Resident Doctor Additional Hours Pay 2026/27: What Extra Rota Hours Are Worth

Last updated: 7 November 2026 · Figures verified against the NHS Employers 2026/27 pay circular.

By the NHS Bands Pay editorial team

What are additional rostered hours?

Resident doctors in England work under the 2016 contract, and the contract pays a basic salary for a 40-hour week. The basic salary is set by the nodal point, from £41,226 for an FY1 at nodal point 1 to £77,348 for an ST7 or ST8 at nodal point 5, in 2026/27. Hours rostered on top of that 40-hour week are called additional rostered hours, and they are paid separately from basic pay, at the rates set out on this page. The rota, not just the grade, decides what a resident doctor actually earns, because two doctors at the same nodal point on different rotas can have very different amounts of additional-hours pay.

The phrase matters because the contract uses it precisely. Additional rostered hours are hours that appear on the rota in advance, above the 40-hour basic week. They are different from hours worked beyond the rota, such as staying late after a shift or covering a gap, which are handled by exception reporting and are covered in the section below. They are also different from on-call availability, which is paid as a separate allowance for periods spent on-call whether or not you are called in. When you compare rotations or job offers, ask for the rota's pay profile, not just the nodal basic: the number of additional rostered hours, and how many of them fall in the premium window, is what turns the basic salary into the total pay for the post. Our FY1 and FY2 doctor salary guide sets out the nodal basics, and our doctor pay scales hub compares every medical scale from FY1 to consultant in one place.

One point of language is worth settling at the start. Junior doctors in England have been called resident doctors since September 2024, and the contract is still the 2016 contract, formally the 2016 Terms and Conditions of Service for NHS Doctors and Dentists in Training. Older payslips and rota documents may still say junior doctor, and the two terms mean the same group of doctors. The guide to the name change explains the history. This page uses resident doctor throughout, and every figure is for England in 2026/27, under the 2016 contract as amended by the June 2026 deal.

The two rates: plain time and the 37% premium

There are exactly two rates for additional rostered hours, and the only thing that decides between them is when the hour falls. Hours in waking hours are paid at plain time, which is your basic hourly rate with nothing added. Hours between 9pm and 7am, and hours on a Sunday, are paid at plain time plus a 37% premium, which is your basic hourly rate multiplied by 1.37. There is no third rate, no time and a half, and no double time anywhere in the resident doctor contract for additional rostered hours.

The premium window has two parts, and both are worth stating exactly. The night window runs from 9pm to 7am, which is two hours wider than the Agenda for Change night window of 8pm to 6am, and it applies on every night of the week. The Sunday window runs all day Sunday, from midnight to midnight, so a Sunday additional shift is paid at the premium rate for every hour, including daytime hours. A Saturday daytime shift is paid at plain time, because Saturday is not in the premium window at all, and a weekday daytime shift is plain time for the same reason. The boundary is exact: an additional hour from 8pm to 9pm is plain time, and an additional hour from 9pm to 10pm attracts the premium, so the start and finish times on the rota are worth checking against the payslip.

The 37% premium is the same for every nodal point, from FY1 to ST8, which keeps the maths simple: work out the plain hourly rate, multiply by 1.37, and that is the premium rate. At FY1 the plain rate is £19.77 and the premium rate is £27.08, and at ST7 the plain rate is £37.08 and the premium rate is £50.81. The premium adds £7.31 an hour at FY1 and £13.73 an hour at ST7, so the same night shift is worth considerably more at a senior nodal point, purely because the basic salary is higher. The premium is paid on the basic hourly rate only, and it does not compound with any other enhancement for the same hour.

How the two rates sit alongside the rest of the contract is worth knowing. Flexible pay premia, paid nationally for specific hard-to-fill training programmes, are separate from additional-hours pay and are set for the programme, not the rota. Additional responsibility payments, for extra duties such as a rota coordination role, are also separate. Neither of them changes the additional-hours rates on this page, and neither is calculated from them. The junior doctor take-home pay guide lists the other additions that can appear on a resident doctor's payslip.

