The indicative ballot on industrial action is open, cast your vote now.
We are calling for changes which reflect the demands and complexity of the consultant role, make the role sustainable, recognise the value of the profession and ensure that becoming a consultant remains attractive to the next generation of doctors.
We need to show the Government the strength of our feeling. Our focus is on:
Restoring the value of the profession
SPA time has been eroded, with it becoming seen too often as an optional extra for employers. We want a contractual guarantee in the proportion of SPA time to provide the leadership, innovation and training needed to improve services. We also want to take action on the length of PAs in general and particularly for the most onerous elements of our working lives in unsocial hours, which are woefully undervalued.
Improving pension arrangements
The BMA’s lobbying led to a number of changes, including a raise of the tapered annual allowance threshold, which removed the effect of the taper from consultants with a threshold income of less than £200,000; increased the annual allowance to £60k; and removed the lifetime allowance. Both the consultants committee and the pensions committee recognise there are still issues with the current state of pensions that will push consultants to reduce their workload and leave the profession; we are continuing to push for pension tax reform.
We’re calling for the guaranteed right to access partial retirement so that consultants can choose to take the pension they’ve paid for without needing their employers’ permission. Additionally, consultants should have the right to elect to have contracted additional PAs greater than ten count towards their pension, if they wish.
Restoring consultant pay
We need more action from the Government on pay restoration which, as previously described by the secretary of state before he entered Government, is a journey not merely ‘an event’. We previously made a deal with Government to enact meaningful reform to the DDRB (the pay review body), however, they have since reneged on that agreement.
Staying united for a better future
Our collective efforts over the last two years led to significant achievements for consultants in England.
- A new shortened pay scale and improved pay deal.
- Vital reforms to the pay review body (DDRB) – including changes to its Terms of Reference and a commitment to the pay award being known at the start of the financial year.
- A bigger boost to pay for the majority of consultants than delivered by the DDRB for decades.
We must take a stand again now, for the benefit of our profession and for our patients.
We recorded a webinar on the pay campaign that we held in mid-July.
This covers all the issues around the campaign and why the indicative ballot is so important.
Watch it now and then vote in the indicative ballot.
Programmed activities (PA)
Since the implementation of the 2003 contract, supporting professional activity (SPA) time has continued to be a point of contention between some employers and consultants. We are aware that some Trusts have been suspending SPA time or swapping it out for additional clinical activities in an attempt to relieve some of the system pressures, however, we want to be clear that this carries serious implications impacting on quality improvement, leadership, development and teaching and is unsustainable as a practice.
We are therefore calling on the Government to introduce a contractual guarantee that an appropriate proportion of SPA time will be mandated in job plans, giving consultants the time needed to effectively carry out every aspect of their role. Additionally, we are campaigning for the length of PAs in standard and premium time to be revalued, to help consultants manage their working days better and recognise the onerous effects of out of hours workloads.
Pay award 2025 and pension value
The 4% pay uplift for consultants in England announced in May showed the Government has reneged on its pledge to reform the independent pay review body and it undermined years of campaigning. Consultant pay erosion remains at 26% - if we accept this it gives a green light to future governments to reduce the real-terms value of our pay forever more. Furthermore, not addressing the pay erosion that has occurred will have a direct and lasting impact on your pension value – the main route to restore pension value also lies in pay restoration.
When we re-entered into dispute with Government in May following the announcement of 4% pay award, we reintroduced the consultant rate card in England. If the Government does not value us, we must ensure we value ourselves and our own time appropriately, and therefore we encourage you to use the consultant rate card to do so.
Changes to pay
Back in July 2023 DDRB recommended a sub inflation pay uplift of 6%, at a time when inflation was much higher. This led to us entering dispute in late 2023. A first offer, in the midst of members’ industrial action, was rejected. Ongoing action, coupled with direct negotiations with the Government, led to additional increases to pay applied in the successful 2024 pay deal.
The 2024 negotiations shortened the pay scale, enabling consultants to reach the top of the pay scale 5 years earlier, after 14 years. The changes to the pay scale resulted in the uplift individuals received varying depending on the point of the pay scale they were at. Indeed, concerns over a number of consultants receiving no immediate uplift to DDRB original recommendation of 6% were a factor in the initial rejection of the pay offer. Further industrial action led to increases of between 6% and 19.6%, showing that your action worked enormously well.
This work is however unfinished, both in terms of the journey towards pay restoration for all (we are already 17 years in deficit) and specific groups towards the beginning and at the end of the consultant pay scale, it is vital we continue to be ready to fight for fairness if needed.
The chart compares the change in consultants’ average earnings to other sectors’ average earnings in real terms, using RPI inflation from April 2009 to December 2024. Data from NHS digital and the ONS.
Pay body reform
The deal we accepted in 2024 stated that the BMA would have a greater role for the BMA in the process of appointing DDRB members. It also included changes to the terms of reference that guide the panel’s recommendations. These include factoring in long-term pay trends as well as the salaries of comparator professions, including those of our international counterparts.
The sum total of these reforms to the DDRB – the first meaningful reforms since 1998 – was intended to equip the pay review body with the independence and scope it needed to determine a fair pay award for consultants.
However, The Government reneged on its pledge to reform the independent pay review body. This included making reference to wider economic factors in its remit letter last year, despite undertakings not to do so.
Vote now in the indicative ballot for consultant industrial action, to ensure your voice is heard.
Campaign resources
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