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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 leave4.

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 that you are entitled to may be affected if your due date is within the first 6 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)4.

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:

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 / Maternity Allowance

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 childbirth5.

To claim MA, you will need to complete an MA1 form either via or through Jobcentre Plus. 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 employer6.

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) before the 11th week before your expected week of childbirth and you intend to return to work in the NHS for at least 3 months5. Breaks in service due to OOP placements should be disregarded4.

A summary of Maternity pay for a period of 52 weeks maternity leave is as follows5:

  • 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 as follows7:

  • During 1st year of service : 1 month’s full pay and (after completion of 4 months service) 2 months half pay
  • During the 2nd year of service: 2 months full pay and 2 month’s half pay
  • During 3rd year of service: 4 months full pay and 4 months half pay
  • During the 4th and 5th years of service: 5 month’s full pay and 5 months half pay
  • After completing 5 years of service: 6 month’s full pay and 6 month’s half pay

In addition to this, you may be eligible for Statutory Sick Pay (SSP) which is £92.05 per week for up to 28 weeks if you have been unable to work for 4 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)

Handling sickness absence – BMA

Professional subscriptions

Many professional subscriptions such as the RCOG, GMC, MDU, BMA, and MPS will 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 5 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 (i.e. the trust you have just left) if you are still receiving either full or half pay8.

If you are just receiving SMP or MA, you will need to disclose your locums to either your trust or job center (if receiving MA) as this will affect your payments8.

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 payments8.

Sick leave

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