About our campaign

Join the fight for fair pay by committing to our collective power. By signing up to our pledge, you agree to withhold extra work if escalation becomes necessary. Your name will remain confidential unless we move forward with action, ensuring your safety in numbers.

Our Goal

To force employers to scrap the medical rate cap and significantly increase the rates for all grades of doctors across London.

Our Leverage

By uniting as one, we hold the power to collectively withdraw from paid extra work beyond our contracts. Together, we can apply the pressure needed to negotiate meaningful pay increases across all specialties and grades.

Our opening negotiating position is provided below, and has been informed by your views through our membership survey. We believe it represents a reasonable reflection of your true value.

Further to the above rates, our opening position includes 80% of the appropriate rate above for periods of availability during non-resident on-call (NROC) shifts, and 100% of the appropriate rate above for periods of work undertaken during NROC shifts. 

It is important to note that these rates presented are solely our opening negotiating position, and nothing else at this stage. We share this information as this is your campaign, your negotiations, and your union.

How you can get involved

We’ve done this before, both nationally and at local London hospitals, with great outcomes. Let’s do it again across the capital. 

Now is the time to Act 

• Sign the Pledge – Complete the form today.
• Start Preparing – Save money now in case we need to withhold extra work for a period of time.
• Spread the Word – Encourage your colleagues to sign the pledge too.
• Get Involved – Register as an Active Member Sign Up to support the campaign where you work.

Rest assured, the names of doctors who sign up to the pledge will not be disclosed unless and until:

• we secure sufficient numbers of doctors signing up where you work to provide safety in numbers, and
• we feel the need to escalate the campaign into a dispute and call upon doctors to cease their extra hours of work.

Campaign materials

You can order "London - Scrap the Cap" lanyards, badges and pens by visiting our BMA reps support page.

What's next?

Now is the time to get active, start talking to your colleagues about this campaign and the pledge, and sign up to get more involved where you work! 

Your BMA LNC Chairs and regional committee leaders will meet again in late January / early February to assess the campaign’s progress and decide next steps, including whether we’re ready and need to escalate at that time. 

Your questions answered

What is our campaign strategy?

Your BMA London reps are seeking negotiations with NHS London and representatives of all NHS Trusts in London about the rates they offer. At some point – either prior to or during these negotiations – your reps will almost certainly need leverage to bring the Trusts to the table, or improve the offers they are making during the negotiations. That leverage will come through our collective action.

When the day comes – and we don’t know when that will be just yet – BMA London will send out texts and emails to the doctors who have signed up to the campaign pledge, asking them to stop booking new locum/bank shifts from that day forward.

Thousands of London doctors have told us that the rates currently being offered are not good enough, but the difference is that now we will all be expressing that at the same time, and via the same method: by not taking the shifts at the rates currently on offer.

It will take a few weeks for Trusts to notice the difference, as some shifts will have already been booked and will take a while to work through, but that will change as the weeks go by. The more difficulty they have in getting doctors to undertake extra work, the more leverage we generate for your BMA London negotiation team.

When, as part of negotiations, an offer is received that your BMA London reps consider credible enough that it may be acceptable, we will come back to you, our members, in a referendum on the offer.

If the result of that referendum is to accept the offer, we will deactivate the collective action, and the newly agreed rates will come into effect across the city.

If the result of that referendum is to reject the offer, the collective action will remain in effect and we will return to negotiations with that clear instruction from you, our members.

Will my department know that I have signed up to the pledge?

While the campaign is in the early stage of collecting signatories, your participation is confidential and only BMA London can see who has signed up.

When and if the pledge gets activated by the BMA notifying all the doctors to stop taking extra work, the BMA will write to Trusts with the names of doctors in each specialty who will be participating.

They will also be told how many shifts now won’t be filled each month that the action goes on for, to emphasise the seriousness of impact.

With strike action, employers generally know who is and is not on strike, and likewise with this collective action, we will be standing together in front of employers to demand that our value be recognised.

People who tick the box to say they want to help with the campaign will have their details sent to the BMA reps where they work, so that they can coordinate active members, but hospital management will not be informed of any of this.

Is this industrial action?

No.

We have several robust legal opinions confirming that this form of activity does not constitute industrial action, as you are not breaching your contract of employment.

You are still doing your regular job as usual; it is just the additional shifts you are no longer taking. Those hours are your own time to do with as you please, and you are not obliged to offer them up for locum or bank shifts.

How do we know this will work?

Anaesthetic doctors at Chelsea & Westminster and Imperial did exactly this on a smaller scale last summer. They organised themselves and refused to do extra sessions until the rates (some of which had been frozen since 2009) were increased.

It took just over two months for the Trusts to realise that the doctors were serious and could sustain this indefinitely, and they won big improvements to their rates for extra work – including a 50% increase for weekday shifts.

We are now going to use this same tactic across all specialties and grades across London.

Unity and solidarity are our strength, so it is very important that we do not let them try to pick off groups of doctors with offers to break the pledge; we want a deal that covers rates for all doctors doing extra work in the city, regardless of grade or specialty.

Which shifts will have the biggest impact if we leave them unfilled?

There are certain specialties or types of shifts without which the hospital cannot function for long (eg. resident doctors’ night shifts covering wards, or specialties that are very understaffed).

We want to be able to get as many people as possible who normally do those kinds of shifts participating in the pledge, as this increases our leverage markedly.

