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Take a look at a selection of our recent media coverage:

Consultant strikes end as pay package accepted alongside reform of pay review body

5th April 2024

Consultants in England have voted to accept the Government’s latest pay offer and put an end to recent strikes, with 83% voting in favour of the revised package (turnout 63%) on behalf of the profession.

The accepted pay offer represents an improvement on the offer that was rejected by consultants in January. It includes reform of the consultant pay scale backdated from 1 March 2024, reducing the time it takes to get to the top, which aims to reduce the gender pay gap in medicine. A 2.85% (£3,000) uplift for those who have been consultants between four to seven years was also agreed.

This offer is in addition to the 6% pay uplift awarded during the Review Body on Doctors’ and Dentists’ Remuneration (DDRB)’s process last summer and is separate to the pay award following the outcome of the review body process for 2024/25.

The deal also includes the reform of the DDRB, which advises the Government on rates of pay for doctors and dentists.

Changes, which will be implemented from next year, will include greater involvement from unions in the process of appointing to the DDRB, considering ‘long-term trends’ and changes to doctors’ pay over the years, and that the Government will not be able to ‘constrain’ its remit with reference to inflation and economic evidence.

Commenting on the agreement, the British Medical Association’s consultants committee chair Dr Vishal Sharma said it is ‘the end of the beginning’ in consultants’ efforts to restore their pay to 2008 levels as there is ‘still some way to go’ to achieve this.

‘The last year has seen consultants take unprecedented strike action in our fight to address our concerns about pay and how the supposedly independent pay review process was operating,’ Dr Sharma said.

‘After years of repeated real-terms pay cuts, caused by government interference and a failure of the pay review process, consultants have spoken and now clearly feel that this offer is enough of a first step to address our concerns to end the current dispute.’

He also stressed that it is ‘imperative’ for the DDRB to utilise its independence to restore doctors’ pay and prevent future pay disputes.

Chief executive of NHS Confederation, Matthew Taylor, said NHS leaders would ‘breathe a sigh of relief’ at the news of the pay deal.

‘The health service relies heavily on its consultant workforce and these professionals have helped to keep the most life-critical services afloat including over the difficult winter period and the recent junior doctors’ walkouts,’ he said.

However, he warned the NHS would still face the impact of further junior doctor strikes, after 98% voted earlier this year to continue industrial action between April and September after no pay deal was reached.

‘While NHS organisations have worked tirelessly to fill rota gaps and keep patients safe, more than 1.4 million appointments and operations have been cancelled over the last year of industrial action, with even more patients joining waiting lists,’ Mr Taylor said.

‘This [pay] agreement between the BMA consultant committee and Government shows that a sensible middle ground can be reached through negotiations, and we urge the BMA junior doctors committee and Government to quickly re-enter negotiations to reach a similar agreement to stop further damaging strike action by junior doctors.’

Sir Julian Hartley, chief executive, NHS Providers, added that the consultant pay deal was ‘welcome’ news, but that ‘we aren’t out of the woods yet’.

‘Hugely disruptive and costly strikes in the NHS can’t become “business as usual”,’ he said. ‘Remaining concerns must be resolved. Industrial action takes a toll on patients, staff and stretched services. We urge politicians and unions to find a way to end all disputes.’

In January 2024, NHS England issued post-strike priorities to reduce elective long-waits and meet cancer 62-day backlog targets following this month’s strike action.

And in March, NHS 2024/25 priorities and operational planning guidance set an overall priority for the NHS in England over the next 12 months as the ‘recovery of core services and productivity following the Covid-19 pandemic’ continues.

A version of this article was also published by our sister publication Healthcare Leader.

Industrial action to continue as new mandate sees overwhelming junior doctor support

21st March 2024

The NHS will face further industrial action from junior doctors between April and September after 98% voted to continue striking.

The BMA’s mandate for industrial action had ended after junior doctors undertook a five-day strike at the end of February – the tenth round in this current pay dispute which began in March 2023.

This new ballot gives the BMA a new mandate between 3 April and 19 September 2024. It also approved the use of ‘action short of strike’, which is when employees continue to work but do not perform some of their duties.

BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: ’It has now been a year since we began strike action. That is a year of strikes too many.

‘The Government believed it could ignore, delay and offer excuses long enough that we would simply give up. That attitude has now led to the NHS wasting £3bn covering the strikes. This is more than double the cost of settling our whole claim. And as we see in the results of today’s [20 March] ballot, delaying tactics will not work: doctors are still determined to see their pay cuts reversed, and they are willing to keep striking another six months to achieve that.’