Additional-hours hourly rates by nodal point

The table below gives the plain and premium additional-hours rates for every nodal point in England in 2026/27, with the 2026/27 basic salary alongside each one. The hourly rate is worked out as the basic salary divided by 40, the contracted basic week, and then divided by 52.143, the number of weeks in a year on the 2016 contract. The June 2026 nodal-point reform split the old nodal points 3, 4 and 5 into sub-points, so there are now ten nodal points where there were five: N3a and N3b share the same basic of £55,355, N4b and N4c share £67,998, and N5b and N5c share £77,348, which is why the same hourly rates repeat across those rows. GP registrars sit on the same scale: GPST1 and GPST2 are paid at £55,355 and GPST3 at £67,325, before any supplement. Dental trainees on the 2016 contract use the same nodal scale, with dental core training at £55,355 and dental specialty training running from £67,325 to £77,348.

Read the table from the bottom up and the shape of a medical career is visible in one column. A premium additional hour is worth £27.08 at FY1 and £50.81 at ST7 or ST8, almost double for the same hour of the night. The jumps that matter most in practice are the ones inside training: moving from FY2 to ST1 lifts a premium hour from £31.27 to £36.36, and moving from ST3 to ST6 lifts it from £44.22 to £50.30. The smallest step is inside nodal point 4, where ST3 at £44.22 and ST4 at £44.66 differ by 44p an hour, because the June 2026 reform split the old point into sub-points only £673 apart. Averaged over a 48-hour week, the FY1 basic rate is £16.47 an hour and the ST7 rate is £30.90 an hour, which is the figure to use when comparing resident doctor pay with jobs quoted on a 48-hour week. The junior doctor hourly pay guide sets out the same rates in a wider comparison with locum work and other graduate careers.

The 2026/27 figures are higher than 2025/26 by the DDRB award of 3.5%, announced on 25 March 2026 and effective from 1 April 2026, plus the effect of the June 2026 nodal-point reform. An FY1 earned £18.62 for a plain additional hour in 2025/26, at the old basic of £38,831, and £25.51 for a premium hour, against £19.77 and £27.08 in 2026/27, a rise of £1.15 an hour plain and £1.57 an hour premium. At the top of the scale, an ST6 to ST8 doctor earned £35.48 plain and £48.60 premium in 2025/26, at the old basic of £73,992, against £36.72 to £37.08 plain and £50.30 to £50.81 premium in 2026/27. The 2026/27 pay rise guide sets out the award in full.

Worked examples: what extra hours are actually worth

Hourly rates are abstract until they are turned into pounds for a real rota. The examples below use 2026/27 England rates, and each one uses the rounded hourly rates from the table above, so every total can be checked by multiplying the table figures. Annual and monthly values for regular extra hours use the exact fraction of the 40-hour week, so 8 extra hours a week is exactly 20% of basic pay, and the figures are exact rather than rounded approximations.

Example 1: FY1, 8 additional hours in a week. Basic hourly rate £19.77, premium rate £27.08. Eight additional hours in waking hours are worth 8 multiplied by £19.77, which is £158.16 for the week. The same eight hours at night, between 9pm and 7am, are worth 8 multiplied by £27.08, which is £216.64, a difference of £58.48 for the same eight hours. A 48-hour week, 40 basic hours plus 8 waking additional hours, is worth £790.63 basic plus £158.16, a total of £948.79 for the week. If those 8 extra hours were worked every week of the year in waking hours, they would be worth 20% of the £41,226 basic, which is £8,245.20 a year, or £687.10 a month. If they were all night hours, they would be worth £11,295.92 a year, or £941.33 a month.

Example 2: FY2, 8 additional hours in a week. Basic hourly rate £22.83, premium rate £31.27. Eight additional waking hours are worth 8 multiplied by £22.83, which is £182.64, and eight additional night hours are worth 8 multiplied by £31.27, which is £250.16, a difference of £67.52. The FY2 basic of £47,610 is £3,967.50 a month, and 8 extra waking hours every week would add £793.50 a month, which is 20% of the basic divided by 12, while 8 extra night hours every week would add £1,087.10 a month. The step from FY1 to FY2 is worth £24.48 a week on 8 additional waking hours, and £33.52 a week on 8 additional night hours.

