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FOURTH TRIMESTER HUB
Parental Leave for Doctors: A Practical UK Guide
Pregnancy, maternity, paternity, adoption, shared parental leave and returning to work
The things most of us wish someone had explained before we started filling in forms.
For doctors in NHS, primary care, academic and independent-sector posts. Use this handbook alongside your employer’s policy and your own contract.
This guide is an information resource, not legal advice. Your employer’s local policy, contract, country-specific rules and individual circumstances determine your entitlement.
Welcome!
The aim of this guide is to make your life easier and provide all the useful information in one place that is specific to the practical realities of pregnancy, parental leave and returning to work as a doctor.
Becoming a new parent as a doctor comes with added challenges. Alongside often confusing guidance about different types of parental leave and pay are questions such as what happens if you rotate to a new hospital mid pregnancy? Or how do I arrange shift adjustments during pregnancy?
You’ve spent your career caring for other people, now it’s time to look after yourself and your baby!
How to use this handbook
This handbook is designed for doctors who are pregnant, becoming parents through adoption or surrogacy, or planning parental leave. The practical steps are relevant across the UK, but employment law and NHS terms are not identical in every nation or contract.
Important country and contract differences
GOV.UK guidance covers Great Britain in many areas. Since 6 April 2026, the day-one rights to paternity leave and unpaid parental leave described in this guide apply in England, Scotland and Wales, but not Northern Ireland, where parental leave and pay law is devolved. NHS occupational arrangements, local policies, training support and childcare offers may also differ by nation, employer, lead-employer model and contract type. If you work in Northern Ireland, seek advice from your employer and use nidirect guidance in addition to this handbook.
Your first five steps
1. Tell your employer when you're ready.
This allows pregnancy-specific workplace protections to be put in place.
2. Ask for an individual risk assessment.
3. Ask HR/payroll for a written leave and pay calculation.
4. If you're a trainee, tell your educational supervisor/TPD early.
5. If you are rotating or have a fixed-term contract, establish who your legal employer is and what happens to your contract.
Stay well during shift
Take your break. Consider sitting down more than you are used to! Sit down whilst seeing patients and at handovers. Drink plenty of water. Eat when you need to.
When should I tell work?
Line Manager
It’s a personal choice when to tell your line manager and colleagues. However, your employer can only put pregnancy-specific protections in place once you have told them. Therefore, it’s advised to tell your line manager and complete a risk assessment with them as soon as you know you are pregnant to ensure you aren’t exposed to unnecessary risks. You can ask your line manager to keep this information confidential if you prefer.
HR: Formal maternity notification
For statutory maternity leave and pay, you normally need to tell your employer by the end of the 15th week before the expected week of childbirth.
Provide the expected week of childbirth, your intended leave start date and the MATB1 certificate when requested. Your MATB1 form is also called a maternity certificate, it proves you are pregnant and lists your baby's due date. Your midwife or GP will issue you one for free. They can only give it to you after 20 weeks of pregnancy.
Your employer may have a trust specific notification form. If you cannot meet the deadline, notify them as soon as reasonably practicable. Keep a dated copy of what you send and ask for written confirmation of your leave and pay calculation.
Should I notify anyone else?
You may need to consider informing the following people depending on your situation:
- Supervisors (educational/clinical)
- College Tutor or Foundation Program Director (if you are in a training program)
- Rota Co-ordinator
- Training Program Director (if on a multi-year training program such as specialty registrar)
- Other colleagues you may have commitments with such as audit etc.
What should the risk assessment cover?
A meaningful assessment should consider the realities of medical work. This can include long or night shifts, fatigue, limited access to water, food, toilets or rest, prolonged standing or sitting, manual handling, infection and hazardous exposure, radiation, violence or lone working, travel between sites, heat, emergency response work and workload intensity. Explain any individual advice from your midwife, obstetrician, GP or occupational health clinician.
Where a material risk cannot be removed, the employer should consider adjustments to your hours or duties, suitable alternative work or, where necessary, suspension on full pay. Ask for the agreed controls to be recorded and review them rather than relying on an informal arrangement.