They also called on the Government to come forward with a ‘credible offer on pay’.

‘No doctor wants to be on strike for a second longer than they have to. But it took us 15 years of declining pay to get here’, they added.

Matthew Taylor, chief executive of the NHS Confederation, said the renewal of the mandate was ‘extremely disappointing’.

‘More disruption is the last thing that our members want when they are trying to tackle long waiting lists and improve performance across urgent and emergency care, mental health and community services,’ he said.

‘Health leaders will also be worried about the impact action short of a strike could have on services. The NHS faces wide staffing gaps and, unfortunately, can need to rely on the goodwill of staff to fill vital rota gaps and maintain patient safety. Action such as working to rule could pile immense pressure on to already stretched rotas.’

He called on both the government and the BMA junior doctors committee to restart negotiations to find a solution.

Deputy chief executive of NHS Providers, Saffron Cordery added that the news marks ‘another worrying escalation in this lengthy dispute’.

‘With today’s results underlining the sheer strength of feeling among junior doctors, trust leaders are now facing anxious waits on three fronts with consultants voting on whether to accept their new deal, and specialist, associate specialist and specialty doctors being surveyed on their rejected deal,’ she added.

‘Alongside the nearly 1.5m appointments delayed since industrial action began, strikes are expected to cost the NHS an estimated £3bn. We cannot go on like this. Politicians and unions must urgently find a way to resolve all disputes for the sake of patients, staff and the NHS.’

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

More junior doctor strike action announced and BMA‘s attempts to extend current mandate fail

12th February 2024

Further strike dates have been announced by the British Medical Association (BMA)’s junior doctors committee (JDC) after the Government failed to meet the deadline to put an improved pay offer on the table.

The BMA asked the health secretary Victoria Atkins to extend the current strike mandate for four weeks to allow for negotiations to continue, avoiding the need for strike action and for progress to be made in finding a resolution to the pay dispute.

‘Disappointingly, Victoria Atkins declined to agree to extending the mandate,’ the BMA said.

As such, the JDC announced that junior doctors will now strike for five days from 7am on 24 February to 11:59pm on 28 February unless ‘a credible offer is made’.

BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: ‘The glacial speed of progress with the Government is frustrating and incomprehensible.’

They added: ‘From the very start of the industrial action, we have been clear that there is no need for strike action as long as substantial progress is made, and we remain willing to carry on talking and to cancel the forthcoming strikes if significant progress is made and a credible offer is put forward.

‘The Government’s actions are difficult to understand, especially when their own MPs are telling the Chancellor to pay junior doctors more fairly. Whatever the holdup, from whomever it is coming, it needs to end now.

‘This will be the last action of our current mandate, but we are already balloting for six months more. Even now we are willing to put off these strikes to find a solution – it’s in the health secretary’s hands.’

Meanwhile, the BMA chair of council, Professor Philip Banfield wrote to Danny Mortimer, chief executive of NHS Employers, asking for him to agree to the extension of the strike mandate in return for the cancellation of the strikes, which would allow for two weeks’ negotiations.

The BMA said allowing for the extension was ‘something he can do on behalf of NHS employers in hospital trusts, and which would avoid, in hospitals, the disruption which the strike action causes.’

However, in his response to the letter, Mr Mortimer stated that ‘NHS leaders are deeply concerned’ about the latest strike action announcement.

‘They would join me in urging the JDC to instead focus on finding a way to resume and conclude negotiations with the Government,’ he said.

Referring to the fact that the BMA asked the health secretary to consider an extension to the present JDC strike mandate, he said: ‘I want to be clear that her response is one I support and, in any event, I do not have the ability to direct NHS organisations to accede to your request.’

Junior doctors took strike action for six days in January, marking the longest consecutive strike action taken in NHS history and following failed talks with the newly appointed health secretary.

In late January, the BMA called on the Government to discuss making improvements to its latest pay offer for consultants after members voted 51.1% against the offer.

With such a slim margin, the BMA announced it will not immediately resume consultant strike action, instead giving the Government time to improve the offer.

Consultants in England have a mandate to take industrial action until 18 June 2024.

Calls for fresh talks as consultants in England reject Government pay offer

26th January 2024

The British Medical Association (BMA) is calling on the Government to discuss making improvements to its latest pay offer after consultants narrowly voted against it.

