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Types of Leave, Uncategorized

Pregnancy and Maternity Leave

Thank you to Dr Katharine Elliot for sharing the original document to be made into this post. Dr Elliot would like to thank the women of PGMUK who contributed to her document and especially Jenny Walton-Kaye and Gennie Cottrell.


Pre-maternity Leave Logistics

Useful Information/Definition

Maternity Pay

Pregnancy and Duties at Work

Annual Leave and Public Holidays during Maternity Leave (ML)

Paternity Leave, Shared Parental Leave & Other Options for Leave

Adoption Leave

Activities Useful for Pregnancy/Maternity Leave

Pearls of wisdom from Other Trainees

Post-maternity Leave Logistics

Pre-maternity Leave Logistics

  • Either self-refer or ask your GP to refer you to a midwifery booking service. Ask around and choose a hospital which suits your needs, i.e. location, NICU, Birthing centre, etc.
  • Complete the maternity leave application form (obtain from your local trust’s HR) along with the MAT B1 form (proof of pregnancy given by the midwife or GP at the 20 weeks appointment) and submit this to your line manager at your current trust before the end of the 25th week of pregnancy. This should then be sent to HR. They will then sort out your leave and pay. Check if you need to send an original MAT B1 form (as you may need this later if you need to apply for maternity allowance if Statutory Maternity Pay is not covered by your trust)
  • You will need to inform your ES, TPD, Line Manager, HR and Occupational Health Department. Your TPD will then sort out your time away from training.
  • Get your Maternity Exemption Certificate card – valid until your child’s 1st bday and entitles you to free medical prescriptions, dental visits etc.

Useful Information/Definition

  • EDD: estimated date of delivery
  • EWC: expected week of childbirth – which starts at 00:00 on the last Sunday before your baby’s EDD, or inclusive of your EDD if it is on a Sunday.
  • ‘Maternity Leave’ must start on a Sunday before/inclusive of your baby’s due date.
  • You have a statutory right to take up to 52 weeks of maternity leave.
  • The first 26 weeks is termed ordinary maternity leave, the final 26 weeks is termed additional maternity leave.
  • You must take at least 2 weeks’ of leave immediately following childbirth.
  • Maternity leave can commence as early as 11 weeks before the EWC.
  • Maternity leave begins automatically on the day after any birth which takes place after 24/40 gestation, or the day after any live birth at any gestation.

Maternity Pay

Average Weekly Earnings / Qualifying Period

Both Occupational Maternity Pay (OMP) and Statutory Maternity Pay (SMP) are calculated based on your average weekly earnings during a period of roughly 8 weeks up to and including the final payday before the end of the qualifying week. The qualifying week is the 15th week before the expected week of childbirth (see above).

For working out SMP purposes, ‘pay’ means gross pay that is due to you before any deductions (tax, pension etc), which includes any premia you receive for antisocial hours, weekend work etc and any locum pay or exception pay you receive from your main employer during this period. It is when you get paid the money that counts and not when it was actually earned.

Occupational Maternity Pay (OMP)
  • If you have 12 months’ continuous service with the NHS by the beginning of the 11th week before your baby is due (ie. 29 weeks gestation) and will return to work for the NHS for at least 3 months at the end of your maternity leave, then you qualify for NHS occupational maternity pay (OMP). 
  • OMP is subject to income tax & other deductions.
  • OMP should be paid by the employer for whom you work with immediately before commencing maternity leave. It includes:
    • 8 weeks at full pay minus SMP/MA
    • 18 weeks at half pay plus SMP/MA
  • If you don’t return to NHS employment for at least 3 months after the end of your maternity leave, you may have to pay back OMP.
  • Therefore, most SpRs will be eligible for this.
Statutory Maternity Pay (SMP)
  • If you have worked for the same employer/trust for at least 6 months by the beginning of the 15th week before your baby is due (ie. 25 weeks gestation) then you qualify for SMP.
  • SMP is subject to income tax & other deductions.
  • SMP should be paid by the employer for whom you worked with during the qualifying period. 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).
Maternity Allowance (MA)

If you are employed but not eligible for SMP  (i.e you have not been working for the trust for the minimum of six months but have been in contractual employment with no gaps within the NHS) then you can receive the maternity allowance instead. You will need to complete a maternity allowance claim form and send this alongside an SMP1 to your local job centre.