The assessment should be reviewed whenever your clinical duties, working environment, health needs or stage of pregnancy changes, and again when you return if you are breastfeeding or expressing.
Here is a Pregnancy & Breastfeeding Risk Assessment Template to use as an example.
Further information: GOV.UK, Pregnant employees’ rights https://www.gov.uk/working-when-pregnant-your-rights
Can I take time off for scans and appointments?
Pregnant employees are entitled to paid time off at their normal rate for antenatal care. Antenatal care can include appointments and antenatal/parenting classes where recommended by a doctor or midwife. A partner may have the right to unpaid time off for up to two antenatal appointments. Give as much notice as possible and follow the local process for releasing a clinician from a clinical rota.
What if I am unwell during pregnancy?
Pregnancy-related illness is normally managed under the employer’s sickness procedure before the final four weeks before the expected week of childbirth. If you are absent with a pregnancy-related illness in that four-week period, statutory maternity leave and pay normally start automatically.
How much maternity leave can I take?
Maternity leave can feel very complicated at first glance. You can take up to 52 weeks of leave. You do not have to take all 52 weeks, but you must take at least two weeks off after the birth. The total 52 weeks leave may be extended by local agreement, in exceptional circumstances, such as sick pre-term babies or multiple births. Your trust should have a policy for Leave and Pay for New Parents, look on the intranet or ask HR to send to a copy.
Statutory requirement (compulsory)
It is compulsory for the mother to take at least the first 2 weeks off, starting on the date of the birth of your child.
Ordinary maternity leave – the first 26 weeks
The earliest date you can begin this is the 11th week before due date
Additional maternity leave – the next 26 weeks
This follows your ordinary maternity leave
Annual Leave
Annual leave continues to accrue during maternity leave.
Discuss when you will take accrued leave with your employer, particularly if you are rotating, changing employer or crossing leave years.
What about adoption, paternity, shared parental and neonatal care leave?
| Leave type | Core national position | Planning point |
|---|---|---|
| Maternity leave | Up to 52 weeks. It is usually split into 26 weeks ordinary and 26 weeks additional maternity leave. Leave can begin no earlier than the 11th week before the expected week of childbirth. There is a compulsory two-week period after birth, or four weeks for factory workers. | Give formal notice by the statutory deadline and agree the start date. Check your local process if you need to change dates. |
| Adoption leave | Eligible adopters can take statutory adoption leave and pay. The detailed route depends on the adoption or fostering-to-adopt arrangement and whether there is a partner. | Speak to HR as soon as the match is notified. Ask for the adoption and surrogacy policy and confidential support. |
| Paternity leave | Eligible parents can take up to two weeks of paternity leave. From 6 April 2026, paternity leave is a day-one right in England, Scotland and Wales, although pay still has separate eligibility rules. The change does not apply in Northern Ireland. | Confirm eligibility, notice and whether leave will be taken before or after shared parental leave. Do not assume that leave entitlement means automatic entitlement to pay. |
| Shared parental leave | Eligible parents can share up to 50 weeks of leave and up to 37 weeks of statutory pay in the first year after birth or placement. Eligible parents can be off work together for up to 6 months or alternatively, they can stagger their leave and pay so that one parent is always at home with the child in the first year. | Both parents’ employers may need notices. Use the GOV.UK planner and ask your payroll team how local occupational enhancement interacts with shared leave. |
| Neonatal care leave | Neonatal Care Leave: day-one employment right, up to 12 weeks if the qualifying conditions are met. Statutory Neonatal Care Pay: separate eligibility requirements apply. | Contact HR or payroll early, even while your baby is receiving care. Ask for a named contact and a written explanation of leave, pay and evidence requirements. |
| Unpaid parental leave and carer’s leave | Unpaid parental leave is separate from maternity, adoption, paternity and shared parental leave. Carer’s leave provides up to one week of unpaid leave each 12 months for a dependant with a long-term care need. Emergency time off for dependants is a different right. | Check your local special-leave policy. It may be more generous than the statutory position, and rules differ in Northern Ireland. |
Further information: GOV.UK, maternity pay and leave https://www.gov.uk/maternity-pay-leave
Further information: GOV.UK, paternity pay and leave https://www.gov.uk/paternity-pay-leave
Further information: GOV.UK, shared parental leave and pay https://www.gov.uk/shared-parental-leave-and-pay
Further information: GOV.UK, employer guide to neonatal care leave and pay https://www.gov.uk/employers-neonatal-care-pay-leave
Pension and other considerations:
Check with your employer the effect on pension contributions, salary sacrifice arrangements, parking, study budgets, appraisal or revalidation.