BMA consultant members in England voted 51.1% against the offer in a referendum held from 14 December to 23 January.

Some 23,544 consultants cast their vote – a turnout of 64.8% – of whom 12,037 voted against and 11,507 (48.9%) for the offer.

Dr Vishal Sharma, BMA consultants committee chair, said: ‘The vote has shown that consultants do not feel the current offer goes far enough to end the current dispute and offer a long-term solution to the recruitment and retention crisis for senior doctors.

‘It backs up conversations we’ve had with colleagues in recent weeks, who felt the changes were insufficient and did not give them confidence that pay erosion would be addressed over the coming years.

‘In addition, they were concerned about the fairness of the offer and how it impacted different groups of doctors. There were also clear concerns about changes to professional development time, and time dedicated to teaching and research.’

With such a slim margin, the BMA has announced it will not immediately resume strike action, instead giving the Government time to improve the offer.

Consultants in England have a mandate to take industrial action until 18 June 2024.

Dr Sharma said: ‘In the coming days we will be further engaging with consultants, and seeking talks with Government to explore whether the concerns expressed by our members during the referendum process can be addressed.’

Responding to the consultants’ vote, health secretary Victoria Atkins said: ‘I hugely value the work of NHS consultants and I am disappointed that after weeks of constructive negotiations the BMA has, by the narrowest of margins, rejected this fair and reasonable offer.

‘I want to build on our progress on waiting lists and for us all to be able to focus our efforts on offering patients the highest quality care. The Government is therefore carefully considering next steps.’

Earlier in January, some 58% of consultant members of the Hospital Consultants and Specialists Association (HCSA) voted against the pay offer.

HCSA president Dr Naru Narayanan also called on the Government to return to the negotiating table after the offer was rejected ‘on a number of points’, including further erosion of Supporting Professional Activities (SPA) time and the overall level of investment and unevenness of the award across the pay scale.

Dr Narayanan said: ‘We have listened to our members and the prospect of changes to SPA time in this offer rang clear alarm bells. They are deeply concerned that the time they need to develop their skills and impart knowledge to trainees has already been eroded beyond a sustainable level. They know first-hand the constant pressure they face from managers to reduce it still further.’

Targeting the suggested investment at specific pay points means ‘many consultants would have missed out on an uplift this year’, he said.

Dr Narayanan added: ‘The Government needs to revisit the investment it is willing to make in our most experienced doctors. This result is a wake-up call. We have observed the Prime Minister’s repeated suggestion that the senior doctors’ pay dispute had been resolved, but the result … shows there is no room for complacency given low morale and years of underinvestment in staffing.

‘We are confident that with a positive approach to further negotiations it is still possible to strike a deal which a majority of consultants will be willing to accept.’

BMA Cymru Wales’ consultants are also being balloted for strike action over the six weeks to 4 March 2024.

The rejection of the Government’s offer by BMA consultant members in England comes as the union’s junior doctors committee in England announced it is to reballot its members for another six months of industrial action.

The current mandate expires at the end of February and the new ballot will run from 7 February to 20 March 2024.

If returned with a ‘yes’ vote, the mandate for strike action in England would be extended to September 2024.

The new ballot will also include approval of Action Short of a Strike (ASOS), which encompasses any other industrial action taken in order to put pressure on the employer in a trade dispute, such as refusing to work overtime, but which does not amount to full walkouts.

In December, HCSA junior doctors in England voted by over 96% in favour of continued strike action over pay until at least June.

NHS England issues post-strike priorities as reality of reducing elective backlog becomes clearer

16th January 2024

NHS trusts and integrated care boards must work to reduce elective long-waits and meet cancer 62-day backlog targets following this month’s strike action, NHS England has said.

In a letter addressed to chief executives and directors, NHS England outlined its expectations following the disruption caused by the junior doctors’ strike held in January.

It said that trusts will likely face a combination of pressures including seasonal Covid and flu presentations, cold weather-related presentations, staff sickness and the need to reschedule patients’ cancelled appointments.

NHS England urged trusts to ‘continue to prioritise the safety of patients’, including urgent planned surgery and other treatment for time-sensitive conditions, particularly fast progressing cancers.

