Health & Lifestyle

End of devastating NHS strikes in sight as ministers agree to give consultants up to an extra £20,000 each after striking deal with militant unions

  • Officials said they refused to budge on six per cent salary increase for the year
  • But the BMA said there will be an additional 4.95 per cent ‘investment in pay’

Striking NHS consultants have finally reached an agreement with ministers which might spell the end of devastating walk-outs.

Officials refused to budge on their original offer, worth around the 6 per cent mark, for months.

But now the Government has vowed to give an additional 4.95 per cent ‘investment in pay’ that will see consultants — who earn six-figure salaries, on average — get up to an extra £20,000.

The British Medical Association (BMA) said it will now put the offer to members for a vote. If accepted, it could end a wave of industrial action. 

Action among NHS staff, which kicked off last December, has seen around 1.2million appointments cancelled and cost £1.4billion, official figures suggest.  

NHS Consultants carry placards as they strike at a picket outside the University College Hospital in London on  19 September

NHS Consultants carry placards as they strike at a picket outside the University College Hospital in London on  19 September

Official data shows strikes by NHS have seen more than 1million routine procedures and appointments rescheduled

Official data shows strikes by NHS have seen more than 1million routine procedures and appointments rescheduled

The Government agreed to changes to consultants’ pay scale structure, which will see fewer points at which their pay increases. 

However, the medics will reach the top rung of the ladder five years earlier than the current scheme.

It means consultants with eight years’ experience will see their pay jump by £19,459, or 12.8 per cent, from January 2024, compared to their earnings up to March 2023.

While this group of medics are the biggest winners of the deal, those who have just two years’ experience will see their pay rise by £5,634, or six per cent — the Governments initial offer. 

Consultants, along with other medics, are expected to see their salary rise further from April 2024 as part of an annual pay review process.

The BMA said the reforms will benefit women who take time out of work and ‘can be disadvantaged under the current system’ and extend the right for shared parental leave, helping to target ‘the gender pay gap in medicine’.

Officials also agreed with the union that it will reform the Review Body on Doctors’ and Dentists’ Remuneration’s (DDRB) — the body that sets the pay of medics.

The BMA will be given a say in the members on the panel and the Government will no longer limit how much the DDRB can recommend based on the UK’s economic performance and inflation targets.

The BMA will ask consultants to vote on these proposals from December. The poll will close in January, with results expected soon after.

The pay uplift will be funded, in part, by scrapping Local Clinical Excellence Awards — a scheme that sees up to 600 medics a year have their salary topped up by up to £40,000 for the following five years.

The union has also agreed to scrap its rate card, which advises senior doctors to charge hospitals up to £3,440 per shift when covering, such as during strikes by other medics. 

Prime Minister Rishi Sunak said ending ‘damaging strike action’ was ‘vitally important’ in cutting waiting lists.

‘This is a fair deal for consultants who will benefit from major reform to their contract, it is fair for taxpayers because it will not risk our ongoing work to tackle inflation, and most importantly it is a good deal for patients to see the end of consultant industrial action,’ he said.

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.’

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 per cent 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.’

Pictured: NHS consultants and junior doctors carry placards as they strike outside St Thomas' hospital in London on September 20

Pictured: NHS consultants and junior doctors carry placards as they strike outside St Thomas’ hospital in London on September 20

Medical consultant members of the British Medical Association (BMA) on the picket line outside University College London hospital on August 24, 2023

Medical consultant members of the British Medical Association (BMA) on the picket line outside University College London hospital on August 24, 2023

Amanda Pritchard, chief executive of NHS England, said: ‘It is extremely welcome news for patients, staff and the entire health service that an agreement between the Government and the unions for NHS consultants has been reached.

‘NHS teams across the country have worked incredibly hard to ensure urgent and lifesaving care has continued during industrial action, but there is no doubt that strikes have had a significant impact on patients and families, and so today’s breakthrough comes as a huge relief.

‘This is particularly welcome as we prepare extensively for what it is likely to be another challenging winter and continue to make progress on our recovery plans, following inevitable disruption caused by the pandemic.

‘This agreement is a critical first step and we now need all parties to continue to work together to find a solution to remaining pay disputes as soon as possible.

Sir Julian Hartley, chief executive at NHS Providers, said the deal between the Government and BMA is a ‘vital step’ towards resolving industrial action, which has triggered ‘unprecedented disruption’ over the last year.

He said: ‘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.’

Danny Mortimer, chief executive of NHS Employers who chaired the talks between the Government and the BMA, said it would ‘end the disruption and heartache of the dispute’ if BMA members accept the deal. 

However, the Royal College of Nursing (RCN) said the pay deal makes strikes by nurses ‘more likley in the future’.

Professor Nicola Ranger, the RCN’s chief nurse, said: ‘Nursing staff will be appalled by this announcement and where it leaves them. The government has shown it has the political will to reform pay for some of the highest earners in the NHS – while our members are left with the lowest pay rise in the public sector.

Analysis by the Nuffield trust found NHS consultants in England were among the top earners in the profession globally

Analysis by the Nuffield trust found NHS consultants in England were among the top earners in the profession globally

NHS consultants striking outside University College London hospital on August 24, 2023

NHS consultants striking outside University College London hospital on August 24, 2023

‘Nursing staff work closely with consultants, and we too have campaigned for years to have quicker progression through the pay scale. This would help recognise nurses’ safety-critical and lifesaving skills, and yet many spend most of their career stuck on the same NHS pay band.

‘It’s galling that almost 12 months since nursing staff took the unprecedented decision to strike, our pay dispute remains unresolved, and the government continues to undervalue our profession.

‘Today’s news will ignite our members’ fury further, making nursing strikes more likely in the future.’

The dispute between consultants and the Government kicked off when the BMA argued that senior doctors’ pay has been eroded over the last 15 years.

It said consultants, who are in the top two per cent of earners in the country, should see their pay increase by 11 per cent.

However, the Government had said their 2023/24 pay offer of six per cent was final. This would see the medics’ basic full-time pay increase from around £88,300 to £93,600.

When extra payments, such as for overtime, is added on, this would see the average consultant earnings increase to £134,000.

However, the BMA said the offer left senior doctors ‘angry’ and at ‘rock bottom’ and 86 per cent of its senior doctor members subsequently voted back strike action.

As a result, consultants took to picket lines in July — marking the first strike by senior doctors in a decade. They staged further action in August and September, including the first ever joint walkout with junior doctors.

However, the BMA announced in October that it would pause strike action by consultants to create a ‘window’ for talks with the Government. 

It urged the Prime Minister to let the Advisory, Conciliation and Arbitration Service (Acas) get involved to try to bring an end to their pay dispute.

Officials had said that pay was not up for negotiation but that other incentives could be discussed.

While official figures suggest 1.2million NHS appointments have been cancelled due to strikes, the figure is thought to be even higher.

Not all NHS trusts share data on cancelled appointments and some hospitals stopped booking surgeries and consultations for strike days.


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