Example 3: ST3 registrar, one extra 12-hour shift, 9pm to 9am. Basic hourly rate £32.28, premium rate £44.22. Ten hours fall inside the 9pm to 7am premium window and 2 hours, from 7am to 9am, fall outside it, so the shift is worth 10 multiplied by £44.22, which is £442.20, plus 2 multiplied by £32.28, which is £64.56, a total of £506.76. The same 12 hours in plain time would be worth 12 multiplied by £32.28, which is £387.36, so the premium adds £119.40 to the shift. A 12-hour additional shift that runs entirely inside the premium window, such as 9pm to 9am on a Sunday, would be worth 12 multiplied by £44.22, which is £530.64. The 7am finish is the detail to watch: the two plain hours at the end of a 9pm to 9am shift cost £23.88 against the all-premium figure.

Example 4: GP registrar, GPST2, 6 additional Sunday hours. Basic hourly rate £26.54, premium rate £36.36, on the GPST2 basic of £55,355. Six additional hours on a Sunday are worth 6 multiplied by £36.36, which is £218.16, because Sunday hours attract the premium all day. The same six hours on a weekday in waking hours would be worth 6 multiplied by £26.54, which is £159.24, so the Sunday premium adds £58.92. GP registrars sit on the same nodal scale as hospital trainees, GPST1 and GPST2 at £55,355 and GPST3 at £67,325, so a GPST3 working the same six Sunday hours would earn £265.32, at the premium rate of £44.22 an hour. Our GP registrar salary guide sets out the full GP training picture, including the supplement that sits on top of the nodal basic.

Example 5: ST7 registrar, 4 additional night hours every week. Basic hourly rate £37.08, premium rate £50.81. Four additional night hours a week are worth 4 multiplied by £50.81, which is £203.24 a week. Over a year that is 10% of the £77,348 basic multiplied by 1.37, which is £10,596.68 a year, or £883.06 a month, on top of the basic monthly pay of £6,445.67. The same four hours in waking hours would be worth £148.32 a week, £7,734.80 a year, or £644.57 a month. A permanently heavy rota with regular additional night hours is worth several thousand pounds a year at senior nodal points, which is why the rota's pay profile matters as much as the nodal point when comparing posts.

Example 6: FY2, a 12-hour Saturday day shift against a 12-hour Sunday shift. Basic hourly rate £22.83, premium rate £31.27. A 12-hour additional shift on a Saturday from 8am to 8pm is paid entirely at plain time, because Saturday daytime is not in the premium window, and it is worth 12 multiplied by £22.83, which is £273.96. The same 12 hours on a Sunday are paid at the premium rate all day, and are worth 12 multiplied by £31.27, which is £375.24, a difference of £101.28 for the same length of shift. A Saturday night shift from 9pm to 7am would be paid at the premium rate, because the hours fall inside the 9pm to 7am window, and it would be worth £375.24 as well. The day of the week matters less than the clock: it is the 9pm to 7am window and the Sunday rule that decide the rate, not the word Saturday or Sunday on the rota.

Additional hours are not Agenda for Change overtime

Resident doctors are outside Agenda for Change, and that single fact explains why the additional-hours rules look nothing like the overtime rules most NHS staff know. Agenda for Change overtime, under Section 3 of the handbook, is time and a half for Bands 1 to 7, and double time on bank holidays, starting above 37.5 hours a week, with Bands 8 and 9 receiving time off in lieu only. Resident doctor additional hours are plain time in waking hours and plain time plus 37% for nights and Sundays, starting above the 40-hour basic week. There is no time-and-a-half rate anywhere in the resident doctor contract for additional rostered hours, and no double-time rate either.