  • 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

Pregnancy and Duties at Work

  • As soon as you inform your employer of your pregnancy, you are entitled to paid time off to attend scheduled antenatal appointments and classes. However, it is expected that you attempt to organise these outside working hours if possible.
  • Plan adjustments to your working pattern and/or working hours in advance via your ES and/or occupational health department (or GP) as needed. You will be typically asked to complete a risk assessment as soon as your HR/OH department is aware of your pregnancy.
  • The guideline from the Royal College of Physicians suggests that pregnant trainees may wish to discontinue night shifts and consider other measures to limit their working hours (eg: reducing maximum hours per week, reducing maximum hours per day) after 28 weeks of pregnancy. Ultimately, this is your decision.
  • However, those experiencing complications of pregnancy such as hyperemesis, pelvic girdle pain, or other medical conditions in pregnancy may need to amend their duties much earlier in pregnancy, or to take leave from work during pregnancy.
  • Adjusting your work schedule or duties because of pregnancy does not affect pay.
  • If you need to take leave from work due to illness in pregnancy then in almost all cases you should receive the same treatment as any other employee under the sick leave policy – anything else is maternity discrimination.
  • Your employer may trigger the start of your maternity leave if you become unwell or unable to work partly or wholly due to a pregnancy related illness, in the 4 weeks before your expected week of childbirth (i.e. from roughly 36/40 onwards). They cannot trigger your maternity leave before this (unless of course you yourself wish to start maternity leave), and they cannot trigger your maternity leave for an illness unrelated to pregnancy (for example, if you break your ankle).

Annual Leave and Public Holidays during Maternity Leave

  • You will accrue paid annual leave (AL) and bank holidays (BH) as usual whilst you are on maternity leave (ML). Many trainees find it easiest to take accrued annual leave and public holidays in one block at the end of their maternity leave, effectively extending their leave from e.g. 12 months to almost 14 months!
  • These AL and BH, generally a total (if full-time (FT) pre ML) of 27 or 32 (depending on the years of service) + 8, count towards training.
  • You ‘accumulate’ AL at the rate that you were working pre-ML, i.e. FT; but ‘spend’ it at the rate you will be going back, e.g. 60%= 3 AL days = 5 days (or 1 week) off.
  • On call and weekend allowances as you were receiving them immediately before commencing ML are included in the pay you receive during accrued AL.
  • Similarly, if you are going from FT to LTFT (less than full time), or changing your LTFT, this has no effect on your accrued AL or BH entitlement.
  • You do not need to take on / swap into extra on calls or weekends prior to going on maternity leave to qualify for these allowances during your accrued annual leave

Paternity Leave, Shared Parental Leave & Other Options for Leave

  • Every partner is entitled to 2 weeks statutory paternity/parental leave after their baby is born. (You do not have to swap out of on calls, weekends etc which fall within this period).
  • Shared parental leave allows parents to share 50 of the 52 weeks’ maximum maternity leave (it is mandatory for a woman who has given birth to take a minimum of 2 weeks’ maternity leave commencing the date of the childbirth). You can overlap this leave, or take it in series. 
  • Eligibility for shared parental leave is almost entirely based on the father/partner and their employment. The only requirement for the pregnant woman is to meet a very low minimum earnings threshold during certain qualifying weeks of your pregnancy.
  • In most jobs, in order to be eligible for shared parental leave, the father/partner must have worked for the same employer/trust for at least 6 months by the beginning of the 15th week before the baby is due (i.e. for 6 months before approximately the 25th week of pregnancy). The wider NHS may be considered the same employer but you should still check this with your individual trusts.
  • Anyone may consider using unpaid parental leave (a limit of 8 weeks in the first year of your child’s life) or making an OOP application to spend more time with their child.

