By Adam Surtees, Founder, Affinity Advice
Most doctors I speak to aren’t reckless with money. They’re not naive. They’ve worked incredibly hard to get where they are, and they’re smart people who make good decisions every day.
So when I ask them what would happen to their income if they were seriously ill and couldn’t work, I’m not expecting a blank stare.
But more often than not, that’s exactly what I get.
Not because they haven’t thought about it. But because somewhere along the way, they decided the answer was obvious. The NHS would cover them. Of course it would.
It’s a reasonable assumption. It’s also, in most cases, wrong.
Let’s talk about what NHS sick pay actually is
The NHS has a sick pay scheme. It’s real, it’s valuable, and in the short term it absolutely helps. But there are two things most doctors don’t know about it.
The first is how quickly it runs out.
The second is how little most of them actually have.
Here’s the reality, based on your length of NHS service:
- 1st year: 1 month full pay, 2 months half pay
- 2nd year: 2 months full pay, 2 months half pay
- 3rd year: 4 months full pay, 4 months half pay
- 4th and 5th year: 5 months full pay, 5 months half pay
- Over 5 years: 6 months full pay, 6 months half pay. Then nothing.
A consultant with 20 years of NHS service gets 6 months full pay followed by 6 months half pay. A doctor in their third year gets 4 months full and 4 months half. And a junior doctor in their first year? One month full pay, two months half pay. Then nothing.
After that, the NHS stops paying. Regardless of how long you’ve served.
When did you last check where you actually stand?
I ask this not to make anyone feel bad. But because most doctors genuinely don’t know the answer.
It’s not something that gets explained at medical school. It’s not in the induction pack when you start a new post. You sign your contract, you get on with the job, and you assume that if something goes wrong, something will kick in.
The FCA published a major market study on protection insurance in January 2026. It found that of the adults in the UK who don’t have income protection, 59% have never even considered their need. They just assumed they were covered.
Doctors, in my experience, are no different. Often they’re worse, because at least with the NHS they have something, which makes the assumption feel more justified.
But having something isn’t the same as having enough.
What does month thirteen actually look like?
Let’s say you’ve been in the NHS for more than five years. You’re entitled to the maximum: six months full pay, six months half pay.
So for the first six months, you’re fine. Your mortgage gets paid. Your family’s lifestyle stays intact.
Month seven, your pay drops to half. Manageable, just about, if you’re careful.
Month thirteen, it stops. Completely.
Your mortgage doesn’t stop. Your bills don’t stop. School fees, car finance, the costs of a life you’ve spent a decade building. None of it pauses.
The cost of living is real. Most people I speak to don’t have the kind of accessible savings that would cover months of lost income. Their money is tied up in pensions and investments, or it’s equity in their home. It’s not sitting in a current account waiting to be used.
I ask doctors a question that tends to land quite hard: how long did it take you to save what you have right now? For most, the answer is years. Then I ask: if your income stopped today, how long would those savings last?
Usually, not as long as they’d hoped.
It’s probably not what you’re imagining
When people think about being too ill to work, they tend to picture the dramatic stuff. Cancer. Heart attack. Something that makes the need for cover obvious.
The reality is different. The most common reasons doctors claim on income protection aren’t dramatic at all.
Mental health, burnout, severe anxiety, depression, accounts for a significant proportion of long-term absences in medicine. The GMC’s own data backs this up. This is the reality of working in a high-pressure profession, and it can happen to anyone, at any stage of their career.
Beyond that: a cycling accident and a broken elbow. A back injury from a car crash. A cancer diagnosis that needs a year of treatment. These are the things that actually happen to people in their thirties and forties. Things that happen to colleagues. Things that don’t feel likely until suddenly they are.
We speak to people every week who are in exactly these situations. Already off work. NHS sick pay running out. Calling us too late to help.
That conversation, telling someone we can’t help because they’re already ill, is the one I’m most motivated to prevent.
Nobody told them. And that’s the real problem.
I want to be clear about something. The doctors I speak to who don’t have cover aren’t irresponsible. They’re not ignoring this because they don’t care.
They simply weren’t told.
Not at medical school. Not when they signed their contract. Not by the unions, not by the BMA in any meaningful way. The assumption that the NHS takes care of its people is baked into medical culture, and it’s true enough in some ways to make the gaps easy to miss.
Doctors spend their entire training becoming exceptional at one thing. Why would they spend their evenings researching insurance? That’s not a criticism. It’s just how it works.
Which is exactly why we exist.
So what do you do with this?
The good news, and there genuinely is good news, is that sorting this is not complicated.
It doesn’t require hours of research. It doesn’t require you to become an expert in insurance products. It requires one conversation with a specialist who understands exactly how doctors are paid, how NHS sick pay works, and how to map the right cover to your specific situation.
That conversation takes about thirty minutes. It’s free. And at the end of it, you’ll have complete clarity on where you stand: whether you need cover, what kind, and what it would actually cost.
Some people find out they’re better covered than they thought. We tell them that too.
But most find out that the assumption they’d been carrying, that they were covered, that something would kick in, was more fragile than they realised.
Better to find that out now, when there’s still time to do something about it.
About the author
Adam Surtees is the founder of Affinity Advice, a UK protection advisory firm specialising exclusively in income protection, life cover, and critical illness insurance for doctors and dentists.
This article is for informational purposes only and does not constitute financial advice.