The comparison is worth making carefully, because the two systems produce different answers for the same shift. A Band 5 nurse working a 7.5-hour shift above 37.5 hours earns time and a half, £24.57 an hour at the entry point, while an FY1 working an additional 7.5-hour shift in waking hours earns plain time, £19.77 an hour, even though the FY1 basic salary is higher than the Band 5 basic. The doctor's advantage comes at night and on Sundays, where the 37% premium applies to every additional hour, while the Agenda for Change unsocial-hours enhancement applies only inside its own windows and cannot be claimed together with overtime for the same hours. Neither system is simply better than the other: the doctor contract pays less for extra daytime hours and more for extra night and Sunday hours, relative to basic pay. Our unsocial hours and overtime guide sets out the Agenda for Change rules in full, and the weekend pay rates guide gives the Saturday and Sunday hourly rates for every Agenda for Change band.

The threshold difference matters too. Agenda for Change overtime starts above 37.5 hours a week, while resident doctor additional hours start above the 40-hour basic week, so a resident doctor working 39 hours in a week earns no additional-hours pay at all, while an Agenda for Change colleague on the same hours would be approaching the overtime threshold. Part-time resident doctors are paid additional-hours rates on hours above their contracted hours in the same way, with the premium applying to hours in the 9pm to 7am window or on Sundays, and the junior doctor hourly pay guide explains how the hourly rate is worked out for any contracted-hours pattern.

Sundays, Saturdays and the weekend allowance

Sunday is the best-paid day for additional rostered hours, because the premium applies all day, including daytime hours. A Sunday additional shift is paid at plain time plus 37% for every hour, which is why Example 4 above, six Sunday hours for a GPST2, is worth £218.16 against £159.24 for the same hours on a weekday. Saturday is the opposite: daytime hours are plain time, and only the hours between 9pm and 7am attract the premium, so a Saturday day shift is the worst-paid weekend shift for additional hours, and a Saturday night shift is paid the same as any other night shift. Doctors who assume the Agenda for Change weekend rules apply to them will overestimate Saturday day pay and underestimate Sunday day pay, because the two systems treat the weekend differently.

There is one more weekend payment to know about, and it is separate from additional-hours pay. The contract provides a weekend allowance, additional pay for doctors who work one in two weekends or more frequently. It is a frequency allowance, not an hourly rate, and it is paid for the pattern of weekend working rather than for individual hours, which is why no hourly figure for it appears in the table on this page. The exact terms are set out in the national terms and conditions and the annual pay circular, and your trust's payroll applies them according to your rota. The FY1 and FY2 doctor salary guide lists the weekend allowance alongside the on-call availability allowance, which is payment for periods spent on-call whether or not you are called in, and both are separate from the additional-hours rates on this page.

When you compare rotas, count the weekend hours in each premium category separately: Sunday daytime hours at the premium rate, Saturday night hours at the premium rate, Saturday daytime hours at plain time, and the weekend allowance for the frequency of weekend working. A rota with frequent Sunday shifts is worth materially more than a rota with the same number of Saturday day shifts, and the difference is visible in the worked examples above: £101.28 for a single 12-hour shift at FY2. The locum doctor hourly rates guide covers bank and agency weekend rates, which are set locally and run higher than the salaried rates.

Exception reporting: hours that are not on the rota

Additional rostered hours are planned in advance and appear on the rota, and they are paid automatically at the rates on this page. Hours worked beyond the rota are a different matter, and they are handled by exception reporting. If you consistently work beyond your rota, staying late every shift, missing breaks, or covering gaps, the contract provides exception reporting: you file a report, and the outcomes can include additional pay or time off in lieu, and ultimately rota redesign if the pattern persists. It is the mechanism that stops a 48-hour average from quietly becoming 55, and it is monitored by the guardian of safe working hours at each trust.

