What changed for resident doctors in England in 2026
From 1 April 2026, the resident doctor pay structure in England moved from five nodal points to ten. The reform aligns the pay points more closely with stages of training. It applies alongside the 3.5 per cent pay award that took effect from the same date. The Department of Health and Social Care described the reform as adding pay steps for resident doctors in formal training and for locally employed doctors, with progression linked to competencies in the relevant arrangements.[2]
The ten points are commonly expressed as FY1, FY2, ST1 or CT1, ST2 or CT2, ST3 or CT3, ST4 or CT4, ST5, ST6, ST7 and ST8. The revised 2026 to 2027 scale gives each of those stages its own nodal point.[1][2] Do not assume that a doctor on a named training grade and a doctor in a locally employed role will need the same mortgage evidence. The grade and pay point explain one part of the picture. The written terms, employer and work pattern explain the rest.
NHS Employers confirms that the new circular includes the revised figures for doctors and dentists in training and mirrored nodal points for locally employed doctors. It also confirms that the on-call and weekend allowances were recalculated in line with the new structure and pay values.[1] This is why a contract, work schedule and rota can be useful alongside payslips. They help show whether an amount is connected to the agreed working pattern rather than being an isolated payment.
The details remain specific to England. A doctor moving between UK nations, or holding work that is governed by another national contract, should not assume that this structure applies to all of their income.
Why September arrears need a clear explanation
The pay changes are backdated to 1 April 2026. NHS Employers stated that the changes and arrears would be reflected in September salaries.[1] Arrears are pay owed for an earlier period, rather than an indication that the September monthly salary will repeat at the same level.
That distinction is central to clear mortgage evidence. A larger September net pay figure can be entirely legitimate, but it may combine normal monthly pay with a backdated adjustment. Presenting the single payslip without context could leave an avoidable question about what your ongoing income is.
Keep the September payslip, but place it beside the documents that explain it. These could include the NHS Employers announcement, your contract or confirmation of current pay point, and the payslips immediately before and after September. If your payroll team can provide a clear breakdown, retain that too. The useful narrative is factual: the pay change took effect from April, the arrears relate to the earlier period, and the current recurring pay can be identified separately.
Do not treat arrears as a predictable monthly income stream when working out your own household budget. Equally, do not hide a legitimate payment from an adviser. Transparency enables a better discussion of your true current position.
Basic pay is not the whole of your NHS income
For many resident doctors, basic pay is only one line of the total employment income shown over time. A rota can give rise to on-call and weekend allowances, and the 2026 changes included a recalculation of those allowances.[1] The relevant amount may be set out in a work schedule, rota documentation, contract, payslip or a combination of these records.
Rota-related income deserves a careful explanation because the pattern may change when you rotate, change department, work less than full time or receive a revised schedule. It may also vary between pay periods. That does not make it irrelevant. It means the evidence should show its source, regularity and expected continuation as accurately as possible.
Start with the written terms. If you have a work schedule or rota that identifies the agreed pattern, preserve the current version and any approved changes. Then match it with several recent payslips. If the figures differ, make a simple note of why, using payroll descriptions rather than assumptions. For example, a change of rota, hours, employer or pay point may be relevant. Use only documents that you can substantiate.
Avoid assuming that any particular lender will use every allowance, or use it in the same way as basic salary. Mortgage policies differ, and affordability assessment considers more than income. An adviser can help you present the evidence, but cannot turn a rota payment into guaranteed borrowing capacity.
The new substantive contract route for locally employed doctors
A locally employed doctor, often called an LED, may have experienced a sequence of fixed-term contracts even while delivering ongoing service. New NHS Employers guidance, published on 11 September 2026, says that employers should by default offer permanent, substantive contracts to new LEDs and transition current staff to permanent contracts. Fixed-term contracts should be an exception where there is a legitimate reason.[3]
The guidance gives examples of legitimate reasons, including cover for a secondment, long-term sickness, maternity, paternity, shared parental or adoption leave. It also recognises certain short-term capacity and externally funded situations. A fixed-term contract can therefore still be appropriate in some circumstances. The change is not a promise that every individual will receive a substantive contract immediately.[3]
For existing LEDs, the guidance says that the doctor must be given a choice about accepting a substantive contract. Unless otherwise agreed, an offer must retain the same contracted whole time or less than full time status and pay point. It also says that an offer which does not meet those requirements does not discharge the employer’s obligation to offer a substantive contract.[3]
A substantive contract may provide a clearer record of ongoing employment, but it is not a mortgage approval or a promise of a particular lending outcome. Lenders still apply their own affordability and credit assessment. If you are moving from fixed-term work to a substantive role, the most helpful approach is to document the transition accurately. Keep the current contract, the substantive offer or signed contract, the start date, the employer name, the pay point and any written confirmation of continuity. If you have been employed continuously, retain the prior contracts too.
