotland and that its version is current. Similar UK contract titles can conceal different dates, schedules or implementation rules.

02 · Contract

Identify the grade and the exact terms

Scotland introduced reformed Specialty Doctor and Specialist contracts in 2022. Closed 2008 or earlier SAS grades continue for doctors who remain on those terms. A locally employed title does not itself reveal which national or local conditions apply.

  • Record grade, contract version, basic hours or programmed activities, pay point and recognised experience.
  • Check work locations, travel, on-call availability, premium-time treatment, additional work and notice provisions.
  • Confirm whether the role is permanent or fixed term and whether the reason for a fixed term is stated.
  • Read leave, study leave, sickness, parental leave, expenses and pension arrangements in the applicable document.
  • Compare the written job plan with the advertised and actual work before accepting a variation.
Specialist grade is an employment grade.
It is not the same as entry to the GMC Specialist Register and does not by itself confer eligibility for every consultant post.
03 · Job planning

Make time, responsibility and development visible

A job plan should prospectively describe duties, timing, location, objectives, resources and professional activity. The May 2024 Scottish SAS Charter says the allocation needed for job planning, appraisal and revalidation must be separately identifiable.

2022 contract workloadCharter minimum for job planning, appraisal and revalidation
5 or more PAs, including EPAs1.0 SPA
More than 2 but fewer than 5 PAs0.5 SPA
2 or fewer PAs0.25 SPA
2008 Specialty Doctor or Associate Specialist contractMinimum 1 PA

Further SPA time may be needed for education, supervision, leadership, governance, research or agreed development. Evidence actual workload, do not absorb recurring work invisibly, and use the national mediation or appeal route where the applicable terms provide one.

04 · Pay and deductions

Use the Scottish award and circular

On 12 August 2026 the Scottish Government announced a 3.5% uplift for consultants, GPs and SAS doctors and dentists for 2026/27, backdated to 1 April 2026, with payment expected from the end of September. That announcement establishes the award; the detailed circular and the doctor’s payslip establish the applied scale and arrears.

  • Confirm grade, point, credited experience and effective date.
  • Check the calculation of arrears, additional PAs, on-call availability and extra-contractual work separately.
  • Remember that Scottish income-tax bands and rates can change net pay compared with the rest of the UK.
  • Check pensionable pay and contribution treatment rather than assuming every payment is pensionable.
  • Keep the circular, contract, change letter and payslips together for future audit.
Read the 12 August 2026 pay announcement ↗
05 · Development

Use NES and local SAS support

NHS Education for Scotland provides national SAS development infrastructure. Local Educational Advisers and board contacts can help identify educational need, available funding and the route for an application. Funding is additional support, not a replacement for contractual study leave or the employer’s responsibility to resource required work.

  • Link the request to appraisal, PDP, service need and an achievable outcome.
  • Identify course fees, travel, backfill and protected time separately.
  • Seek approval before committing expenditure.
  • For Portfolio Pathway plans, map evidence and workplace opportunity before buying a course.
  • For regrading, use development support to close a named capability gap—not to substitute activity volume for evidence of level.
Open NHS Scotland Deanery SAS resources ↗
06 · Territorial boards

Fourteen local systems

Use the board link for current sites, vacancies and operational pathways. National and special boards sit alongside these territorial organisations.