Exception reporting is underused, partly because trainees worry about being seen as complaining, but it is a contractual right, and the BMA advises using it whenever the rota does not reflect reality. From a pay perspective, it is the difference between working extra hours for free and working them for pay or time back. It also matters for your pension: hours that are paid through exception reporting are pensionable, so reporting protects both your hourly rate and your long-term pension accrual. Keep your own log of hours worked against hours rostered, a simple spreadsheet is enough, so that if a pattern emerges you have the evidence to file and, if needed, to escalate. Our junior doctor hourly pay guide explains exception reporting in full, including the guardian of safe working hours role.

The distinction between rostered and unrostered hours is the one to hold on to. Rostered additional hours are paid at plain time or plain time plus 37%, automatically, on the payslip for the month the shifts were worked. Unrostered hours need a report before they are paid or returned as time off, and they are not paid at the additional-hours rates automatically. If a month's payslip shows fewer additional hours than the rota promised, check the rota first, then the exception reports, because a missing shift is usually a rota coding issue, and a pattern of missing hours is usually a rota that needs redesigning rather than a pay error.

What additional hours are worth over a year

Single shifts are easy to price, and the annual figure is what matters for budgeting, because additional hours are usually a regular feature of a rota rather than a one-off. The maths is simple because the rates are fractions of basic pay: 8 extra hours a week is 20% of a 40-hour week, so 8 extra waking hours every week are worth exactly 20% of basic pay over a year, and 8 extra night hours every week are worth 20% of basic pay multiplied by 1.37. At FY1, 8 extra waking hours a week are worth £8,245.20 a year, or £687.10 a month, and 8 extra night hours a week are worth £11,295.92 a year, or £941.33 a month. At ST7, 4 extra night hours a week are worth £10,596.68 a year, or £883.06 a month, on top of the basic monthly pay of £6,445.67.

The same fractions scale to any pattern. Two extra waking hours a week are 5% of basic pay, worth £2,061.30 a year at FY1 and £3,867.40 a year at ST7. Four extra night hours a week are 10% of basic pay multiplied by 1.37, worth £5,647.96 a year at FY1 and £10,596.68 a year at ST7. A full extra 8-hour shift every week at night is worth more than a quarter of basic pay, which is why a rota with regular night additional hours can lift total pay far above the nodal basic, and why two posts at the same nodal point can pay very differently. The junior doctor take-home pay guide works through what those gross figures mean after tax, National Insurance and pension, and the doctor pay scales hub sets out the nodal basics the fractions are calculated from.

One caution belongs here. Additional-hours pay follows the rota, and rotas change between placements, so an annual figure based on one rotation is an illustration, not a promise. A rotation with heavy additional hours can be followed by one with almost none, and the monthly pay will move with it. Budget on the basic salary, and treat additional-hours pay as variable income, because that is how it behaves in practice. The same caution applies to the premium: a rota that looks generous on paper because it has many night hours will pay less if the nights are swapped for days, and the payslip will show the difference in the month the change happens.

Take-home pay and pension

Additional-hours pay is pensionable pay, so it counts towards your NHS pension and it also increases the pension contributions deducted from your pay, because contributions are a percentage of pensionable pay. An FY1 on £41,226 sits in the 9.8% contribution tier, and regular additional hours raise the pensionable pay the percentage is applied to, which means slightly higher contributions each month and slightly faster pension building over a career. The effect is small for occasional extra shifts and material for a permanently heavy rota, and it is one of the few compensations for the unsocial hours involved. The pension contributions guide sets out the tiers in full, and the pension calculator will project a pension from any salary, with or without regular additional-hours pay included.

Additional-hours pay is also subject to income tax and National Insurance in the normal way, so the gross figures on this page are not the amounts that land in the bank. Enhancements are worth roughly three-fifths of their face value in cash at basic rate, after tax, National Insurance and pension, plus the pension accrual they build, which is the maths to run whenever you compare rotas. The exact amount kept depends on the tax code, the student loan plan and the pension tier. The junior doctor take-home pay guide breaks down the full calculation month by month, including how additional-hours pay flows through tax and pension, and the consultant take-home pay guide shows where the same maths leads at the top of a medical career.

