The British Medical Association has today entered into dispute with four trusts1 in the Black Country over the imposition of cuts to medical bank pay rates for doctors doing extra-contractual work from the 1 October (6 October 2025 for Sandwell and West Birmingham Hospitals NHS Trust)2.
The doctors’ union are warning that new rates of pay being imposed unilaterally across the four trusts, represent significant and unacceptable cuts to pay across all grades of doctors, including consultants, SAS doctors, and resident doctors. They have condemned the decision which has been taken without any meaningful consultation or negotiation with BMA representatives.
At a meeting held by the BMA on Wednesday night (24th September) attended by hundreds of doctors impacted, many expressed their anger and frustration over the trusts' decision to impose new rates, as the doctors have still not been informed of their plans to change the rates of pay.
Doctors also warned that if they do not urgently withdraw the imposition, many will be left with no choice but to refuse extra contractual work at the reduced rates which will have a direct impact on the safe delivery of patient care. This extra-contractual work is essential to maintain safe staffing levels and patient care across the NHS, with doctors regularly working beyond their contracted hours to cover rota gaps.
One resident doctor working at Sandwell and West Birmingham Hospitals NHS trust said:
“In A&E we already work with rota gaps that leave us dangerously short - on a recent night shift, a quarter of our registrar rota and a quarter of our SHO rota were unfilled. To then cut rates further, and to impose a flat rate that fails to recognise the additional sacrifice of evenings, nights, and weekends, will only further disincentivise doctors from covering these essential shifts.”
“This feels like an attack on the value of doctors, delivered at a time when unemployment amongst resident doctors is at record high - it's an opportunistic move that exploits desperation."
The BMA is calling on each of the four Trusts to immediately withdraw their plans to impose these reduced rates and are open to negotiations to end this dispute.
Dr Rinesh Parmar, BMA West Midlands regional consultants committee Chair, said:
“As we head into what will undoubtedly be another busy winter, this is a kick in the teeth to doctors in the Black Country and devalues the vital work that they do to keep patients safe over and above their contracted hours.
“There is a clear sense of anger among doctors who feel they have been blindsided by these new rates that are being imposed, without any meaningful negotiation.
“As well as the frustration felt among doctors, this is also incredibly concerning for patient care as a reduction in rates will only discourage doctors from picking up any additional work that they ordinarily would.
“We urge the trusts to urgently withdraw this imposition to avoid damaging morale beyond repair and to avoid any potential disruption to patient care.”
Dr Erin Gourley, BMA West Midlands regional resident doctors committee Co-Chair said:
“It is unacceptable that doctors who are already going above and beyond to provide care in challenging conditions are being treated so unfairly by these trusts having not even been notified of changes to extra contractual pay a week before it is being imposed.
“The imposition of these new rates will ultimately mean a cut in pay in extra-contractual work for many and is a real betrayal to hard working resident doctors in the Black Country. This will clearly disincentivise doctors from taking up additional shifts and the trusts must carefully consider its actions given the groundswell of discontent from doctors.”
Notes to editors
1.The four affected Trusts are:
- Walsall Healthcare NHS Trust
- Sandwell and West Birmingham Hospitals NHS Trust (SWBH)
- Dudley Group NHS Foundation Trust
- The Royal Wolverhampton NHS Trust
2. The proposed changes will take effect from 1 October 2025 (6 October 2025 for SWBH).