This is particularly useful where the title of the post, payroll reference or trust changes. A lender does not need a complicated story. It needs a coherent record that can be supported by documents.
If your earnings also include locum work or private practice, Broadbench’s guide to securing a mortgage with NHS, private and locum income explains how those additional income streams may need separate evidence.
Build a mortgage evidence file before you apply
Preparing early can reduce pressure when you are busy with a rotation, a house move or a new contract. Create a secure folder with clear file names and keep the contents current. Your adviser can then identify which documents are relevant to the application and which need further explanation.
A practical evidence file may include the following:
- Your current employment contract or formal offer. This should show the employing organisation, role, start date, contracted status and salary terms where available.
- Confirmation of grade and pay point. Retain the document that connects your current role to the relevant pay point. For LEDs, include a document confirming the relevant pay point where available.
- Recent payslips. Keep a run of recent payslips, not just the highest one. Include September 2026 if it contains arrears, while making clear which part is backdated.
- Your P60. This provides a year-end view of employment income. It is useful context, particularly if a job or rota change means recent payslips tell only part of the story.
- Your work schedule or rota evidence. Where rota-related payments form part of your income, retain the current agreed schedule and documents that explain material changes.
- Contract transition evidence. If an LED role is moving from fixed term to substantive employment, keep the old contract, new offer or contract, and the written confirmation that explains the change.
- A short factual chronology. If you have changed trust, grade or contract recently, list the dates, employer names and roles. Keep it to facts that match the documents.
Do not alter statements or try to reconstruct documents after the event. If something is unclear, ask payroll, medical staffing or human resources for an accurate confirmation. A clean document trail is more valuable than a complicated explanation.
Time your mortgage discussion around career changes
There is no single perfect point in a doctor’s career to seek mortgage advice. The right time is before a decision creates time pressure. Speak to a specialist adviser early if you are approaching a property purchase, remortgage, rotation, change in working hours or change from fixed term to substantive employment.
Bring the evidence file and explain what is about to change as well as what has changed. A future rotation may affect employer, rota or work location. A revised pay point may affect basic pay. A substantive LED offer may clarify your employment terms. An adviser can discuss how different lenders may approach the available evidence, subject to their current criteria, without making assumptions about the final decision.
It is also sensible to review household commitments before deciding what payment feels sustainable. A lender’s maximum is not automatically your comfortable budget. Consider housing costs, pension deductions, professional expenses, childcare, travel, future changes to hours and a reserve for unexpected costs.
Speak to Broadbench before you apply
Moving grade, receiving pay arrears or changing contract? Ask a Broadbench clinician mortgage specialist how a lender may assess your current NHS income before you apply. We can help you organise the mortgage conversation around your actual documents, whether your income is basic pay, rota-related pay or a combination of both. You can also explore Broadbench’s clinician mortgage calculators before the conversation.
Mortgage warning: Your home may be repossessed if you do not keep up repayments on your mortgage.
General information, dated 16 September 2026: This article provides general information for resident doctors and locally employed doctors in England. It is not mortgage, financial, legal, employment or tax advice. Pay, contractual arrangements and lender criteria can change. Mortgage availability is subject to lender criteria, affordability assessment and credit status. Obtain personalised advice before acting.
References
[1] NHS Employers, Updated medical and dental pay and conditions circular: https://www.nhsemployers.org/news/updated-medical-and-dental-pay-and-conditions-circular
[2] Department of Health and Social Care, Offer to BMA UK resident doctors committee, June 2026: https://www.gov.uk/government/publications/government-offer-to-resident-doctors-june-2026/offer-to-bma-uk-resident-doctors-committee-june-2026-accessible-version
[3] NHS Employers, Transitioning LEDs to substantive contracts: https://www.nhsemployers.org/publications/transitioning-leds-substantive-contracts
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