The government and doctors’ unions have reached an agreement on consultants’ pay in England after more than a month of negotiations.
Members of the British Medical Association (BMA) and the Hospital Consultants and Specialists Association (HCSA) will now vote on the package of proposed changes to the core pay spine, alongside other benefits and amendments to terms and conditions.
An additional 4.95% will be added to consultants’ pay funding, on top of the 6% annual pay rise they received this financial year. A minority of consultants will receive no extra pay, while others could receive as much as 12.8% extra.
If the offer is accepted, the changes will be applicable from January 2024, but paid retrospectively in April 2024.
The deal makes provisions for changes to the consultants’ pay scale structure, resulting in fewer points (four versus eight currently) at which pay increases. The BMA said that consultants will reach the top of the pay scale five years sooner than under the current scheme.
NHS consultants’ pay
Government to hold talks with BMA consultants
There will be increases in starting salaries (to approximately £100k) for consultants, and the salary at the top of the new pay scale structure (around £132k).
The exact amount a consultant will receive under the offer will depend on the current stage of their career. This BMA graph details how the new pay structure affects different consultants’ pay
Dr Vishal Sharma, BMA consultants committee chair, said: “We are pleased that after a month of intense talks and more than six months of strike action we never wanted to take, we have now got an offer we can put to members.
“It is a huge shame that it has needed consultants to take industrial action to get the government to this point when we called for talks many months ago.
“The 4.95% investment and much-needed changes to the pay scale system comes after we successfully persuaded the government to reform the punitive pension taxation laws earlier this year, and we also now have commitments to reforming the pay review process, which has been a key ask from the profession throughout our dispute. Only by restoring the independence of this process can we hope to restore consultant pay over the coming years.
“How each consultant will benefit will depend on their individual circumstances, and we will be providing them with as much detail as we can, so they are able to look carefully through the details to help them decide whether to accept the offer.”
HCSA president Dr Naru Narayanan said: “Today’s announcement follows weeks of intense negotiations. Yet while it has benefits for consultants our executive expressed concerns about some parts of the package, including around changes to pay progression and [Supporting Professional Activities] time.
“In the coming days, we shall do our utmost to educate our consultant members on the changes so they can make their own informed decision. Whatever that decision is, we shall be led by our members.
“While the ballot is open HCSA has agreed to pause strikes by consultants, but the mandate members have given us for industrial action will remain in place.”
The offer also includes commitments to reform the Review Body on Doctors’ and Dentists’ Remuneration (DDRB). The unions will be given a say in the selection of members and the government has agreed to no longer include information on economic performance in its remit letters to the DDRB and remove references to the government’s inflation targets from the DDRB’s terms of reference.
Health secretary Victoria Atkins said: “I hugely value the work of NHS consultants and am pleased that we have been able to make this fair and reasonable offer after weeks of constructive negotiations. If accepted, it will modernise pay structures, directly addressing gender pay issues in the NHS. It will also enhance consultants’ parental leave options.
“Putting an end to this strike action will support our efforts to bring down waiting lists and offer patients the highest quality care.”
Around 1.5% of the new money will come from scrapping the local clinical excellence award. Sharma said the changes will modernise the payscale and make significant progress in addressing the gender pay gap. There will also be secured access to enhanced shared parental leave, something currently not available to consultants.
BMA members are expected to vote on the new consultants’ pay offer for around five weeks from mid-December.
Danny Mortimer, chief executive of NHS Employers, who chaired the talks between the government and trade unions said: “Negotiators from the medical trade unions, the government and NHS Employers have worked hard and constructively over this past month to set out this offer.
“They have sought to address many of the long-standing reform priorities for the employment of the NHS consultant workforce, modernising arrangements first introduced 20 years ago. In particular, the reform of pay scales and improvements to parental leave will improve equity and fairness in pay and employment arrangements. The offer, if accepted, also resolves important concerns on all sides, not least acting to restore confidence in the independence of the pay review process for doctors and dentists.
“If BMA and HCSA members in England accept the government’s offer, we will be able to bring to an end the disruption and heartache of the dispute between the government and the senior medical workforce in England.”
Matthew Taylor, chief executive of the NHS Confederation, said: “NHS leaders will hope that BMA and HCSA members will vote to accept the offer made to them by the government so that further disruption to patient care can be brought to an end.
“Also, they hope that this development will set an important precedent in other parts of the medical workforce which are in dispute with the government on pay. With winter around the corner, the last thing health leaders will want is fresh walkouts to lead to thousands more appointments and procedures needing to be cancelled during what is typically the NHS’s busiest time of the year.
“It is important that local budgets are protected for this and any further developments on pay and that the commitments in the Long Term Workforce Plan around growing the NHS’s headcount continue to be supported. Leaders recognise that the last year of strikes have been hugely challenging for the NHS’s workforce and so they are eager for these to be resolved as soon as possible.”
Sir Julian Hartley, chief executive at NHS Providers, said: “Industrial action has caused unprecedented disruption in the last year. Over 50 strike days have led to 1.2 million appointments for planned care being pushed back and cost the NHS an estimated £1.4bn through lost income and staff cover. Trust leaders will be hugely relieved that consultants won’t be striking over Christmas given that demand for care is always higher in winter.
“But we’re not out of the woods yet. The deal needs to be put to a vote by union members and we won’t know the result until January. It’s essential we now see similar progress with junior doctors and speciality and associate specialist doctors to bring an end to all industrial action across the NHS.”
Sign up to our weekly round-up of HR news and guidance
Receive the Personnel Today Direct e-newsletter every Wednesday
HR opportunities in Healthcare on Personnel Today
Browse more HR opportunities in healthcare
