NHS Career Break to Travel Long-Term: What the Policy Says, What Actually Happens, and What We Did Instead

Written by Tom Widdall | Last updated: 30th April 2026

Most NHS staff who start looking into long-term travel eventually end up on the same page of the NHS terms and conditions, reading the career break policy and assuming the hard part is over. It isn't. We came close to making that assumption ourselves.

Clare and I both worked in the NHS before we left the UK in October 2025 with our two young children. We did not both take career breaks. I took a lump sum payment through the Mutually Agreed Resignation Scheme and resigned. Clare applied for a career break, was refused, and also resigned. Between us, we ended up covering almost every significant path through this decision - and this guide is the one we wish we'd found at the start.

This article forms part of our broader long-term travel planning guide. Some links in this article are affiliate links. If you sign up through them, we may receive a small commission at no cost to you. Our recommendations are not influenced by affiliate arrangements.

What the NHS Career Break Policy Actually Says

The NHS terms and conditions of service allow staff to apply for a career break of up to five years. In theory, this preserves your right to return, maintains your continuous service record for purposes like annual leave entitlement and redundancy, and gives you a route back into the NHS without having to re-apply as a new employee.

In practice, the key word is apply.

The policy typically requires a minimum of 12 months' continuous service before you can apply. The application goes to your manager and then to HR, and the Trust will consider whether your role can be held open, whether it can be backfilled on a fixed term basis, and whether your return can reasonably be accommodated. Trusts in areas with staffing pressures - which in practice means many Trusts across the NHS - will often find reasons to decline.

This is not cynicism. It is what the policy actually permits them to do.

What You Keep and What You Lose on a Career Break

If your career break is approved, here is what the NHS terms and conditions say you retain:

• Continuous service, which protects annual leave entitlement and redundancy rights
• The right to return to your substantive post, or one of equivalent grade and band
• Access to the NHS Pension Scheme as an active member (subject to contribution arrangements - see below)

What you do not retain during a career break is anything close to normal. You will not be paid. You will not accrue pension unless you make arrangements to continue contributing. You will lose access to any salary sacrifice or NHS discount schemes from your departure date.

The pension point is the one that most catches people out.

The MARS Route: What It Is and Why I Chose It

The Mutually Agreed Resignation Scheme is a voluntary exit arrangement that some NHS Trusts run when they need to reduce headcount or achieve financial savings. It works like this: the Trust makes a lump sum payment to staff who agree to resign. You leave, they save on your salary, and both parties agree the departure is voluntary. It is sometimes described as a "voluntary redundancy" equivalent, though the legal structure is different and the payout is often half of what you’d receive through redundancy.

The key thing to understand is that MARS is not always available. It runs when your Trust decides to run it, in response to its own financial pressures. You cannot apply for MARS because you want to travel. You can only apply when your Trust is actively running a scheme. I was fortunate that my Trust happened to be running MARS at the point we were planning to leave.

MARS payments are typically calculated on the basis of years of service, with a formula that varies by Trust. They are subject to income tax in the normal way above the first £30,000 (which is tax-free under current HMRC rules).

The reason I chose it over a career break was financial and personal in roughly equal measure. The MARS payment converted my departure from a cost into a financial positive - it contributed meaningfully to our travel fund and brought forward our departure date. But it also resolved something I had been sitting with for a while: I was not happy in the role. A career break would have meant returning to that role, or one equivalent to it, in two or three years. The MARS payment gave me a clean exit, a financial cushion, and no obligation to return to a situation I had already decided I wanted to leave.

Clare's Experience: What Happens When a Career Break Is Refused

Clare applied for a career break through the standard NHS process. Her application was refused by her Trust. The reason given related to service need and the difficulty of backfilling her role. She was not given a meaningful right of appeal beyond a standard grievance process, which we decided was not worth pursuing given the direction we were heading in anyway. At the eleventh hour Clare’s Trust launched their own MARS, which Clare applied for but we knew the outcome was inevitably going to be a hard no, following the career break application. We had sufficient financial security to proceed without her employment. She resigned.

For NHS staff in a better position with their employer, a refused career break application does have some options. You can request a review or formal appeal if your Trust's policy allows it. You can revise the application with a shorter break period or a more flexible return arrangement. You can escalate through your union representative if you believe the refusal was not applied consistently. In some cases, reframing the application around personal circumstances (caring responsibilities, for example) rather than travel ambitions produces a different outcome.

What you cannot do is force approval. The Trust has that right under the current terms.