If you plan to undertake clinical work during leave, including clinical KIT/SPLIT activity, check that you have appropriate professional indemnity/insurance arrangements in place before working. Ask your employer and indemnity provider what cover applies.
What is NHS occupational maternity pay?
Many NHS-employed doctors are covered by an occupational maternity scheme that is more generous than statutory pay. Under the NHS scheme described by the BMA, a doctor with 12 months’ continuous service with one or more NHS employers at the beginning of the 11th week before the expected week of childbirth, who notifies an intention to return to NHS employment, is normally entitled to:
8 weeks of full pay less SMP or Maternity Allowance
18 weeks of half pay plus SMP or Maternity Allowance up to full pay
13 weeks of SMP or Maternity Allowance
13 weeks of unpaid leave
The BMA has a useful calculator for working out your entitlement.
The exact contractual terms, including any return-to-work commitment and repayment consequences, should be confirmed in writing by your employer. Do not assume the same enhanced terms apply to a non-NHS employer, a locum bank engagement, a GP partnership, a university, a private provider or a contract outside the standard NHS arrangements.
Read more: BMA: maternity leave pay under the NHS scheme
The default way for it to be paid is front loaded (e.g. full pay for 2 months, then half pay for 4 months). By prior agreement with your employer, NHS occupational maternity pay may sometimes be paid in a different pattern, for example spread more evenly across your leave. Ask payroll what options are available to you before your leave starts.
Do I qualify for Statutory Maternity Pay?
To qualify for SMP, you normally need 26 weeks’ continuous employment with the same employer by the beginning of the 15th week before your baby is due, and earnings above the qualifying threshold.
SMP is subject to income tax & other deductions.
It includes:
- 6 weeks at 90% of your average weekly earnings before tax during the qualifying period.
- 33 weeks at standard ‘SMP’ rate per week or 90% of your average weekly earnings during the qualifying period (whichever is less).
What is Maternity Allowance?
If you are employed but not eligible for SMP, you may be eligible for maternity allowance instead. You will need to complete a maternity allowance claim form and send this alongside an SMP1
This is paid to you directly by the job centre, not by your employer
Maternity Allowance is not taxed (as it is a benefit)
You will need your MAT B1 form for this application
You can get Maternity Allowance for up to 39 weeks. This means if you take the full 52 weeks Statutory Maternity Leave, your final 13 weeks will be unpaid.
What if your employment circumstances are more complex?
This is common in medicine. Rotations, lead-employer arrangements, GP training, university contracts, locum work and fixed-term posts can all change the answer.
Rotating to a different hospital:
Rotating doctors should seek advice early.
Continuity for NHS occupational maternity pay is different from continuity for SMP. A single lead-employer arrangement can preserve the same employer for statutory pay purposes, but rotating between trusts, practices or other employers may not.
GP trainees should ask specifically how the host practice and lead employer are treated. Give HR your rotation history and obtain a written eligibility decision rather than relying on verbal reassurance.
Contract expiring:
If a fixed-term contract or training placement is due to end, do not wait until the final weeks to ask for advice.
Your entitlement depends on timing, who employs you in the qualifying week, the terms of the contract and any planned rotation.
For instance depending on your contract, if you are entitled to OMP and your contract expires after the 11th week before due date, then you may be eligible for your contract to be extended to allow you to remain employed during your maternity leave (so you would qualify for the 52 weeks of pay).
If your contract expiring means that you do not meet the conditions for OMP, you may still be eligible for SMP if you have >26 weeks continuous service with that employer before 15th week due date.
Less than 12 months continuous NHS service:
Check your contract for permissible gaps in employment e.g. less than 3 months due to changing training program.
It is unlikely that you will qualify for OMP, but you may still qualify for SMP. If not you may still qualify for MA.
