The indicative ballot on industrial action is now open. Sadly, it has become clear that the Secretary of State will not engage on consultant issues unless we have a clear mandate from the profession. With your voice we can drive the further change so sorely needed. It is vital that we hear consultants’ views on possible industrial action and learn how you feel about campaigning for changes to improve pay and the quality of your working lives. 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.
The derisory 4% pay uplift for consultants in England announced in May represents a betrayal, clearly showing the Government has reneged on its pledge to reform the independent pay review body and it undermines years of campaigning. Consultant pay erosion remains at 26% - at this rate it will take 38 years to reverse. We cannot accept this - if we do then 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.
We have been in dispute with the Government since the pay award, immediately reintroducing the rate card. Frustratingly the Government has continued to ignore our calls for negotiations, and it is time to take a stand again. We cannot let last year’s commitments slide, for the benefit of our profession, our patients and the health of the public. With thousands of members united with us we can convince the Government that it needs to negotiate with us. Our focus is:
- Restoring consultant pay: We are calling for a multiple-year pay deal to continue the journey to full pay restoration
- Improving pension arrangements: We want consultants to have a right to partial retirement the right for consultants to decide that all contracted Programme Activities shall be pensionable, not just the first 10
- Restoring the value of the profession: We want to see a reduction in the duration of a PA, an increase and contractual guarantee in the proportion of Supporting Professional Activities (SPA) time, and appropriate pay for the most onerous work in unsocial hours
We urge consultants to vote now and to vote YES.
View the consultant rate card.
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.
Resident doctor strikes
The resident doctor ballot turned out a strong mandate for industrial action and they have now announced strike action for 25-30 July. We support the resident doctors in their fight and urge you as their senior colleagues to take the necessary steps to support and protect them. This could be by offering words of solidarity to your residents or providing additional teaching support to prospective FY1s that will still be shadowing when strikes are taking place.
There is also guidance for consultants working during periods of industrial action by resident doctors, so that you can understand your rights and responsibilities. This includes updated information about the derogation system and a template letter to use should you have concerns about patient safety. If you choose to cover such work, we recommend that you negotiate payment at an appropriate rate using our consultant rate card for non-contractual work.
Effective action by the resident doctors benefits the profession as a whole. If we stand together, we will win together.
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. Our pay erosion remains at 26%. That means our pay is still down by a quarter compared with 2008/09.
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.
This meant that the DDRB should no longer be able to ignore past trends in pay when making recommendations. And it also freed the body from having to factor in calculations about the wider economy when determining consultants’ pay.
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.
Restoring pay, pensions and value
Last year’s deal was a good first step towards restoring our pay. Changes to pension taxation (AA and LTA) in the March 2023 Budget addressed many of the inequities around pension taxation, but there is still work to do in this area and if action on pay is needed, we will also act to remove or mitigate these remaining issues. Specifically, it is worth noting we should never let pension taxation dissuade us from seeking more pay, in the medium and long term more pay is always better.
The fight must go on. We’ve achieved so much – we must not allow the pace of pay and pension reform to stall.
Let’s unite again, keep the pressure up to restore pay, pensions and value.
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Campaign resources
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