Publication reference: PRN02563                                           

Dear colleague

Expansion of medical specialty training places

As you will be aware, the recent government offer to the British Medical Association (BMA) to resolve the dispute on pay and jobs includes the establishment of up to 4,500 specialty training places over the next 3 years. This includes 1,000 posts to be established over the next year, 250 of which will start in February 2027.

Thank you for your support over the last year in identifying posts for the August 2026 intake. We now need to confirm the next phase at pace.

This expansion is intended to ease the current bottleneck into core training and allow more resident doctors to progress in their career. Accordingly, we are asking that posts are established at CT1/ST1 level wherever possible, with higher-level posts considered only if they support the expansion at a core level.

The following arrangements will apply to these posts:

• Tariff funding (placement fee and salary contribution) will be provided for the 250 posts starting in February 2027.
• The remaining 750 posts for August 2027 will be funded at the placement fee under the Education and Training Tariff (currently, £14,302 plus market forces factor plus associated study leave and educational costs of £3,469).
• For anaesthetics training, NHS England will also fund the first 6 months of education and training salary contribution in recognition of the minimum service contribution of those starting in these posts.
• Salary costs will continue to be provided by trusts by repurposing current spending on medical locums, agency work and some locally employed doctor (LED) roles coming to the end of their contract. No LED contract will be terminated early because of job conversion into training posts.
• To support the establishment of posts and programmes, we invite early consideration of the next phase of post expansions for August 2028 and August 2029 on the same funding basis as in August 2027. This will help trusts grow their resident doctor workforce in a sustainable way.

Training posts attracting a National Training Number do not count toward headcount restrictions.

Given the need to move quickly, we are asking you to begin mobilising now to identify jobs starting in February and August 2027. We will write again in the week starting 6 July to confirm the exact requirements, following the outcome of the referendum by the BMA Resident Doctors’ Committee and consequent discussions on workforce planning.

We recognise the challenges in finding new posts on this timescale. Your regional NHS England team and Postgraduate Dean will support you in considering post expansion.

To ensure inclusion within the specialty training recruitment process, returns must be agreed by 31 July 2026 for posts starting in February 2027 and by 30 September 2026 for posts starting in August 2027.

As discussed in our CEO calls, standardising and reforming terms and conditions for LEDs will be critical to allowing them to benefit from Nodal Point Reform. In the event of a deal, we will expect trusts to move LEDs, should the doctor wish it, onto repurposed 2016 contracts by September 2026, pending the development of a new standardised contract

The offer to the BMA makes clear that employers will be expected to transition LEDs to substantive employment contracts from August 2026, except where there is a legitimate reason to use a fixed-term contract (for example, where a person is employed for the purposes of covering a secondment, long-term sickness, maternity, paternity shared parental leave, or adoption leave).

Thank you for your continued support in delivering this important expansion.

I recognise the additional pressure this is putting on organisations and teams, but it is a necessary step in resolving the dispute with resident doctors and supporting delivery of the 10 Year Health Plan.

Yours sincerely,

Sir Glen Burley, Deputy Chief Executive, NHS England