Speak to HR early to find out your entitlements.
You are still entitled to 52 weeks leave, regardless of how long you have been employed.
If you're a doctor in training, check this first:
- Who is my legal employer?
- Do I have a lead employer?
- When does my current contract end?
- When does my next rotation start?
- Do I qualify for NHS occupational maternity pay?
- What happens to my training dates?
- When is my qualifying week?
- Will my contract need extending?
- What happens to my annual leave?
- Who is my Training Programme Director?
- What happens to my pay progression?
NHS Employers has detailed guidance for rotational doctors and dentists in training, including contract expiry, annual leave and pay progression. Doctors who are due a progression-related pay point should also check that time on parental leave does not create a pay detriment.
Read more: NHS Employers: rotational doctors and dentists in training
| Situation | What to ask |
|---|---|
| You rotate between employers | Who is the legal employer in the qualifying week? Does a lead-employer arrangement preserve continuity for SMP? Give HR your full rotation history. |
| Your contract is due to end | Will it be extended to cover leave? Who will pay occupational pay, SMP and accrued annual leave? Ask before the contract end date. |
| You have under 12 months’ NHS service | You may miss NHS occupational pay but still qualify for SMP or Maternity Allowance. Ask for each entitlement to be assessed separately. |
| You work in general practice | Clarify whether you are employed by a lead employer, practice or another body, and which service counts towards each scheme. |
| You have NHS and university/private work | Each employment may need a separate statutory assessment. Do not assume an NHS occupational scheme covers non-NHS work. |
| Your pay point was due to increase | Ask whether the planned progression should be reflected in maternity pay, especially if leave prevented a normal rotation. |
Training doctors: What should I discuss with my educational supervisor?
- How long you expect to be away and what this may mean for training dates, ARCP, appraisal or revalidation.
- Whether you want occasional updates about courses and opportunities or would prefer not to be contacted.
- Any skills or confidence you would like to refresh before returning, including simulation or supervised practice.
- Whether less-than-full-time training or another flexible arrangement may help.
- When to meet again, usually around two to three months before your return.
- You do not need to use parental leave to maintain your professional development.
Considering returning less than full time?
If you are considering less-than-full-time training or flexible working, start the discussion early. Flexible working and LTFT training are related but not identical processes. In England, Scotland and Wales, employees have a day-one right to request flexible working, although an employer can refuse a request for a genuine business reason. Rules in Northern Ireland differ. Training applications can have separate national or regional arrangements, so follow the route required by your training body as well as your employer.
What practical admin is worth doing now?
| Topic | What to confirm before leave begins |
|---|---|
| Dates and paperwork | Leave start and intended end dates, statutory notice, MATB1 or adoption documentation, local form, payroll contacts and written confirmation of entitlement. |
| Pay and benefits | Occupational and statutory pay estimate, how pay will be distributed, pension and salary sacrifice effects, annual leave accrual, repayment conditions and any outstanding expenses. |
| Rota and handover | Removal from the rota, safe handover of named clinical, audit, research, teaching or leadership responsibilities, and who will communicate any essential change. |
| Training and development | ARCP, appraisal, revalidation, study leave, curriculum requirements, extension to training, local return-to-training support, and whether you want information about courses or opportunities while away. |
| Contact preferences | Who may contact you, the preferred method, how often, what genuinely needs contact, and how you will be invited to optional updates or Keeping in Touch opportunities. |
| Practical matters | IT access, ID badge, accommodation, lockers, equipment, professional indemnity and subscriptions. Do not assume access will remain active without checking. |
| Parking fees | Contact the Estates department if you wish to stop paying for parking whilst on leave. Don’t forget to contact them prior to your return to reinstate access. |
| Professional Fees | Some of your professional subscriptions can be postponed during your leave to avoid paying for it when you are not using it. Some offer a reduced rate whilst on parental leave. Review your subscriptions for GMC, MDU, BMA etc. Remember, if you are doing any clinical KIT days, you will need medical indemnity. |
| Childcare | Consider applying for childcare, particularly where local provision has waiting lists or your working pattern includes early starts, nights or weekends. |
What is a KIT day?