It said the priorities from January to March remain for:

  • All systems to deliver at least 76% four-hour performance and Category 2 ambulance response times as committed to in quarter four in the November planning round, supported by continued delivery of actions identified as part of the Urgent and Emergency Care Recovery Plan
  • All systems and providers to deliver their cancer 62-day backlog reduction targets as well as achievement of the 75% faster diagnosis standard by March 2024
  • All systems to continue to reduce elective long-waits in line with the ambitions in the Elective Recovery Plan and activity levels agreed in the most recent planning exercise.

The latest round of junior doctor strikes lasted for 144 hours from 7am on 3 January to 7am on 9 January as part of their ongoing salary dispute.

NHS data showed that more than 113,700 inpatient and outpatient appointments due to be held during the strike had to be rescheduled.

Since strikes began, the cumulative total of acute inpatient and outpatient appointments rescheduled is now 1,333,221, according to NHS England.

Reducing backlog and building resilience

As these latest NHS priorities were shared, a new study suggested that the NHS must treat 10% more non-urgent hospital cases a month to reverse the increasing waiting list for elective care.

Even if system capacity were to increase by 30% – as NHS England’s target sets out – it would still take ‘several years’ to clear the backlog, researchers from Universities of Edinburgh and Strathclyde said.

Published in The Lancet, the research paper estimated there were 10.2 million fewer referrals made to elective care between the beginning of the Covid-19 pandemic and October 2022.

It also highlighted that the NHS waiting list for elective treatment increased between January 2012 and 2020 suggesting ‘a gradual service decline’ even before the pandemic.

The researchers concluded that even if the 30% increase in capacity is achieved during the next three years, ‘several years (beyond the end of 2025) will be needed for the backlog to clear.’

They added: ’Our study emphasises the need to improve healthcare system resilience to ensure that the effects of any future emergencies on the provision of routine care are minimised.’

The most recent NHS England data revealed that the Covid-19 backlog has fallen for two months in a row, dropping by 95,000 individual pathways from 7.7 million in October to 7.6 million in November.

NHS England said this was due to NHS staff delivering more than 1.63 million treatments in November – the highest monthly activity on record and around 150,000 more than the same month before the pandemic.

Latest junior doctor strike action begins as the NHS faces ‘most difficult start to year’

3rd January 2024

Junior doctors will strike for six days this week, marking the longest consecutive strike action taken in NHS history.

As a result, NHS England has warned it could be ‘one of the most difficult starts to the year‘ the health service has ever experienced with this latest strike action exacerbating pressures caused by seasonal illnesses and staff absence. 

Health leaders have also said trusts will be ‘skating on the thinnest of ice’ and that patient safety will be put at serious risk.

The strike began at 7am on Wednesday 3 January and will end at 7am on Tuesday 9 January – a total of 144 hours of uninterrupted stoppages.

The NHS Confederation highlighted that this will lead to thin rotas and local services being placed in highly vulnerable positions.

Rising levels of flu, norovirus and Covid-19 in hospitals combined with higher staff absences due to Covid will also heighten the risk, it said.

Hospitals will prioritise urgent and emergency cases as consultants cover striking junior doctors – the most recent period of action resulted in ‘thousands’ of postponed appointments. 

Despite pressures, NHSE has encouraged people to continue using 111 online, GP services, and A&E in emergency situations.

NHS England’s national medical director Professor Sir Stephen Powis said: ‘This January could be one of the most difficult starts to the year the NHS has ever faced.’

Despite ‘extensive preparations’, he warned that NHS staff are starting the new year ‘on the back foot’, and the industrial action ‘will continue to have a serious impact in the weeks after’.

In the week to 24 December 2023, there were an average of 942 patients with flu in hospital each day, including 48 in critical care. That is almost six times higher than the 160 patients the previous month and over double the 402 from the week before.

An average of 452 patients were in hospital with norovirus each day, which is 61% higher than the 281 patients the same week in 2022.

There were also 3,620 patients with Covid in hospital on 24 Dec, up 59% from 2,275 the month before.

Strike recall for major incidents

Junior doctors voted for these strike dates at the start of December, along with three strike days in the run up to Christmas, after rejecting the Government’s pay offer – this followed five weeks of ‘intense negotiations’.

BMA junior doctors committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said: ’We spent the holiday period hoping we would get the “final offer“ that the health secretary had promised us last year.

’Sadly, we have received no such offer despite repeatedly saying we would meet for talks any time over Christmas. We will continue to offer to meet throughout these coming strikes. All we need is a credible offer we can put to members and we can call off these strikes.’