Two checks are worth doing every month. First, count the additional rostered hours on the rota and compare them with the payslip: a missing shift is the most common error in this area, and it is usually a rota coding issue rather than a pay error. Second, check the 9pm boundary on any shift that starts or ends near it, because an hour coded as plain time when it falls inside the 9pm to 7am window is the second most common error, and it is worth the premium rate. If your payslip shows a flat additional-hours figure every month rather than a varying shift-by-shift amount, ask payroll which convention they apply, because local practice on coding rotas varies, and the rota is the reference point, not a guarantee of how every trust codes its shifts.

Trust-grade doctors and the June 2026 deal

Trust-grade doctors, also called locally employed doctors, are employed on locally determined pay, and the June 2026 deal offered all of them 2016-contract terms with mirrored nodal points. The mirrored grade codes run from MT01 at nodal point 1, £41,226, to MT10 at nodal point 5c, £77,348, and the hourly rates on this page apply to those mirrored points in the same way: MT01 earns £19.77 for a plain additional hour and £27.08 for a premium additional hour, and MT10 earns £37.08 plain and £50.81 premium. Employers may mirror these points, and local determination is permitted, so a trust-grade post must state the contracted hours and whether it follows the 2016-contract terms, including how extra rostered hours are paid. Always check the actual offer, because a code is useful only if you know what it maps to. Our trust-grade doctor salary guide sets out the full MT01 to MT10 table and the questions to ask before accepting a post.

The June 2026 deal changed more than the nodal points. It ended the dispute after a member vote, and it included exam and royal-college membership fees reimbursed from April 2026, enhanced appraisal for locally employed doctors from October 2026, and clinical-academic flexible pay premia rising from £5,600 to £10,000 from April 2027. The nodal-point reform split points 3, 4 and 5 into sub-points, which is why the table on this page has ten rows, and it sits alongside the DDRB award of 3.5% effective from 1 April 2026. The doctor pay scales hub sets out the reform and the award together, with the 2025/26 baselines for comparison.

Scotland, Wales and Northern Ireland

The figures on this page are for England under the 2016 contract, and they should not be assumed to apply elsewhere. Scotland, Wales and Northern Ireland have their own arrangements for resident doctor pay, and the verified data file this site works from holds the England nodal scale only, so no devolved nodal figures are quoted here. The June 2026 deal was an England deal, and the DDRB award of 3.5% for 2026/27 applies to England, with the devolved nations making their own awards. The nation guides are NHS Scotland pay, NHS Wales pay and NHS Northern Ireland pay, and staff in the devolved nations should check the local pay circular for the exact figures rather than budgeting on the England rates.

Frequently asked questions

What are additional rostered hours for resident doctors?

Additional rostered hours are the hours on your rota above the 40-hour basic week in the 2016 resident doctor contract. The contract pays a basic salary for a 40-hour week, and any hours rostered on top of that are additional rostered hours, paid separately from basic pay. In waking hours they are paid at plain time, your basic hourly rate, and for hours between 9pm and 7am or on Sundays they are paid at plain time plus a 37% premium. The hourly rate is worked out as your basic salary divided by 40 and then by 52.143, so an FY1 on £41,226 earns £19.77 for a plain additional hour and £27.08 for a premium additional hour in 2026/27.

How much is an additional hour worth at FY1?

An FY1 on the 2026/27 basic of £41,226 earns £19.77 for an additional hour in waking hours and £27.08 for an additional hour between 9pm and 7am or on a Sunday. The plain rate is the basic salary divided by 40 hours a week and then by 52.143 weeks, and the premium rate is the plain rate multiplied by 1.37. Eight additional waking hours in a week are worth £158.16, and the same eight hours at night are worth £216.64. At ST7, on £77,348, the same rates are £37.08 plain and £50.81 premium, so eight additional night hours are worth £406.48.

What hours attract the 37% premium?