During maternity or adoption leave, you and your employer can agree up to ten Keeping in Touch (KIT) days without ending the leave. During shared parental leave, each parent can agree up to 20 Shared Parental Leave in Touch (SPLIT) days. Doing any work on a calendar day normally uses one whole KIT or SPLIT day, even if you attend for only an hour. There is no expectation on the number of KIT days that should you take. It is completely up to you and there is no pressure to do any at all. You do not need to be a trainee to be eligible for KIT days.
What can I use one for?
Useful options include:
Return-to-work meeting
Induction
Mandatory training
Simulation
Educational meeting
Audit or quality improvement
Supervised clinical work or shadowing a colleague
Regional teaching day
Choose something that genuinely helps. It should not be treated as a route to fill an unplanned rota gap. If clinical work is proposed, agree the level of supervision, shift length, access to support, workload, indemnity and any current restrictions. It is reasonable to choose non-clinical activities if that better meets your needs.
How much will I be paid?
Payment depends on your contract and local policy, the hours worked, and the maternity, adoption or shared parental pay you are already receiving. Agree the date, hours, purpose and payment in writing before attending. If clinical work is planned, confirm supervision, workload, IT access, mandatory training and indemnity.
Can I do locum shifts while on leave?
Do not assume that you can. Paid work during leave can affect statutory or occupational pay, and work for your employer would normally need to be treated as a KIT day. Check the written policy, payroll position, employment status and indemnity before accepting any shift. Annual leave taken before or after statutory leave is different, but the usual fatigue and indemnity considerations still apply.
Further information: GOV.UK, shared parental leave and pay https://www.gov.uk/shared-parental-leave-and-pay
When should I contact work?
Get in touch about two to three months before your planned return. Confirm the date in writing and arrange a meeting with your manager and, if relevant, your educational supervisor. If you want to change the date, remember that the statutory notice period for changing a maternity return date is usually at least eight weeks.
What support can I ask for?
A local re-induction and time to restore IT, prescribing, smartcard, badge and clinical-system access.
A supported or supernumerary period, supervised clinical sessions, simulation or a named person to ask for help.
Time to update mandatory training, life-support certification, appraisal, revalidation or portfolio requirements.
A review of the rota, including nights, on-call work, travel between sites and any health or breastfeeding adjustments.
A follow-up meeting after the first few weeks, because the support you need may only become clear once you are back.
What if I want to work less than full time?
Start early. Employees in England, Scotland and Wales have a day-one right to request flexible working, although employers can refuse for a genuine business reason. Northern Ireland rules differ. Doctors in training usually need to use both the employer process and the process set by their postgraduate training organisation. Ask for the decision and reasons in writing; a trial arrangement can be useful.
Rotating trainees
Contact your Training Programme Director (TPD) to confirm where you will be returning to.
There is support and funding available to you to support your return to work. Look at the SuppoRTT website to see how it can be used. Examples include supernumerary period/supervised clinical sessions as well as courses to help you refresh skills and confidence.
For instance, the ‘Return to work mentoring programme’ offered by the SuppoRTT team is a series of workshops with other trainees that have had time out of training. It can be great to meet other people in a similar position.
What should I arrange before my first shift?
Tell your employer before you return and complete a breastfeeding / expressing risk assessment. Discuss when you can take breaks, who will provide clinical cover, where you can feed or express, access to handwashing, and how expressed milk can be stored safely. The space should be private and clean; a toilet is not suitable.
You do not necessarily need to have everything perfectly arranged before returning; agree an initial plan and review it once you know what your actual rota and clinical workload look like.
What should the risk assessment include?
It should consider the clinical environment, workload, shift length and pattern, hydration and breaks, infection risks, radiation or hazardous exposure, travel, and any individual clinical advice. Review the arrangement if it is not working or if the rota changes. Your trust may have a risk assessment template on their intranet.
What if the local facilities are not adequate?
Raise it early with your manager and occupational health. It may also help to involve a health and safety representative, freedom-to-speak-up guardian or trade union representative. Be specific about what is missing, for example privacy, an internal lock, a refrigerator, handwashing facilities or protected cover for breaks.