Adoption Leave

  • The primary carer in an adoption arrangement has the same entitlement as regular maternity leave providing they have 12 months continuous NHS employment by the beginning of the week they are notified of being matched with a child.
  • Entitled to reasonable paid time off for adoption appointments – arrange with own department.

Activities Useful for Pregnancy/Maternity Leave

Keeping in Touch (KIT) Days

  • You may work a total of 10 KIT days, usually at the trust you were at before ML. These must be taken during ML and not in the AL/BH part of your leave.
  • These can be consecutive, or not, and can include training or an activity which you deem helpful to ease you back into training, e.g. theatre days to practice intubating.
  • Working for any part of a day, i.e. 1 hr or 13 hrs, will count as one KIT day
  • Payment will be at a basic daily rate for the hours worked LESS appropriate maternity leave pay, i.e. it makes sense to do them in the unpaid part of leave.
  • Ideally organise beforehand – although I didn’t and it was okay.
  • Can also be used for courses such as ALS etc.

Antenatal Groups and Other Activities

  • Look at what is available in your area, e.g. NCT group. I joined an existing group post baby which I found invaluable in terms of support and meet ups. Not sure how useful the actual course content would have been!
  • Your hospital provider will also offer antenatal classes.
  • Breastfeeding Cafes, Baby Cinema – i.e. adult movies which you can only attend with a baby in tow, Soft Play, Role to Play (useful to have a look around to see what is available in your area).


  • Apply early! Nurseries fill up and often have 12-month long waiting lists.

Books, Netflix etc.

Pearls of wisdom from other trainees

  • Maternity documentation can be confusing when talking about dates: when referring to a specific ‘week’, this always begins on a Sunday and ends on a Saturday.
  • If you would like to consider returning less than full time (LTFT) after ML, discuss with deanery/TPD ideally before starting ML – they may not have a LTFT placement for you immediately and you may not want to worry about organising this when you have a young baby at home.
  • Boost income during qualifying weeks (average weekly income during 18-25/40) to improve overall maternity pay (MP) e.g. in-house locum shifts.
  • Consider requesting MP to be averaged and paid over 12/12 rather than a reducing amount (must be agreed in advance, not all trusts will agree but should).
  • Organisations will often reduce fees during ML – you must contact them in advance as you are not usually able to claim retrospectively (e.g. BMA/GMC/RCP/MPS etc). and remember the total pay salary runs for the financial year so you may not qualify depending on when ML starts
  • Ensure both your trust and your deanery know your correct ML dates to ensure correct CCT date and pay.
  • Think carefully before planning to write papers/take exams during ML – this may be the last thing you can actually manage.
  • Ask other trainees when they came off the on-call rota.
  • When planning antenatal appointments, it may be easier to schedule these either early morning or late afternoon to reduce travel to and from work and to minimise disruption to your working day.
  • When deciding LTFT, think about the emotional/ practical issues. What works for one trainee may not work for you.
  • You must let HEE know 16 weeks in advance when going/changing to LTFT.
  • Look into Gov.UK to get tax free childcare: step by step.

Post-maternity Leave Logistics

  • Complete a Return to Work form at least 8 weeks prior to returning to work date. This should be obtained from your Educational Supervisor or the Training Programme Director. This should include a return to training plan considering whether trainees will require a phased return to work; less than full time training; enhanced supervision or a supernumerary period; coaching or mentoring and a plan forward to ARCP. For more information see https://www.lpmde.ac.uk/professional-development/inductreturnretain/rtp/rtp-suppoRTT
  • You will be involved in the Supported Return to Training Programme and any extra support with depend on your pre-return and return meeting with your Educational Supervisor. SuppoRTT can provide:
  1. Coaching, mentorship and networked events
  2. Funding for supernumerary arrangements
  3. Refresher courses & updates, accelerated learning activities and keeping in touch (KIT) days.
  • You may also need to participate in an employer’s “Return to Work” package at the end of any prolonged absence from work, including parental leave. Please contact your Medical Staffing Department for more information.


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