The British Medical Association (BMA) and the Government were unable to agree to national derogations for the January strikes, but there is an agreement in place whereby junior doctors can be recalled for major incidents and extreme circumstances.

The Confederation said NHS leaders are calling on the BMA to respond to requests for junior doctors to be recalled and for the judgement of senior managers to be trusted when they say they need urgent cover.

Matthew Taylor, chief executive of the NHS Confederation said: ‘Many NHS trusts will have thin rotas and will be in a highly vulnerable position as they enter what is widely regarded as the busiest week of the year for local NHS services. Parts of the NHS will be skating on very thin ice, and they will need the BMA to back any recall requests for junior doctors when services find themselves under extreme pressure.’

He added: ‘To face almost 150 hours of continuous stoppages is a serious and unprecedented risk – and one that NHS leaders and their staff have never experienced before. The good news is that the NHS has again prepared extensively and has had to become adept at planning for strikes.

‘While they will again do all they can to mitigate the risks, especially for patients needing emergency care, they have again been left with no choice but to schedule in less activity in anticipation of the strikes. That means more delays for patients who have faced lengthy waits for routine treatment.’

In October, NHS England formally warned the BMA about the ‘cumulative’ impact of the doctor strikes which were causing ‘significant disruption and risk to patients’.

In November, the BMA and Hospital Consultants and Specialists Association (HCSA) reached an agreement in principle on a pay offer of 4.95% that could bring an end to consultant strike action.

A recent Health Foundation report found that the NHS waiting list will reach a high of eight million in the summer of 2024 if current trends continue, regardless of strike action.

Junior doctors confirm dates for strike action after failed talks with new health secretary

7th December 2023

Junior doctors in England have voted for further strike action over the Christmas period and in the new year after rejecting the Government’s new pay offer.

This follows five weeks of ‘intense negotiations’ between the British Medical Association (BMA)’s junior doctors committee and the Department of Health and Social Care. 

The Government has offered an additional 3%, on top of the average 8.8% increase already awarded this year.

But the committee co-chairs Dr Robert Laurenson and Dr Vivek Trivedi said this increase ‘would still amount to pay cuts for many doctors’.

Last month, former health secretary Steve Barclay was replaced by Victoria Atkins, and the BMA has said her approach to pay negotiations has been ‘more constructive’. 

The new strike action will take place for three days from 20 December and six days from 3 January – the January strike will be the longest of the industrial action so far.

Strikes have been put on hold over the last five weeks, but the BMA said the ‘deadline’ has now passed and the Government has been unable to put forward a ‘credible offer’ for junior doctors.

Dr Laurenson and Dr Trivedi said: ‘Without enough progress by the deadline, we have no choice but to take action that demonstrates doctors are as determined as ever in reversing their pay cuts. 

‘However, we can still avoid the need for these strikes. We will be ready and willing any time the Government wants to talk. If a credible offer can be presented the day before, or even during any action, these strikes can be cancelled.’

Health secretary Ms Atkins said: ‘The new strikes will result in more disruption for patients and extra pressure on NHS services and staff as we enter a busy winter period, risking patient safety.’

Last week, the Government and the BMA reached an agreement in principle on an offer that could end consultant strikes.

The offer also saw the Government committing to an overhaul of the workings of the Review Body on Doctors and Dentists Remuneration. 

In October, NHS formally warned the BMA over the ‘cumulative’ impact of consultant and junior doctor strikes which it said are causing ‘significant disruption and risk to patients’. 

At the time, consultants and junior doctors were jointly striking for three full days.

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

Consultant pay reform package agreed in principle with UK Government

27th November 2023

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.

Newly appointed health secretary commits to finding strike action resolution

17th November 2023

Victoria Atkins MP has been appointed as England’s new secretary of state for health and social care in a Cabinet reshuffle, Downing Street has confirmed.

She used her first speech in post to commit to ‘getting around the table’ regarding the strike action among NHS consultants and junior doctors.

She said that she is ‘acutely aware’ of how the strikes have disrupted patient care, and she ‘wants to see a fair and reasonable resolution’.

During the speech, which was pre-recorded and delivered virtually at the NHS Providers annual conference in Liverpool, Ms Atkins said: ‘We’ll face challenges along the way. But believe me, I am an optimist.

‘Together, we can overcome these challenges, and take the long-term decisions that will build a brighter future for our NHS.

