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Financial implications

Taking an absence from work can have significant financial implications.

Out of Programme (OOP) Pay

Pay will depend on your individual contract. However, it is important to be aware of the potential changes in your NHS pay, pension and maternity leave 27.

Breaks in service due to OOP placements should be disregarded with respect to eligibility for pay progression and parental leave and pay. However, the amount of maternity pay you are entitled to may be affected if your due date is within the first six months of your return to work (i.e. you return to work from an OOP already pregnant).

This is because maternity pay is based on your average weekly earnings in the eight weeks up to and including the qualifying week which is the 15th week before your due date (see section on Maternity Pay) 27.

Overall it is advisable to seek an NHS honorary contract with your employer to protect certain benefits relating to continuity of service.

Further information can be found here:

BMA guidance on transferring between NHS and university employment during training

BMA guidance on your pension during an authorised absence or career break

Sources of legal advice and support

Maternity Pay

During maternity leave, you may be eligible for Statutory Maternity Pay (SMP) or Maternity Allowance (MA) as well as NHS Occupational Maternity Pay (OMP).

Statutory Maternity Pay (SMP) / Maternity Allowance (MA)

SMP is available if you have been in continuous employment with one employer (i.e. trust) for at least 26 weeks by the 15th week before your expected week of childbirth. This is paid for 39 weeks of your maternity leave.

Your Human Resources department should be able to advise on whether you are eligible for SMP and, if not, whether you are entitled to MA instead.

You can claim MA from the 26th week of pregnancy and payments can start from the 11th week before your expected week of childbirth 9.

To claim MA, you will need to complete an MA1 form via Gov.UK. Additionally, you will need to send proof of income (e.g. pay slip), proof of baby’s due date (e.g. MATB1 form) and an SMP1 form if you were refused SMP by your employer 30.

You can calculate your SMP using the government calculator Maternity, Adoption and paternity calculator for employers:

NHS Occupational Maternity Pay (OMP)

You are eligible for NHS OMP if you have been in continuous employment within the NHS for 12 months (not necessarily in same trust/board) before the 11th week before your expected week of childbirth and you intend to return to work in the NHS for at least three months 9. Breaks in service due to OOP placements should be disregarded 27.

A summary of maternity pay for a period of 52 weeks maternity leave is as follows 9:

  • 8 weeks – Full pay less any SMP/MA receivable
  • 18 weeks – Half pay plus flat rate of SMP (or average weekly earnings, whichever is lower) providing the total does not exceed full pay
  • 13 weeks – Flat rate SMP or MA (or 90% of average weekly earnings, whichever is lower)
  • 13 weeks – Unpaid leave*

Advice regarding different types of pay that you may be entitled to can be found on the following links:

*Accrued annual leave can be added to the end of your 52-week maternity leave period or be taken during unpaid leave.

Sick pay

If you are unable to work due to illness, you are entitled to occupational sick pay. The BMA have guidance leave and entitlement to sick pay.

You may be eligible for Statutory Sick Pay (SSP) which is £109.40 per week for up to 28 weeks if you have been unable to work for four or more days in a row (including non-working days). More information regarding eligibility for SSP and Occupational sick pay can be found below:

Statutory Sick Pay – GOV.UK

Sickness absence – Section 14(a)(England)

Professional subscriptions

Many professional subscriptions such as the RCOG, GMC, MDU, BMA and MPS offer income discounts, so contact each of the organisations in advance to see what they can offer you.

The amount and timing will depend on whether you apply before or after a fee notice.

Additionally, many of these subscriptions are tax-deductible so if you haven’t asked HMRC for a discount over the last five years, it may also be worth doing so in case you are entitled to a tax refund (providing you have been paying tax at the correct rate over this period of time – you can check that your payslip tax codes correspond to the tax code sent to you from HMRC for that particular tax year).

If you are considering pausing or stopping your indemnity cover during leave, bear in mind that a re-application will be needed. This could get complicated if, for example, you were involved in a serious incident (SI) with an ongoing investigation as you will need to declare this.

Working locum shifts whilst absent from work

The rules for working locum shifts depend on your reason for leave of absence.


For terms of working in additional employment during your OOP, please refer to your individual contract.

Maternity Leave

If on maternity leave, you will have to ask permission from your employing trust/board (i.e. the trust/board you have just left) if you are still receiving either full or half pay (8).

If you are just receiving SMP or MA, you will need to disclose your locums to either your trust/board or job centre (if receiving MA) as this will affect your payments (8).

If you are in the unpaid period of maternity leave then you do not need to disclose or seek permission for any additional work that you undertake.

Before undertaking any additional work, it is always advisable to check your contract as well as your local maternity leave policy to confirm how this may affect your payments (8).

Sick leave

If you have been deemed unable to work because of illness, it is advisable that you do not undertake any additional work whilst on sick leave.