However, we also need the Trusts to see that the action is widespread and covers all specialties and grades, so that they know they cannot divide us. They will try to offer increases only to one group who do those critical shifts, while continuing to offer low rates to people who can only do the less-critical or over-supplied shifts. We will demonstrate solidarity by maintaining our action until all specialties and grades have their rates increased, not just the ones whose absence the Trusts feel most keenly.

When are we starting the collective pause to booking extra, bank and/or locum shifts?

We do not yet know when, or if, we will need to activate the pledge and ask everyone to pause booking shifts.

It is possible, though unlikely, that we will not need to do so, and that we will secure negotiations and receive an offer early in those negotiations that will be acceptable to everyone.

If the Trusts learn the clear lesson from the success of this action on a smaller scale at Imperial, Chelsea & Westminster and elsewhere, they will not wait to feel the pain of the collective action before negotiating to increase the rates.

However, what is much more likely is that the Trusts will want to test how serious we are, and it may be that we will need to activate the pledge to both bring them to the table and secure a credible enough offer to put to you all.

Feel free to book extra shifts between now and then to build up some cash reserves if you usually do lots of locums, as this will mean we can sustain the collective pause for longer.

What about shifts we have already booked?

In the event we feel we need to trigger the pledge, if you already have locum or bank shifts booked when we do, you should honour those bookings. However, please do not take or book any more bank or locum shifts after that.

What might management do in response to our campaign?

Hospital management may say a number of things if and when we activate the pledge. Here are some examples and our responses to these:

They may say this is strike action, or unlawful, or breach of contract.

The hours of work in question are extra and non-contractual; it is therefore not a breach of contract, and we have robust legal advice confirming it is neither unlawful nor a form of industrial action.

They may say this breaches Good Medical Practice (GMP).

It does not. It is your employer's responsibility to staff their hospitals sufficiently to be safe for patients, not yours.

They may say we are blackmailing the hospital.

We are not blackmailing anyone; we are simply asking for our worth to be recognised at a time when the services we work in are understaffed.

They may say you are being unprofessional by refusing to take on the shifts they want you to take.

You can do what you like with your own time, and if the rates offered do not meet your expectations, you are fully entitled and within your rights to say no.

They may say this will affect your progression in your training.

Locum work is obviously not part of the training programme, and if anyone threatens your training outcomes on that basis, the TPD (and the BMA) should be informed immediately, as this is grossly inappropriate and constitutes bullying.

They may offer increased rates to select groups of doctors where they perceive there to be higher service pressure (for example in specific specialties where there is a bigger cost impact for the Trust from our action).

This is an attempt to divide us, and we should not go along with it. The rates have to go up for everybody via agreement, otherwise they will not stay at that height for anyone.

They may leave shifts uncovered to “call your bluff”.

The responsibility for safe staffing lies with management, not with working doctors, and you are not obliged to solve their staffing problems for them. They may say these or other things to you individually, or they may say them in the media or online. If you feel you are being personally bullied, or forced to take shifts you do not want to take, contact your local BMA rep as soon as possible.

What if the Trust leaves shifts unfilled and it creates a patient safety issue?

The Trust bears the responsibility to maintain safe staffing levels, not you. If you believe that safe staffing levels are not being maintained because the Trust is choosing to leave a shift unfilled during our campaign, you can and should raise that concern as you would about any situation posing an avoidable risk to your patients, and your BMA will support you in that.

Beyond the usual GMC obligation not to walk away from sick patients without handing over care, you are not obliged to solve their staffing problem by working beyond your contract in your own time if you do not want to. You do not have to take locum or bank shifts to solve their problems.

In the bigger picture, the NHS is massively understaffed (not just for doctors), and the service overall depends on people working shifts beyond their main contract. If the rates on offer do not keep up with expectations, and if Trusts try to artificially suppress the rates through collusion, the situation becomes unsustainable, and patient safety is affected in the long term through chronic understaffing.

We have now reached that point, and this campaign by the BMA is correcting a difficult situation that Trusts have created for themselves.

I only do locum work; I do not have a main job at the moment. What should I do?

We completely understand that if your only income is locum shifts, you obviously cannot stop doing locum work altogether. However, any leverage you can lend to the campaign is very welcome, so if you can reduce the number of shifts you take a little bit, that would be great.

Please sign up to the campaign and tick the “half pledge” option (to reduce your shifts taken by half), but you can judge for yourself how much is affordable for you. Everyone participating in the action who normally does locum or bank work is going to be missing out on some income while the pledge is in action, and hopefully you will be able to share that burden proportionately.

If you really cannot afford to reduce your income at all and cannot participate in the pledge, at least please do not start taking more shifts than usual when your colleagues are taking this collective action – there will be lots of extra uncovered shifts out there during the collective action, of course, but if you take them, you would be undermining your colleagues and assisting Trusts in the continued suppression of rates.

You could also look outside London for shifts in the short term while the action is ongoing if that’s viable for you to do.

As a doctor whose main income is from locum shifts, you will benefit more than most from the success of this campaign, so please give your negotiation team as much leverage as possible in the negotiation room.

Get in touch

To contact us for more information, or to share your thoughts, email James Steen, Head of BMA London.

This is your campaign. Your negotiations. Your union. Let’s achieve fair pay for all doctors in London.