Negotiating Tips

This guide aims to empower doctors to secure fair compensation for extra-contractual shifts, complementing the leadership provided by the BMA's publication of a rate card. Grassroots doctors are now encouraged to actively negotiate for each and every extra-contractual shift.

• Recognise that NHS trust-issued "rate" cards are starting points for negotiation and not final offers. Like negotiating the price of a house or car, accepting the first offer for shift work is unwise. These lowball opening offers should not deter you from negotiating for fair compensation for a shift. These rates are set intentionally low in order to "frame" your respose; decreasing your expectations of securing fair remuneration.
• Leverage the rate card, discuss it with colleagues, and establish your non-negotiable, minimum acceptable rates; your "red lines".
• Negotiate for each and every extra-contractual shift without exception. Supply and demand economics apply, what you can negotiate week to week will vary.
• Know your minimum acceptable rates but keep them confidential from your employer to prevent them from using this knowledge against you.
• Be willing to decline shifts offered below your minimum rate. This principle is crucial for effective negotiation.
• Maintain professional integrity by not settling for less than your skills, training, and responsibilities deserve. Share resources, such as this website, with colleagues who might accept lower rates. Do not feel bad if someone else takes the shift or makes you feel like you somehow "missed out" if you did not secure the shift. You did not miss out on anything, you demonstrated self respect and professionalism.
• Resist any pressure to accept lower rates, recognising that it's the system, not your colleagues, that undervalues your skills. Be proud that you are taking a stand against the de-professionalisation of medicine.
• Your negotiation is with your employer, not with consultants or colleagues.
• Research and keep documentation on local initial rates and final negociated rates. Share this information with your colleagues. Show others how effective negotiation is.
• Use social media and your professional networks (WhatsApp, Reddit, Twitter etc.) to share your experience and tactics for successful negotiation.
• Adjust your rates based on qualifications and experience. For example, consider increasing your base rate if you have a key milstone qualification in your specialty (e.g. MRCP, FRCA, FRCS etc.) Communicate your experience, skills and value clearly.
• Anticipate that NHS Trusts will likely not recognise or value your exerperience or training. They will not be used to doctors standing up for themselves through negotiation.
• Maintain the highest professional standards, remembering that negotiation is a sign of professionalism, not a failing.
• Refuse compensation in the form of time in lieu unless it offers clear advantages for your specific situation. Time in lieu generally undervalues your skills.

Negotiation is a cornerstone of professional conduct. Accepting work for less than your skills are worth or working unpaid overtime are truly unprofessional behaviors. Embrace negotiation as a means to respect and value your own professionalism.