Career Break vs Resignation vs MARS: The Honest Comparison

	Career break	Resignation	MARS
Payment at departure	None	None	Lump sum (tax-free up to £30k)
Right to return	Yes (to equivalent post)	No	No
Continuous service preserved	Yes	No	No
Pension accrual	Paused unless voluntary contributions made	Stops	Stops
NHS benefits retained	No	No	No
Employer must approve	Yes	N/A	Yes (scheme must be open)
Best suited to	Staff who genuinely plan to return and have a supportive employer	Staff who are ready to leave regardless	Staff whose Trust is running MARS and who want a clean exit with financial benefit

The career break is the right answer if you plan to return to the NHS and your Trust will approve it. It is not the right answer just because it feels safer. Preserving the right to return to a role you may not go back to, while losing pension accrual you will not recover, is not automatically the conservative choice.

Financial Steps to Take Before You Leave

Regardless of which route you take, there are financial decisions that need to happen before your last working day - not after.

NHS Pension: Get a current pension statement from NHS Pensions before you leave. Understand which scheme you are in (1995, 2008, or 2015 Section) and what your projected benefits are at current retirement age. If you are taking a career break, understand exactly what voluntary contributions would cost to maintain accrual. If you are resigning or taking MARS, understand the deferred benefits position and when you can access them. This is one area where paying for an hour with an independent financial adviser is a genuinely good use of money.

HMRC and tax residency: If you plan to be outside the UK for a full tax year, your UK tax residency status may change under the Statutory Residence Test - with implications for how your income, savings interest, and the MARS lump sum are taxed. We cover this in detail in our guide to UK tax residency and long-term travel. Do not overlook this. The MARS lump sum in particular needs to be considered alongside your tax residency position for the year you receive it.

National Insurance: Leaving employment stops your NI contributions. You can make voluntary Class 3 NI contributions while abroad to protect your State Pension entitlement. Whether this is worth doing depends on your existing NI record and how many qualifying years you still need. Check your NI record on the HMRC personal tax account before you leave.

Salary sacrifice schemes: These end on your last day of employment. If you have anything in a cycle-to-work, childcare vouchers, or tech scheme that is mid-agreement, clarify the position with HR in advance.

Emergency fund and runway: Our guide to how much you need to save before long-term family travel covers the numbers in detail. The short version: leaving employment means leaving behind the safety net of a regular salary. Your emergency fund needs to be larger than it would be for a short holiday, and you need a clear view of your burn rate before you depart. We cover what long-term travel actually costs in this guide.

Travel insurance: Employer-provided health cover ends when employment does. You need a dedicated long-term travel insurance policy in place before you leave. We use True Traveller for our 11-month policy. SafetyWing is the main alternative for families who prefer a monthly rolling subscription rather than paying upfront. We cover both in detail in our travel insurance guide for families.

Banking: Once you resign, your salary stops but your financial life continues. We manage ours across Starling and Wise - Starling for everyday spending and ATM withdrawals, Wise for holding multiple currencies and sending money internationally. Setting these up before you leave is straightforward; doing it once you're abroad and your UK address is dormant is not.

Open a Wise Account

What We Would Tell NHS Staff Considering This

Looking back, I do not regret taking MARS. It resolved a role I was not happy in, gave us a financial start, and brought forward a departure we were going to make anyway. The fact that the option was available at the right moment was luck - but we were positioned to move quickly when it appeared because we had already done the planning.

Clare would have taken a career break if it had been approved. That is worth saying honestly. It was not a route we dismissed - it was a route that was closed to us. If her employer had been supportive and the application had gone through, the ability to return to NHS employment after two years would have had real value. The refusal forced a clean break that turned out to be the right outcome, but it was not the plan.

If you are in the NHS and considering long-term travel, the single most useful thing you can do right now is have an honest conversation with your manager about the career break policy before you tell HR anything formal. Get a sense of whether your Trust is likely to support it. Ask whether MARS has been available recently or is expected to be. Neither conversation commits you to anything, and both will give you information that changes how you plan.

The policy exists. Whether your Trust will apply it in your favour is a separate question entirely.

Who This Is and Isn't Right For

A career break makes sense if you want to keep the door open to NHS employment, your Trust is supportive, and you understand the pension gap you will be accepting. It is the lowest-disruption option for people who are genuinely uncertain about whether they will return.

MARS makes sense if your Trust is running a scheme, you are confident you want to leave regardless, and the lump sum materially improves your financial position for travel.

Resignation is the default if neither of the above applies - which, in our experience, is the situation more NHS staff end up in than they expected when they started planning.

None of these is the wrong answer. The wrong answer is assuming the career break is guaranteed and building a travel plan around an approval that has not yet been given. Ready to start? Read our Long-term travel planning guide.

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