Armed Forces pay review body (AFPRB) – BMA and BDA evidence

The BMA and BDA evidence on pay erosion for the armed forces doctors and dentists.

Published: Thursday 27 April 2023
Contract and pen article illustration


Each year, the BMA and BDA is invited to provide written and oral evidence to the AFPRB. The Armed Forces Committee leads on this work and represents the views and experiences of DMS colleagues.

The Armed Forces’ Pay Review Body (AFPRB) provides independent advice to the Prime Minister and the Secretary of State for Defence on the pay and charges for members of the Naval, Military and Air Forces of the Crown.


Summary of this years evidence

  1. Pay erosion is the primary concern of the defence workforce but is closely followed by the impact of unavoidable taxation arising from notional pension contributions.
  2. Armed forces doctors and their dental colleagues have suffered significant pay erosion (26.8% RPI, 18.2% CPI) as a result of austerity measures and repeated failure to match the DDRB award over recent years. This is the key piece of evidence the AFPRB should be considering.
  3. The BDA continues to strongly challenge the two pay comparator reports commissioned by the AFPRB. As we stated in the meeting, we would welcome dialogue and greater involvement to ensure that any comparator work is credible and respected by those working within the sectors covered by the remit of AFPRB.
  4. The BDA discerned a reluctance to acknowledge the growing gap in annual remuneration amongst all dentists through the pay award AFPRB process; also an inference that any required correction to the MODO pay scale should be addressed through other mechanisms.
  5. Armed forces doctors and their dental colleagues are unable to mirror the behaviours of their professional peers to protect personal incomes and save for retirement.
  6. 61% of regular respondents to the BMA’s survey said that they believed NHS colleagues are better able to avoid paying pension tax. 51% believed their pay hasn’t kept up with doctors working outside of defence. Benefits such as CEAs have not been uplifted since 2018, which has left them devalued by roughly 17% (adjusted for CPI). This further reduces the financial incentive to remain in the DMS.
  7. DMS is not considered the financially attractive career path it once was. This is damaging recruitment and driving workforce shortages.
  8. For the dental cadres, it is only the declining uniformed manpower requirement that allows current recruiting targets to be met.
  9. Workforces shortages in key areas are effecting morale. 36% of regular respondents to our survey stated they were unhappy or very unhappy with their current work/life balance. These doctors listed workforce shortages (55%) and unreasonable expectations at a systemic level (53%) as two major causes of the imbalance.
  10.  Many current armed forces doctors and dentists are considering their employment options in both the NHS and private sector. Both, but particularly the private sector, can offer more attractive overall packages, with pay, pensions, recognition of specialist skills and additional benefits being significant competing factors.
  11.  Pensions represent the second key issue for armed forces dentists.
  12.  Poor pay awards have a disastrous effect on pension taxation, and drive retention and recruitment problems. Pensions are a fundamental concern for armed forces doctors, with 61% of respondents citing ‘dissatisfaction with future pension arrangements’ as one of the top reasons for not considering extending their current engagement.
  13.  The Chancellor’s budget announcement on 15 March 2023 may have addressed some key asks surrounding the AA and LTA allowances, but might encourage those close to retirement to do so earlier.
  14.  When armed forces doctors and dentists retire early, some return to work in the NHS or enter the private sector. Their specialist skills enables them, if they wish to, to re-enter the civilian workforce until the end of their careers. In particular, the private sector remunerates these doctors very handsomely and recognises the expertise they develop in the armed forces.
  15.  Taking a wider perspective, X factor is not generally considered as adequate compensation for life in uniform. The current payment taper negatively impacts more senior officers who, due to current workforce shortages, are still subject to the same employment expectations as those who receive the full X factor payment.
  16.  Only 39% of regular respondents to the BMA’s survey believed current X-Factor compensated them for the demands of a life in uniform.
  17.  DMS pay must remain comparable with competing employment sectors, primarily the NHS. Impending junior doctor industrial action will put armed forces doctors at risk of being expected to cover absences but more importantly, any additional pay outcomes arising from their strike action should be considered by the AFPRB in this pay round.
  18.  We trust that in the AFPRB’s independence, they will consider the pay awards being agreed in the wider NHS.


BMA Armed Forces Committee