A failure to keep armed forces doctors’ pay competitive with rates paid in the NHS is threatening to undermine defence medical capability, the BMA has warned.

The association’s armed forces committee has called for pay scales for medical personnel within the armed forces to reflect enhancements seen in the health service.

The recommendation comes as part of the committee’s submission to the AFPRB (Armed Forces Pay Review Body) made earlier this month.

The report makes clear that pay rates for MODO (medical and dental officers) has not kept pace with developments such as the pay deal for resident doctors in England reached following industrial action.

It warns that this disparity risks ‘weakening the military employment offer’ and calls upon the AFPRB to take action to avoid ‘serious risks to recruitment and retention’.

Recruitment concerns

In a member message sent out earlier this week, AFC chair Sally Acton warned that the growing disparity on pay risked ‘weakening the military employment offer’ and called on the AFPRB to take action to ensure the armed forces could continue to recruit and retain medical staff adequately.

She said: ‘Our latest submission makes clear that MODO pay has not kept pace with NHS comparators, weakening the military employment offer and creating serious risks to recruitment, retention and Defence medical capability.

‘Our evidence shows that MODO pay has progressively fallen behind NHS comparators across the career pathway, creating multiple points at which Defence doctors may choose to leave and making an Armed Forces career less attractive overall.

‘The AFPRB must therefore recommend urgent action to close the widening pay gap and enable the MOD to recruit and retain the doctors they need.’

In its report the committee also urges the AFPRB to end the two-year cycle to pay recommendations and instead return to an annual approach in line with that taken by the Review Body on Doctors' and Dentists' Remuneration.

Other recommendations include a call for greater transparency around armed forces pay by ensuring that the AFPRB adopt a confidential evidence-sharing arrangement, which would enable the sharing of information around pay recommendations subject only to minimum necessary redactions on national security grounds.

Report's recommendations

The full list of recommendations made in this year’s report include:

Recommendation 1: That the AFPRB returns to making annual MODO-specific pay recommendations, rather than considering MODO pay on a two-year cycle.

Recommendation 2: That the AFPRB ensures that Defence Clinical Impact Awards and Trainer Pay are uprated in future pay rounds so that their value is maintained.

Recommendation 3: That the AFPRB adopts a confidential evidence-sharing arrangement comparable to the DDRB, subject only to minimum necessary redactions on national security grounds. This will maintain confidence in the independence, balance and credibility of the pay review process.

Recommendation 4: That the AFPRB instructs the Office of Manpower Economics (OME) to work directly with the BMA to produce agreed comparator pay calculations.

Recommendation 5: That the AFPRB collates MODO specific data on staff morale and satisfaction with pay and shares this with all parties.

Recommendation 6: That the AFPRB recommends an uplift for resident MODOs matching the circa 6.6% average investment in the nodal points awarded to resident doctors in England, including equivalent pay-scale/progression reform.

Recommendation 7: That the AFPRB recommends a structural increase in pay for consultants to correct the deficit in pay against their civilian comparator that is caused by the career delay of general duties. This increase should be applied to the early post-training return of service period, such that it operates as a retention incentive.

Recommendation 8: That the AFPRB recommends a general increase to consultant pay to restore the pay lead that was foundational to the current pay structure since its creation by the Medical Manning and Retention Review.

Recommendation 9: That the AFPRB recommends that Armed Forces GPs receive a pay uplift which brings them in line with what their NHS counterparts are earning, before applying X factor.

Recommendation 10: The AFPRB should seek data on exception reports submitted by military doctors, the proportion resolved through time off or payment, the time taken to provide time off, and any additional hours that go unreported, to ensure compensation is fair and no less than civilian colleagues.