Two Reforms, One Moment: What the New SAS Permanency Framework and Training Expansion Mean for LEDs and Their Trusts
Two significant changes are landing for locally employed doctors within weeks of each other.
The first gives experienced LEDs a route off rolling local contracts and onto permanent SAS terms. The second opens up to 4,500 new specialty training posts over the next three years, with the first tranche starting in 2027. Taken together, they mark the most concrete shift in LED career security and progression in some time, and they bring a tight set of obligations for trusts and education leads too.
This article is relevant for LEDs and SAS doctors working out what these changes mean for them, as well as workforce leads who now need to act on them.
TL;DR
Key changes:
The SAS Eligibility and Permanency Framework (EPF), published by NHS Employers on 4 June 2026, lets LEDs doing SAS-level work for 24+ months move from a local contract onto a permanent, national SAS contract. Initial choice window: 1 September 2026 – 31 March 2027; a standing process after that.
An NHS England letter (23 June 2026) confirms up to 4,500 new specialty training posts (mostly CT1/ST1) over the next three years, including 1,000 next year: 250 starting February 2027, 750 starting August 2027.
No LED contract will be ended early to create a training post.
Trusts are expected to move LEDs onto repurposed 2016 contracts by September 2026, and onto substantive contracts from August 2026, with fixed-term only where genuinely justified.
Trust deadlines: 31 July 2026 for February 2027 training posts, 30 September 2026 for August 2027 posts.
If you're an LED wanting to pursue a permanent SAS post, next steps are:
What it means for LEDs and SAS doctors
If you’ve been doing SAS-level work for two years or more with your current employer, the EPF is worth looking at closely. Eligibility is assessed against the actual duties you perform relative to a SAS job description, not your job title, so it’s worth reviewing what you actually do day to day rather than assuming your current title rules you in or out. The entry criteria are full GMC registration, at least four years’ postgraduate experience with two of those in your relevant specialty, and Royal College membership or an equivalent. Overseas training and experience gained outside a formal UK programme counts too, provided you can evidence equivalent competencies through documented clinical roles, supervised practice or recognised international qualifications, a point worth knowing if you’re an IMG assuming this doesn’t apply to you.
Why go through the process at all?
Well, national terms and conditions are negotiated centrally and provide a consistent floor of protections that employers must meet, whereas local contracts vary by organisation and don’t automatically pick up future national pay uplifts or improvements. Moving from a rolling local contract to a permanent national one is mainly a trade of uncertainty for stability. Importantly, this is entirely your choice: nobody will move you onto a SAS contract without your applying, and if you’re made an offer, you’re free to decline it and stay on your current contract.
The process runs in four stages: an initial choice window where you express interest, a competency evaluation form signed off by your clinical or educational supervisor, an employer review with a six-week turnaround, and, if you’re found eligible, an offer of a permanent contract. If your trust is slow to notify you that you’ve reached the 24-month threshold, your window shouldn’t start until you’ve been informed, and it should pause rather than run out if you’re on extended leave.
On pay, you’re placed at the entry point of the relevant 2021 SAS pay scale, with prior experience at a comparable level, including non-NHS roles, recognised toward your starting salary. There’s no automatic pay protection, and any reduction has to be justified by your employer, so it’s worth checking your own contract for protection clauses and comparing your current terms against the relevant SAS TCS yourself. One nuance: if your current contract mirrors older 2016 or 2002 resident doctor terms, which were built to directly reward frequent nights, weekends and on-call work, moving to SAS terms could change how those hours are paid, so it’s worth understanding the full picture rather than assuming a straightforward uplift.
If your role isn’t judged comparable to a SAS job description, your employer should explore an alternative permanent contract, and explain why they can’t offer one. If you disagree with the outcome, your organisation’s grievance process is the route, not automatic termination, and if you’re rejected, you and your supervisor should identify the gaps and build them into your development plan, with reapplication typically at your next appraisal. For support along the way, your SAS tutor, SAS advocate, LED tutor or LNC LED rep (where your trust has one) can help, as can the BMA’s employment advice service.
Separately, the training expansion opens a second route for newer or more junior LEDs, including IMGs, who aren’t yet doing SAS-level work: applying into one of the new CT1/ST1 posts as they come online from 2027. If this applies to you, the useful thing to do now is get your portfolio into shape, since portfolio readiness is being flagged as a specific gap for LEDs moving into these new training routes.
Either way, the practical advice is the same: start building your evidence now. Employment history, ALS/ACLS certification, audit and teaching evidence, and your appraisal record will all matter. The SAS choice window opens 1 September 2026, closer than it might feel.
What it means for trusts and workforce leads
Unlike the choice given to LEDs themselves, the EPF creates active obligations for employers that aren’t optional. Eligible LEDs should be identified proactively rather than left to apply on their own initiative, and local governance needs to be in place to assess competency evaluation forms consistently. That means resourcing SAS tutors, LED tutors, and clinical/educational supervisors, and giving medical workforce teams capacity to review forms within the six-week turnaround.
On the training expansion side, trusts were required to submit posts for the February 2027 intake by 31 July 2026, with a further deadline of 30 September 2026 for the August 2027 intake, and it’s worth confirming your trust’s posts have gone in or are on track. Funding differs between the two tranches: February 2027 posts come with tariff funding that includes a salary contribution, but August 2027 posts are funded only via the placement fee (currently £14,302 plus market forces factor and study leave costs), which means trusts need to fund the service salary element themselves, largely by reducing reliance on locum and agency staff.
There’s a wider signal running through both documents about LED contract reform. Trusts are expected to move LEDs onto repurposed 2016 contracts by September 2026, as a step toward a standardised LED contract, and from August 2026, employers are expected to move LEDs onto substantive contracts except where a fixed-term contract is genuinely justified: secondment cover, long-term sickness, or parental leave, for example.
For education leads specifically, the sign-off role on competency evaluation forms means you need a clear, consistent view of what “comparable to a SAS role” looks like in your specialty, ideally worked out before doctors start bringing you forms. And with two new pathways opening in parallel, supervision and mentoring capacity is likely to become the real bottleneck: identifying suitable candidates, supporting IMGs and LEDs into these routes, and sharing practice across regional networks are all being flagged as live concerns.
Where the two schemes meet
The EPF and the training expansion aren’t happening in isolation from each other. A trust converting LED roles into training posts at the same time as processing SAS transfers needs coordinated workforce planning, so the two schemes don’t inadvertently pull against each other, for instance, converting a post into a training role while a doctor in a similar position is mid-way through an SAS transfer assessment. Building both processes with a shared view of the LED workforce, rather than treating them as two separate compliance exercises, will save real friction later.
For LEDs, engaging with the EPF is entirely optional, but the choice window won’t stay open indefinitely, so deciding sooner keeps more options available to you. For trusts and education leads, several of the actions above are not optional at all: proactively identifying eligible LEDs, meeting the training post submission deadlines, and moving LEDs onto repurposed and substantive contracts by the dates above are compulsory obligations, not things to get to eventually.
Together, the EPF and the training post expansion represent an opportunity to make LED careers more secure. The practical takeaway is the same regardless of where you sit: check where you stand against the criteria and dates above, and start acting on it now rather than once the choice window or a submission deadline has already closed.
The practical takeaway is the same regardless of where you sit: check where you stand against the criteria and dates above, and start acting on it now rather than once the choice window or a submission deadline has already closed.
SAS Eligibility and Permanency Framework
Read the full guidance here!
OTHER INSIGHTS YOU MIGHT BE INTERESTED IN
Unlocking the potential of the SAS grade
Five things doctors get wrong in medical interviews- and what to do instead