‘And this is the approach I will take to industrial action. I’m acutely aware of how the strikes have disrupted patient care, and I’m committed to getting around the table.

‘Because, I want to see a fair and reasonable resolution. This winter will be challenging, but I know that rising to such challenges is what you all do so well.’

Workforce priorities

Welcoming Ms Atkins‘ appointment, president of the Royal College of Physicians (RCP), Dr Sarah Clarke said: ‘As we have consistently said, retaining the hardworking staff we have now is necessary to bringing down waiting lists and ensuring the health service is able to meet demand now and in the future. This means resourcing the service appropriately.

‘Acting on retention must be the top priority for the new secretary of state, including continuing talks and finding a resolution to industrial action. Getting the basics right including embracing flexible working, improving IT equipment and ensuring staff have time for research and teaching will all make a difference to improve retention of staff.

‘We welcome the secretary of state’s comments on driving forward discussions with trade unions. It is crucial that staff feel valued and supported.‘

Dr Clarke said the RCP looks forward to working with the secretary of state on these workforce issue, as well as wider issues such as reducing health inequalities, prioritising prevention and tackling climate change.

Strike action ‘top of the agenda‘

Also responding to Ms Atkins‘ appointment, NHS Providers chief executive Sir Julian Hartley said: ‘Trust leaders will welcome the appointment of Victoria Atkins as health and social care secretary. This change comes at a critical juncture for the sector, which faces unprecedented challenges.

‘Top of the agenda is the resolution to ongoing industrial action. The cumulative impact of strikes on patients, staff and the NHS cannot be understated. Constructive dialogue between the Government and unions is key to finding a sustainable solution.

‘Ahead of the Autumn Statement, we urge her to ensure sufficient capital investment in deteriorating NHS facilities and equipment. This is vital for the sustainability and modernisation of health services.‘

Earlier this month, the British Medical Association (BMA) launched a re-ballot of hospital consultants to extend their industrial action mandate until June next year.

The union said that talks between BMA leaders and Government on how to resolve both pay disputes were still underway, but ‘no credible offer’ has been put on the table.

The BMA also said that ‘productive and intensive talks’ between the consultants committee and the Government had began, after ministers agreed to meet with the committee in the hope to find a resolution to the pay dispute.

In July, consultants announced additional strike dates over the summer after rejecting ‘final’ pay offer of 6% from the Government, despite the Government saying ‘no amount of strikes’ would change its position.

Professor Philip Banfield, BMA council chair, said: ‘The new health secretary must make solving the NHS’s workforce crisis her top priority. Negotiations to find a fair way forward to restore doctors’ lost pay and value their unique expertise must continue unabated. Long waiting lists and striking doctors have the same root causes – a catastrophic and chronic under-investment in our NHS.’

He added: ’It would be disastrous if the revolving door of health secretaries was responsible for the failure of talks and further strike action.’

Professor Banfield called on Ms Atkins to ’take action to rebuild a health service that is fit for purpose and for patients’ and ’without delay’.

Strong and integrated care

In her speech, the new secretary of state for health and social care also highlighted the importance of primary and secondary care working together to help create ’strong and integrated’ care across England.

She also said that delivering the Urgent and Emergency Care Recovery Plan for winter would be her ‘number one priority’.

And she highlighted the government’s long-term workforce and other recovery plans.

Ms Atkins recognised there was ‘a lot of work to do’ to ensure the health service was ‘in fighting fit form for our children and our grandchildren’.

She added that building on government reforms to ‘create strong and integrated care systems across England’ would be ‘a shared endeavour’.

‘And it will require all of us to work in partnership. Across our acute hospitals, mental health, community, general practice and pharmacy,’ the secretary of state for health and social care told the conference.

While stressing the coming winter ‘will be challenging’, Ms Atkins said: ‘I know that rising to such challenges is what you all do so well.’

‘You’ve overcome a once in a generation pandemic. You’ve tackled the longest waits for care it left behind. And you’re delivering reforms that will give patients more choice and control over their care,’ she added.

In addition, she noted that ‘clear recovery plans’, ‘financial certainty for the rest of the year’ and ‘the first-ever, fully funded, reform-focused, long-term workforce plan’ were in place.

Chair of the health and social care select committee Steve Brine MP welcomed Ms Atkins‘ appointment, which he said comes ‘at a critical time for the NHS with the number of patients waiting for treatment at a record high‘.

