Guidance

2026 resident doctors deal: implementation update

Published 30 September 2026

Applies to England

Since the 2026 resident doctors deal was accepted by resident doctors on 29 June 2026, the government and the British Medical Association (BMA) resident doctors committee (RDC) have been working together to implement the deal.

The Resident Doctors Industrial Relations Committee (RDIRC) was established in July 2026 to begin implementation of the deal. RDIRC acts as the senior steering committee, overseeing progress on the deal and ensuring each element is implemented to an agreed timeline. Implementation will be taken forward through 5 delivery groups, each reporting into RDIRC.

Nodal point reform: pay uplift from September 2026

Resident doctors whose pay is targeted for pay scale reform in year 1 (2026 to 2027) will receive a further uplift through the implementation of nodal point reform, with this reform hitting pay packets from September 2026. This uplift will be backdated to April 2026.

Together with the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) award already implemented, this means resident doctors will receive an average uplift of 4.9% in the 2026 to 2027 financial year.

Further nodal point reform will be applied in April 2027 alongside the routine annual pay uplifts for the 2027 to 2028 financial year.

Additional training posts from 2027

On 10 August 2026, the government made over 350 additional training posts available for resident doctors in England, with these posts starting from February 2027.

This first round of new posts exceeded the original target of 250 for this point in the deal. The higher number reflects feedback from trusts about patients’ needs in their communities.

The government is on track to create 1,000 additional posts in year 1 of the deal. Any of the 350 or so posts that remain unfilled will be included in the August 2027 recruitment round, which opens in October 2026.

Reimbursement of mandatory exams

Through RDIRC, the Academy of Medical Royal Colleges published guidance on the examinations that are in scope for reimbursement and the eligibility criteria for individual doctors and dentists on 14 September 2026.

The group is now finalising 2 sets of further guidance:

• one to support eligible doctors and dentists to claim reimbursement through their employer
• one for employers to explain the arrangements for how to claim reimbursement from the Department of Health and Social Care

Transitioning locally employed doctors to substantive contracts

Substantive (permanent) contracts will now become the default for locally employed doctors (LEDs). This represents a significant change in employment practice to put LEDs on par with the rest of the NHS workforce, moving away from them being used as a temporary and transient resource.

Guidance on Transitioning LEDs to substantive contracts, developed through RDIRC, was published by NHS Employers on 11 September 2026.

Enhanced appraisal

The enhanced appraisal for LEDs is intended to go beyond a routine annual performance review. It provides a structured development process that supports career and pay progression in line with the gaining of competencies, workforce retention and safe patient care.

We are expecting to publish guidance on enhanced appraisals in the coming weeks.

The process will become a contractual right for all doctors employed under the new national contract for LEDs, which is expected to be implemented in 2027.

Preliminary guidance for employers to follow was published by NHS Employers on 28 August 2026: Enhanced appraisals under the resident doctors deal.