How does this affect me?


  • Current Doctors in Training - current doctors in training were onboarded in August 2018 by the lead employer for their current programme of training and will remain with that lead employer for the duration of that programme of training. This means a reduction in repetitive on and off boarding as current trainees rotate through placements. There is now one contract of employment for the duration of the training programme, with amendments issued for each rotation to a new placement (Placement Detail letters).
  • Current Doctors in Training on national programmes – the same principles applies to your employment as for any other doctor in training:
    • Single contract of employment with one employment Board for the duration of the programme of training.
    • Payroll delivered by the employing Board for the duration of the training programme.
    • Rotation through placement Boards with local medical staffing support on behalf of the employing Board and amendments to contract issued for each rotation to a new placement (Placement Detail letters).
  • GP trainees - current GP Trainees also transitioned to the lead employer arrangements.
  • GP trainees (future) - future GP Trainees will be employed by NES for the duration of their specialty training programme in General Practice. There will be one contract of employment for the duration of the training programme, with amendments issued for each rotation to a new placement (Placement Detail letters).
  • Military/ Academic/ Industry employed trainees: as these trainees are not an employee of a NHS Board the employment arrangements will not be impacted by the lead employer arrangements.
  • Out of Programme: if a trainee was out of programme in August 2018, on return to a training programme, the contract will be issued under the new arrangements.
  • Current trainees on long term sickness absence: if a trainee was on long term sick leave in August 2018, on return to a training programme, the contract will be issued under the new arrangements. 
  • Current trainees on maternity leave now/ future: if a trainee was on maternity leave in August 2018, on return to a training programme, the contract will be issued under the new arrangements. 
  • Future Doctors in Training - future Trainees will be employed by a lead employer for the duration of each training programme. There will be one contract of employment for the duration of the training programme, with amendments issued for each rotation to a new placement (Placement Detail letters).
  • Current Dental trainees– current dentists in training will be transitioned to the lead employer arrangements from August 2019. Further detail will be developed on how the lead employer arrangements will apply to dental trainees.
  • Future Dental trainees - in the future state all dentists in training will be employed by a lead employer for the duration of each training programme. There will be one contract of employment for the duration of the training programme, with amendments issued for each rotation to a new placement (Placement Detail letters).
  • Directors of Human Resources (HRDs) - the HRD group will continue to have strategic responsibility for the employment of doctors in training, a Director of HR will chair the SMT HR Subgroup.
  • Directors of Finance (DoFs) – the DoF group will continue to have strategic responsibility for the financial arrangements for doctors and dentists in training.
  • Regional Workforce Planning Groups – Regional Workforce Planning groups will continue to have responsibility for delivering regional workforce planning, reporting may be impacted on by the lead employer model, with placement Board now describing where a trainee is engaged in clinical practice, rather than their employer.
  • Occupational Health Community – the OH community were asked to develop Once for Scotland solutions to support the lead employer arrangements to ensure that appropriate information can be shared between lead employers and placement Boards to support the trainee in their training programme and throughout employment.
  • Information Governance - information is shared across employing Boards and placement Boards as described in Once for Scotland Data Sharing Agreements.
  • Royal Colleges - the Royal Colleges will not be directly impacted by the lead employer arrangements.
  • TPDs and the Deanery continue to manage rotations, training decisions, ARCPs and be the first point of contact for OOP, performance support unit, careers and LTFT. The difference will be working with an Employer and a Placement Board in some instances – but we have reviewed policies to try and minimise duplications in information sharing and meetings. There are some things that still need to be agreed so we will keep you informed of things as they evolve, but in most cases your roles should not change as a result of the employer changing.
  • Educational Supervisors – the education and training of doctors and training will not be impacted on by the lead employer arrangements, however it is anticipated that the reduced employment administration required of trainees will be a benefit.
  • Practices – the lead employer arrangements has had minimal impact on practices as NES is already (since 2011) the employer for doctors in training when they are in a GP placement. However, practices may benefit from NES having improved employee data as a result of being the sole employer for the duration of GPST.
  • Other NHSS team members - other team members should not be directly impacted by the lead employer arrangements, Once for Scotland policies will be developed in accordance with the PIN Guidelines. The lead employer arrangements will mean team members may have different employers, for example doctors in training may be employed by one of the 4 lead employers whereas other team members are placement Board employees.
  • Universities - the lead employer arrangements should not impact on the undergraduate training and education of doctors and dentists in training, however it will be useful for Universities to have an awareness of the postgraduate employment arrangements.