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Consultant pay reform package agreed in principle with UK Government

The UK Government, the British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) have reached an agreement in principle on a pay offer that could bring an end to consultant strike action.

The Government is offering a 4.95% investment in pay for this financial year, in addition to the 6% pay uplift already awarded.

The pay reform package would also see a reduction in the number of pay points from eight to four and reduce the number of years it takes a consultant to reach the top of the pay scales by five years.

It would also increase the starting pay for new consultants and secure an increase for the top pay point.

The consultant contract will also be amended to enable consultants to access enhanced shared parental leave arrangements. At present, these are available for all other NHS staff but denied to consultants.

‘While this offer does not deliver all that the BMA has asked for, significant progress has been made,‘ the BMA said.

The terms will be put to BMA and HCSA members via a referendum that will likely open in mid-December and run until late January 2024.

If accepted these changes will be implemented in April 2024 and pay increases backdated to January 2024.

No further strike action will be called while members are being consulted.  

If the offer is accepted, the BMA has agreed to call an end to strike action and to stop promoting the extra-contractual rate card for consultants in England.

However, a re-ballot on industrial action remains open and, if passed, would enable consultants to call further strikes in 2024 if the offer is rejected, the BMA said.

As part of the pay investment, funding for new Local Clinical Excellence Awards (LCEAs) will be moved into basic pay, meaning this money will become consolidated, pensionable, and subject to uplifts.

These uplifts will be determined by the outcome of the Review Body on Doctors and Dentists Remuneration (DDRB) process, the workings of which the Government has committed to overhauling.

This review, in conjunction with the BMA, will examine the appointments of members to the DDRB, the timing of the round, remit letters and terms of reference, and the data provided to the body on which it bases its recommendations, with changes to be implemented for the 2025/26 pay year, the Government said.

Responding to the proposed DDRB overhaul, the BMA said: ‘For far too long has the DDRB’s independence been eroded by successive Government’s looking to sway its decisions or setting its remit. Under the reform we have secured this should be less likely in the future.‘

Commenting on the consultant pay reform package, 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.’

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.’

Dr Naru Narayanan, HCSA president, 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 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.’

Also responding to the pay offer, Sir Julian Hartley, chief executive of NHS Providers said: ‘This development is a vital step towards the Government and unions resolving the industrial dispute with consultants in the NHS.

‘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 SAS doctors to bring an end to all industrial action across the NHS.‘

Earlier this month, the new health secretary said she was ‘committed to getting around the table’ to resolve disputes around pay that led to NHS strikes.

In July, the Government announced a 6% pay rise for doctors saying this was a ‘final’ offer which ‘no amount of strikes’ would change.

A version of this article was originally published by our sister publication Pulse.