NHS Wales is not NHS England
Health is devolved. The Welsh Government sets health policy for Wales and NHS Wales delivers services through seven local health boards, three NHS trusts and national support organisations. Local health boards both plan and provide many services, including hospital, community and mental-health care, and commission services from other organisations when their population needs them.
Before relying on a policy, contract or pay table, look for “Wales” in the title and check its date. An English document may describe a different system.
Who you will encounter
Sets national policy and publishes key workforce and pay decisions.
Employ most doctors and plan and deliver services for defined populations.
Publishes national employment resources and administers central SAS processes.
Leads education, training, workforce development and national SAS support.
Your first-week checklist
- 1Identify your employing organisation and base
A health board may cover several counties and sites. Confirm where induction, on-call work and routine clinical activity happen.
- 2Read the exact contract and job description
Check grade, national or local terms, hours or sessions, rota supplements, place of work, notice, study leave and relocation arrangements.
- 3Confirm professional requirements
Complete pre-employment checks, occupational health, local mandatory training, prescribing access, IT access, indemnity arrangements and named supervision.
- 4Understand local clinical pathways
Ask how patients move between sites, which specialties are local or regional, and where referrals and transfers go—especially in rural areas.
- 5Check your pay after the first payroll
Compare the grade, pay code, hours, supplements, pension and tax details with your written terms. Raise discrepancies promptly with payroll or medical workforce.
- 6Find your development support
For SAS doctors, identify the local SAS tutor and advocate. For resident doctors, locate the HEIW training and support contacts relevant to your programme.
Welsh has official status. Follow your employer’s local language standards and use the bilingual tools, interpreting arrangements and training provided. You are not expected to guess—ask during induction.
What changed on 1 August 2026?
Wales introduced new Terms and Conditions of Service for resident doctors and dentists. The previous 2002 terms closed to new appointments from 1 August 2026, while existing doctors move in phases under the national transition timetable.
New appointments
New appointments at all levels use the 2026 terms. Foundation doctors and doctors on unbanded rotas were among the first existing groups scheduled to transfer.
Phased transition
Core, higher, dental and paediatric groups move according to the timetable. All in-scope locally employed doctors must transfer by August 2028.
What this means for locally employed doctors
“Locally employed doctor” describes the employment route, not one single national grade. The 2026 circular says in-scope LEDs should transfer alongside the equivalent training group. Employers may temporarily prioritise doctors in formal training programmes where justified, but no new LED should be put on terms mirroring the 2002 contract from 1 August 2026.
- Ask which national training level your post is mapped to for transition.
- Confirm whether your contract is within scope and the expected transfer date in writing.
- Compare basic pay, rostered hours, out-of-hours arrangements and safeguards—not just the headline salary.
- If your role is SAS rather than resident, use the separate Welsh SAS terms; this resident contract is not the Specialist-grade route.
Current national scales
The figures below are annual basic salaries in the official 2026/27 Welsh medical and dental pay circular, effective from 1 April 2026. They do not show every closed grade, allowance, supplement or individual pay-protection arrangement.
2026 resident contract
2021 SAS contracts
The closed 2008 SAS scales and other medical and dental grades remain in the full circular. Pay progression on 2021 SAS terms is not simply an automatic annual increment; the national review process must be completed.
In Welsh SAS contracts, think “sessions”
The Welsh 2021 Specialty Doctor terms define a session as a scheduled period normally equivalent to four hours. A standard full-time job plan contains ten sessions. Sessions may cover direct clinical care, supporting professional activities, additional NHS responsibilities, external duties, agreed additional sessions and relevant travel time.
Normally four hours each in a standard full-time job plan.
“PA” is a familiar label in other contracts, including English SAS terms. Do not silently substitute one contract’s wording for another.
A job plan is prospective and should record what you do, where and when you do it, agreed objectives and the resources required. The national terms provide for annual review and a mediation and appeal process. Read the whole schedule before making a comparison.
Read the current Welsh Specialty Doctor terms ↗