And he urged the new secretary of state for health and social care to prioritise prevention.

‘Preventing ill-health will be key to helping the NHS manage its resources. Prevention is one of this committee’s priorities and I hope it will be high up the on new secretary of state’s agenda too,’ he said.

Who is health secretary Victoria Atkins?

Prime Minister Rishi Sunak appointed the Lincolnshire MP to succeed Steve Barclay in the reshuffle of his top team. Mr Barclay will stay in the Cabinet as environment, food and rural affairs secretary.

Ms Atkins has been the MP for Louth and Horncastle since 2015 and was previously financial secretary to the Treasury, minister for women, minister for prisons and probation, and minister for Afghan resettlement.

Ms Atkins will be the seventh health secretary since 2018.

She has previously said she was one of the first members of her family to go to university, reading law at Cambridge. Before becoming an MP, she worked as a criminal barrister specialised in prosecuting serious organised crime.

However, she has political ‘pedigree’, being the daughter of former Tory MP and MEP Sir Robert Atkins.

Image credit: Chris McAndrew.

Re-ballot for consultant strike action launched by BMA in England

7th November 2023

The British Medical Association (BMA) has launched a re-ballot of hospital consultants to extend their mandate for strike action until June next year.

The union said that ‘productive and intensive talks’ between the consultants committee and the Government began last week, after ministers agreed to meet with the committee in the hope to find a resolution to the pay dispute.

While these talks are still underway, ‘no credible offer’ has been put on the table thus far and progress has been ‘insufficient to change plans to launch the re-ballot‘.

However, the committee did state that it will not be announcing new strike dates while the talks are ongoing. The consultants’ current mandate for strike action ends on 26 December.

Ahead of the first consultants ballot, the BMA said consultants were effectively working four months of the year for free based on a 35% decline in take-home pay since 2008/9.

Dr Vishal Sharma, the BMA’s consultants committee chair, said: ‘We gave the Government a month to get back around the table. Whilst it’s been incredibly frustrating that the Government didn’t respond until a few days before the deadline, we have now commenced talks.

‘These discussions have been constructive and are ongoing. Therefore, given our willingness to resolve this dispute we are not announcing further strike dates right now – but reserve the right to do so if necessary.

‘Our re-ballot begins today as planned as it’s vital that, even during these negotiations, we continue to have a legal mandate to call more industrial action if they break down.

‘Neither the Government nor senior doctors themselves want consultants to be on strike – we’d both much rather we were in hospitals seeing patients.

‘To prevent further strikes we need the Government to commit to fix pay now and for the future, only then can we not only resolve this dispute, but retain the NHS’s most expert clinicians at a time they’re needed most.’

A separate formal ballot of specialist, associate specialist and specialty (SAS) doctors has also been launched.

Following informal talks with Government and results from an indicative ballot for SAS doctors – in which 88% of respondents would be prepared to strike over worsening pay and working conditions – the BMA’s SAS committee accepted the invitation for formal negotiations.

SAS doctors have seen their pay fall by up to 31% in real terms since 2008/09, according to the BMA. The union is therefore seeking an above-inflationary uplift for this year and meaningful steps to start addressing longer term pay erosion, as well as improvements to SAS doctors’ working conditions and career progression.

Highlighting the disappointment that the Government has yet to present a credible offer, SAS committee chair Dr Ujjwala Anand Mohite said: ‘Whilst talks continue to progress we are clearly still somewhat short of the credible offer we are asking Government for.

‘We are therefore asking SAS doctors to give us the mandate for action, should we need it because the current round of talks fail.

‘SAS doctors have made it very clear that we do not want to strike, we want to work and care for our patients, but we can no longer ignore the profession’s ever-growing pay and working conditions concerns – it’s driving doctors out of our health service and leaving those of us who remain with an unmanageable workload all while feeling undervalued and burnt out.

‘Industrial action is our absolute last resort, and we remain hopeful that we’ll receive a credible offer as talks continue.

‘It is in the Government’s gift to find a resolution before Christmas and avoid strike action; patients and our NHS are relying on our leaders to do so.’

Both ballots began on 6 November 2023 and close on 18 December. If successful, the mandates will run until 17 June 2024.

Previously, NHS England bosses had urged the Government to urgently resume talks with consultants ahead of winter.

In a formal warning letter, NHS England told the BMA that ‘cumulative’ impact of consultant and junior doctor strikes were causing ‘significant disruption and risk to patients’.