What's happened
The June deal said that from August 2026 employers would be expected to move locally employed doctors onto substantive contracts, unless there was a legitimate reason for a fixed-term one. This is the guidance on how that works. Transitions start this month, and trusts have to be able to show progress in September. A trust that drags its feet is breaking the deal it signed.
Who it covers
This is for you if you're a locally employed doctor or dentist paid at a pay point that exists on the 2016 or 2002 resident doctor contracts. So the trust grade, the clinical fellow, the LED post that isn't a training post. It doesn't touch SAS contracts, and the guidance says it shouldn't stop anyone moving into one. If you've done 24 months at the same trust in a role comparable to a SAS doctor, there's a separate route onto a permanent SAS contract, with a window to ask that runs until 31 March 2027, and your trust has to tell you if you're eligible.
What you're owed
- A choice, on the same terms. If you're already an LED, your trust has to offer you a substantive contract on terms equivalent to your current job: the same hours, full time or less than full time, and the same pay point. An offer that doesn't match doesn't count. You can say no and stay fixed-term; if you do, it's recorded, and the next doctor in your post is offered permanent by default.
- No interview. Your trust doesn't re-interview you or run a recruitment process. It's your existing role being made permanent, not a new post.
- New posts too. Every new LED contract is permanent by default, from now.
- Fixed-term only for a listed reason. Covering maternity, paternity, adoption or shared parental leave; long-term sickness; a named doctor's secondment or time out of programme with a return date; a post paid for by outside funding; and posts the deal is converting into training posts. Short-term surges count too, capped at 6 months, but only after the trust has tried flexing rotas, using its existing LEDs and the bank. Winter isn't a reason: the guidance calls winter pressure predictable. And if a post's outside funding has been renewed 2 years running, it's permanent.
The exception that matters
Recurring gaps on a training rota, where training posts keep going unfilled, can still be covered with a fixed-term contract of 6 to 12 months, after the same steps. If the gap is still there when the contract ends, the doctor in it gets a permanent offer. The guidance is blunt about why this exception exists: it calls the spread of fixed-term contracts "a symptom of a failure to workforce plan effectively at national level", and says it is time limited: at the review next February it is either removed or replaced with a cap on how many fixed-term LED contracts a trust can hold.
How it's policed
Trusts have to record how many LEDs they have, what share are fixed-term against permanent, and the reason for every fixed-term contract, and report it to their board and their local negotiating committee. In February 2027 the Resident Doctor Industrial Relations Committee reviews all of it and sets a national benchmark. Any trust below the benchmark is audited. The guidance also reminds trusts that a doctor employed continuously for 2 years or more may already have statutory protection against unfair dismissal.
Sources: Transitioning locally employed doctors and dentists onto substantive contracts, version 1, 11 September 2026 (BMA, NHS Employers, NHS England and DHSC), gov.uk: the government's June 2026 offer to resident doctors (the commitment the guidance implements) and NHS Employers: SAS eligibility and permanency framework (the 24 months, the choice window to 31 March 2027, the duty to notify)