Read more: Health and Safety Executive: new and expectant mothers at work
When should I start looking at childcare?
Earlier than feels necessary. Ask about waiting lists, early starts, late finishes, weekends, holiday cover, how illness is handled and whether sessions can flex around rota changes. It is worth planning a backup for the first inevitable nursery call saying your child needs collecting. Ask and whether the provider accepts Tax-Free Childcare payments. Some hospitals have a nursery on site.
What help is available with costs?
Tax-Free Childcare is a UK-wide scheme for eligible working parents. For money paid into an eligible childcare account, the government tops this up, subject to the scheme’s caps and conditions. The funded-childcare offers beyond this scheme are different in England, Scotland, Wales and Northern Ireland. Use the official national source for your home address, and re-check eligibility if your income, work pattern or family circumstances change.
What if my child or another dependant is ill?
Employers commonly have local special-leave policies for children’s illness, emergency dependants leave, compassionate leave and carers. Those policies may be more generous than the minimum legal rights. Statutory carer’s leave is up to one week of unpaid leave in each 12-month period to give or arrange care for a dependant with a long-term care need. Separate emergency time off for dependants may apply when there is an unexpected event. Check the local policy before using annual leave or agreeing an informal absence.
Who to contact locally
| Contact | What they can help with |
|---|---|
| Line manager / clinical lead | Risk assessment, changes to duties, rota arrangements, leave planning, return plan and breastfeeding facilities. |
| Medical Workforce / HR / payroll | Notification forms, leave dates, statutory and occupational pay, annual leave, contractual terms, fixed-term contracts and repayment questions. |
| Occupational health | Individual work adjustments, health advice in relation to work, returning safely and breastfeeding-related risk assessment. |
| Rota coordinator | Removing and re-entering you on the rota, agreed adjustments, KIT or SPLIT activity, and protected time. |
| Educational supervisor / training programme director | Training progression, ARCP, return-to-training support, less-than-full-time training, mentorship and educational needs. |
| Trade union / professional body / medical defence organisation | Independent employment advice, contract interpretation, professional fees, indemnity and advocacy. |
Which national links are worth saving?
GOV.UK maternity pay and leave — https://www.gov.uk/maternity-pay-leave Leave, pay, planner and notification guidance.
GOV.UK paternity leave and pay — https://www.gov.uk/paternity-pay-leave Paternity leave, pay and appointment rights.
GOV.UK shared parental leave — https://www.gov.uk/shared-parental-leave-and-pay Eligibility and planning.
GOV.UK neonatal care leave — https://www.gov.uk/employers-neonatal-care-pay-leave The additional neonatal entitlement.
BMA parental leave guidance — https://www.bma.org.uk/pay-and-contracts/maternity-paternity-and-adoption Doctor-focused NHS and contractual guidance.
NHS Employers rotational guidance — https://www.nhsemployers.org/publications/general-maternity-guidance-rotational-doctors-and-dentists-training Rotations, contract expiry and pay progression.
Acas pregnancy and maternity — https://www.acas.org.uk/working-while-pregnant-and-maternity-leave Employment rights and resolving problems.
RCOG return-to-work toolkit — https://www.rcog.org.uk/careers-and-training/workforce/return-to-work-toolkit/ Practical return-to-work resources.
SuppoRRT courses and online material – There are also free resources for non-trainees too https://www.hee.nhs.uk/our-work/supporting-doctors-returning-training-after-time-out
There are many social media groups specifically for doctors who are starting a family. It’s worth asking your colleagues to see what they’ve found helpful.
Final checklist
1. I have told my employer and arranged an individual risk assessment. Risk Assessment Template.
2. I have submitted the correct notice and supporting documentation, and received written confirmation.
3. I have a written leave and pay calculation, including my occupational entitlement and any return condition.
4. I have agreed annual leave, rota removal, contact preferences and a handover.
5. I have spoken to my educational supervisor or training programme director, if relevant.
6. I have decided whether I want KIT or SPLIT days and understand how they will be paid.
7 I have planned my return meeting, risk assessment, training and breastfeeding or expressing arrangements.
8. I have checked my childcare, caring, professional subscription and indemnity arrangements.
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