Pay, contracts and pensions

Clinical academics in the UK have a unique pay and pension structure that reflects both their clinical and academic roles. Understanding how salaries, benefits and pension schemes work can help you plan your career and financial future effectively.

In the UK, clinical academics are usually employed on combined contracts that cover both their NHS clinical work and university academic duties. Their pay reflects this dual role, with contributions to NHS and/or academic pension schemes depending on the arrangement. The exact structure can vary by institution, but the system is designed to ensure that both clinical and academic work are rewarded and supported. On this page, we’ve compiled some frequently asked questions about the transition to clinical academia.

What will be the impact on my salary?

There should be no impact on salary. This is because university employers maintain pay parity with the NHS for their clinical academic staff. This means that university pay scales for clinical academics mirror the pay points for clinical staff in the NHS. UCEA develops clinical academic pay scales in consultation with the BMA, BDA and UCU, based on the NHS pay circular.

You will also continue to be eligible for national and local clinical excellence awards.

Will I have two separate contracts?

Yes, although only one employer will handle your salary and financial arrangements. A clinical academic role is one job, but with two linked parts: academic work (research, teaching, education etc) and clinical work (usually in an NHS trust or GP practice). There will be two employers, who will work together to have joint oversight of your role – it is a tripartite relationship between the individual clinical academic, the university employer and the NHS employer.

There will be a substantive contract with one employer (usually the university), and a linked honorary contract with the other employer (usually the NHS trust). You need to maintain a contract with the NHS in order for you to do clinical work with patients.

Sometimes, especially for Nurses, Midwifes, Allied Health Professionals, Psychologists and Pharmacists, you will remain fully employed by the NHS with an honorary contact with the university, which can be advantageous if you later return to full‑time NHS clinical practice.

How will my terms and conditions be affected?

Medical trainees on a clinical training pathway will still have access to occupational benefits. The exact occupational benefits will depend on whether you remain employed by the NHS or move to being employed directly by a university.

If you are early on in your research career, it may be that you stay employed by the NHS, with an honorary university contract. If so, there will be no changes to your terms and conditions. Alternatively, you may move to being “substantively” employed by a university, with an honorary NHS contract. If this happens, you should have access to university occupational terms and conditions from day 1, counting your previous NHS service as though it had accrued in the university. University terms and conditions vary slightly from those in the NHS but are still generous.

Either way, you will not be left with just statutory benefits. The “principles and obligations” underscore this.

In addition, the honorary (NHS) contract includes reference to Schedule 23 of the 2003 NHS Consultant terms and conditions (TCS). Schedule 23 lists all the NHS TCS that apply to clinical academics.

Will I still be entitled to maternity/paternity pay?

Yes – as per the previous FAQ. If you move to a university, you will be entitled to their occupational maternity/paternity pay.

Will my two employers work together?

Yes. The Follett principles, published in 2001, arose from “A Review of Appraisal, Disciplinary and Reporting Arrangements for Senior NHS and University Staff with Academic and Clinical Duties” by Professor Sir Brian Follett and Michael Paulson-Ellis. Universities and NHS trusts still adhere to the principles. Follett underscored that a clinical academic job is one job with integrated (clinical and academic) responsibilities. As such, it requires joint working between the two employers in order to integrate those clinical and academic responsibilities. The Follett principles strongly recommend that university and NHS employers work together to undertake:

• joint recruitment and appointment
• joint job planning
• joint appraisal

This helps to avoid a situation where the two parts of the role compete against each other and that sufficient time and resource is allocated to both parts.

Pensions

NHS employees who move to employment at a university are able to retain membership of the NHS Pension Scheme (NHSPS) where they meet the eligibility criteria* and their employer has a University Direction agreement.

Alternatively, the individual could join the Universities Superannuation Scheme (USS) or could be enrolled in either Teachers’ Pension Scheme (TPS) or Local Government Pension Scheme (LGPS) if they are employed at a post-92 university. Currently, across the UK, over half the clinical academics employed by universities are in the NHSPS and over a third are in the USS. A very small number are in another scheme.

 *The employee must have been eligible to enter into the NHSPS in the 12 months prior to starting with the HE institution and the employee must be working wholly or mainly for the medical school and can be covering duties that are administrative, professional, technical or clerical.

This resource was generated with the assistance of the Universities & Colleges Employers Association (UCEA).