New proposals are out for consultation on giving senior NHS GPs, doctors and nurses access to more flexible pensions to allow them to spend more time working for patients.

The consultation follows estimates from the Department of Health and Social Care (DHSC) that a third of GPs and consultants could be turning down extra shifts because of the way the NHS Pension Scheme works with wider pension tax rules.

This new consultation presents a package of new proposals that go beyond the previous proposals for a narrow 50:50 flexibility. Responses to the withdrawn 50:50 consultation will be considered alongside those received for this consultation.

These proposals offer opportunities for senior clinicians to continue to provide additional care for the NHS by tailoring their pension accrual to the level they wish to achieve, taking into account desired pension growth and the tax implications, and allowing them to increase the level of accrual late in the scheme year.

Health and Social Care Minister Matt Hancock said: "Today we’re taking a decisive step in fixing this issue for good so patients can feel the impact in GP surgeries and hospitals across England and we are already helping hospitals ease the immediate burden with new advice on action which can be taken now.

"To make sure we get this right, however, it is vital we learn from the experiences of our dedicated frontline staff, so I urge them to have their say."

The proposals mean GPs and other senior clinicians would have the freedom to individually control how much their pension grows, allowing them to maximise the amount they can save without facing significant pension tax bills having breached limits on tax relief.

The new proposals include giving clinicians the ability to choose a personalised pension growth level at the start of each tax year and pay correspondingly lower contributions – the level chosen would be a percentage of the normal scheme contribution in 10% increments of the full accrual level.

There would be an option to fine-tune pension growth towards the end of the tax year when there is more clarity on total earnings, which would allow doctors to top-up their pension to the maximum amount without hitting their tapered annual allowance limit.

Also, where an individual has a large increase in pensionable pay, the proposals suggest phasing over a number of years the amount by which the new pay level contributes towards their pension. The DHSC said this smooths any spike in pension growth that can cause sudden pensions tax charges.

The DHSC will work with employers and staff representatives to develop a new tool to help clinicians tailor the new flexibilities to support their individual preferences, helping them to identify the best pensions approach to maximise their clinical work without facing large tax bills.

Subject to the consultation response, the DHSC will aim to introduce the new plans in time for the start of the new tax year.

The consultation, "NHS Pension Scheme: Increased Flexibility – Consultation Document", is available at

Last reviewed 17 September 2019