The 37% premium applies to additional rostered hours worked between 9pm and 7am, and to additional rostered hours worked on a Sunday, all day. It does not apply to Saturday daytime hours, which are paid at plain time even though Saturday feels like the weekend, and it does not apply to weekday daytime hours. The boundary is exact: an additional hour from 8pm to 9pm is plain time, and an additional hour from 9pm to 10pm attracts the premium. A Sunday additional shift is paid at the premium rate for every hour, including daytime hours, which is what makes Sunday additional hours the best-paid daytime hours in the contract.

Do Saturday day shifts attract the 37% premium?

No. Saturday daytime additional hours are paid at plain time. The premium window is 9pm to 7am plus Sundays, so a Saturday shift from 8am to 8pm is paid entirely at plain time, while a Saturday night shift from 9pm to 7am is paid at the premium rate. At FY2, a 12-hour Saturday day shift is worth £273.96 at the plain rate of £22.83 an hour, and the same 12 hours on a Sunday are worth £375.24 at the premium rate of £31.27 an hour, a difference of £101.28 for the same length of shift. This is different from Agenda for Change, where Saturday attracts an enhancement, and it catches out doctors who assume the NHS weekend rules are the same for everyone.

How is the resident doctor hourly rate worked out?

The hourly rate is your annual basic salary divided by 40, the contracted basic week, and then divided by 52.143, the number of weeks in a year on the 2016 contract. An FY1 on £41,226 works out at £19.77 an hour, and an ST7 on £77,348 works out at £37.08 an hour. The same divisor is used for the premium rate, which is the plain hourly rate multiplied by 1.37. Averaged over a 48-hour week, the FY1 basic rate is £16.47 an hour and the ST7 rate is £30.90 an hour, which is the figure to use when comparing resident doctor pay with jobs quoted on a 48-hour week. The full table for every nodal point is on this page, and the junior doctor hourly pay guide sets out the same rates in a wider comparison.

How are additional hours different from NHS overtime?

Resident doctors are outside Agenda for Change, so the Agenda for Change overtime rules do not apply to them. Agenda for Change overtime is time and a half for Bands 1 to 7, and double time on bank holidays, while resident doctor additional hours are paid at plain time in waking hours and at plain time plus 37% for nights and Sundays. There is no time-and-a-half rate anywhere in the resident doctor contract for additional rostered hours. The two systems also differ in structure: Agenda for Change overtime starts above 37.5 hours a week, while resident doctor additional hours start above the 40-hour basic week. Our unsocial hours and overtime guide sets out the Agenda for Change rules, and this page covers the doctor rules only.

What if I work hours that are not on my rota?

Hours worked beyond the rota, such as staying late every shift, missing breaks or covering gaps, are handled by exception reporting, not by the additional-hours rate. The contract provides exception reporting as the mechanism for recording work that goes beyond the rota, and the outcomes can include additional pay or time off in lieu, and ultimately rota redesign if the pattern persists. It is monitored by the guardian of safe working hours at each trust. Exception reporting is different from additional rostered hours, which are planned in advance and appear on the rota, and the two should not be confused: rostered hours are paid automatically at the rates on this page, while unrostered hours need a report before they are paid or returned as time off. Our junior doctor hourly pay guide explains exception reporting in full.

Are additional-hours payments pensionable?

Yes. Additional-hours pay is pensionable pay, so it counts towards your NHS pension and it also increases the pension contributions deducted from your pay, because contributions are a percentage of pensionable pay. An FY1 on £41,226 sits in the 9.8% contribution tier, and regular additional hours raise the pensionable pay the percentage is applied to, which means slightly higher contributions each month and slightly faster pension building over a career. The effect is small for occasional extra shifts and material for a permanently heavy rota. The junior doctor take-home pay guide works through how enhancements flow through tax, National Insurance and pension, and the pension contributions guide sets out the tiers in full.

Sources and independence

Source: NHS Employers, 2026/27 pay award announcement.

Source: BMA, Government offer to resident doctors in England (June 2026); GOV.UK, Government offer to resident doctors explainer.

NHS Bands Pay is an independent guide and is not affiliated with the NHS. Figures were verified against official sources on 7 November 2026 and can change, always confirm with the relevant official body before making financial decisions.