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Fixing pay for consultants in England

Consultants have seen their real-term take-home pay fall by over a third over the last 14 years. We're calling for this to change.

Why it’s still vital to vote in the re-ballot to extend our mandate for industrial action

Fix pay now and for retirement

Your action is working 

After months of hard work by our members and many hours of negotiations, the BMA’s Consultant’s Committee has approved a referendum of all consultant BMA members in England on a new pay offer from Government.

While this offer does not deliver all that the BMA has asked for, significant progress has been made. Throughout this dispute, the BMA has been clear that any such credible offer would be put to members for their approval.

We expect to put this formally to members via a referendum that will likely open in mid-December and run until late January 2024.

Our objective has been to achieve two things – an above inflation pay uplift for this year (2023/2024) and reforms to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to fix pay now and for the future.

As part of the agreement, we have agreed we will not call further strike action whilst we are consulting with members. However, our reballot for industrial action is open. If you have not done so already, please ensure you return your ballot paper to ensure we have an ongoing mandate if required.

The offer

The offer includes total investment of 4.95% that will be used to reform our pay scale structure. This will see a reduction in the number of pay points from eight to four and reduce the number of years it takes a consultant to reach the top of the pay scales by five years.

It also increases the starting pay for new consultants and secures an increase for the top pay point. This increase is in addition to the 6% uplift awarded earlier this year. If accepted these changes will be implemented in April 2024 but pay increases backdated to January 2024.  

As part of this investment, funding for new Local Clinical Excellence Awards (LCEAs) will be moved into basic pay. This will result in this money becoming consolidated, pensionable, and subject to uplifts as determined by the outcome of the DDRB process.

The moving of this money from new LCEAs represents approximately 1.5% of the 4.95%. Therefore, the contractual entitlement to access an annual awards round will stop from 1 April 2024. However, there will be no impact on consolidated, pensionable LCEAs awarded prior to the reforms in 2018. These awards will also no longer be subject to a renewal process. 

Watch: Government offer to end pay dispute for consultants in England - presentation
Watch: Government offer to end pay dispute for consultants in England - presentation

Vote in the consultants re-ballot

It has been consultant action that has brought the Government to the table. While an offer has now been presented to members, we must not be complacent or assume the work is done.

The BMA’s current strike mandate for consultants in England ends on 26 December. It is vital that this mandate is extended in case the offer is rejected by BMA members. We need to ensure consultants in England are ready to continue the fight if necessary.

We have therefore opened another ballot of consultants in England to enable us to continue to take action beyond 26 December if the Government fail to provide us with a credible offer.

Please vote yes and return your ballot paper to Civica Election Services, using the prepaid envelope provided, by midday on 18 December.

The ballot period is shorter than previously and because of Christmas it is essential that you post your ballot as soon as possible.

There is still time to vote in the ballot if you do it very soon. Please post your ballot before Thursday 14 December and if it is received in time for the deadline of midday on 18 December then it will be counted. Alternatively, to make sure your ballot is safely received in time, you can hand deliver it to Civica Election Services, 33 Clarendon Road, London, N8 0NW.

Remember, we need at least 50% turnout to win the re-ballot, so your vote really does matter.

Stand together. Make your voice heard. Vote Yes again.

SPA time

Following the announcement and some confusion around the SPA element of the offer, BMA reps have been in touch with DHSC and NHS Employers, who have agreed to correct the explanatory wording on the NHS Employers website.

This new wording makes clear that SPA time cannot be converted into DCC PAs, as set out in the original offer document presented by the Government to us, among other clarifications.

The NHS Employers website now specifically states that SPA time cannot be used for direct patient care as follows:

“From 2024, by agreement between consultant and their employer, additional SPA time beyond that minimum level which is required for revalidation and appraisal, may be allocated to service improvement/quality improvement work to support NHS priorities such as:

  • urgent and emergency care
  • elective recovery
  • delivery of the NHS Long Term Workforce Plan
  • major conditions strategy

However, this does not permit reallocation of SPA to direct clinical care.”

How we got here

Declining pay

Since 2008/09 the real terms take-home pay of consultants in England has been cut by 35% and that is before the impact of this year’s soaring inflation.

This results in a huge loss of earnings during a consultant’s working life. It also impacts the value of their pension and massively reduces their income throughout retirement. 

Working in the NHS over the last fifteen years has become more challenging, more stressful, and more demanding. There is absolutely no justification for the consultants of today being valued less than they were in the recent past. As it stands, consultants are effectively expected to work until May without pay every year. 

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Your finances
Fix pay now and for the future

It’s essential that it’s fixed for the future and that we never find ourselves in this situation again

One way to achieve this is through reforming the broken doctors’ pay review body (DDRB), on whose watch that shocking decline has been allowed to happen.

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Voting Card
First ballot results

How consultants and public health consultants voted in the first ballot.


Our consultant members voted overwhelmingly in favour of industrial action.

  • Turnout: 71.08%
  • Number entitled to vote: 33,915
  • Number of votes cast in the ballot: 24,106 
  • Number of YES votes: 20,741 (86.08%)
  • Number of NO votes: 3,354 (13.92%)
  • Number of spoiled or otherwise invalid voting papers returned: 11

Public health consultants ballot results

In the public health consultant ballot the turnout of 38% was below the 50% threshold for industrial action required by the Government’s anti-trade union laws.

  • Number entitled to vote: 96
  • Number of votes cast in the ballot: 37 
  • Number of YES votes: 32 (86.49%)
  • Number of NO votes: 5 (13.51%)
  • Number of spoiled or otherwise invalid voting papers returned: 0
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