The contract covering NHS consultants in Northern Ireland could be renegotiated to ensure round-the-clock care, a new framework states.
The British Medical Association (BMA) and NHS Employers have published draft heads of terms for a possible fresh agreement.
Consultants have been criticised for failing to provide adequate cover, especially overnight and at weekends.
Earlier this month, MPs said failings in care could be directly linked to the inability to manage senior doctors. The warning was made by Westminster's Public Accounts Committee after it studied the impact of a 2003 contract.
It said the deal had allowed doctors to refuse to work during evenings and weekends, prompting trusts to pay up to £200 an hour in overtime payments or to rely on locums.
Yesterday's draft heads of terms cover a possible renegotiation for consultants in England and Northern Ireland.