Doctors’ leaders have struck a deal with ministers that could end the strikes by hospital consultants that have badly disrupted NHS care for months.
Grassroots members of the British Medical Association (BMA) and the Hospital Consultants and Specialists Association (HCSA) in England still have to approve the government’s offer. But if medics accept it in referendums then both unions will call off the industrial action that has led to hundreds of thousands of operations and outpatient appointments being cancelled.
Those votes will be held next month and the results will not be known until January, which means consultants will not strike during the start of the NHS’s usual winter crisis.
Relieved NHS leaders welcomed the breakthrough as “a vital step” towards halting the walkouts by various staff groups that have been causing problems for NHS services for almost a year. The government said it represented “a fair and reasonable way forward” towards solving the dispute.
Crucially, ministers have done a major U-turn in order to help reach agreement with the unions. They have dropped their previous refusal – frequently reiterated by Rishi Sunak – to give England’s 59,296 consultants any bigger pay rise than the 6% increase they had already imposed.
Consultants will receive an extra uplift of an average of 4.95%, but only for the last three months of the financial year – next January, February and March. That money will be added into their salaries next April, but only if both unions’ ballots produce a majority in favour.
The deal came after weeks of highly detailed talks about pay and other issues between BMA and HCSA leaders and ministers and civil servants, chaired by Danny Mortimer, the chief executive of NHS Employers. Both sides were so keen to resolve the dispute before the coldest period of the year starts that the negotiations continued overnight several times last week.
Neither the unions nor the Department of Health and Social Care claimed victory in their respective announcements about the prospective resolution. Both sides moved from their original positions during the talks to help agree the deal that consultants will now vote on.
The unions appear to have emerged with a package of improvements to consultants’ pay and conditions that a majority of their members are likely to endorse. One well-placed BMA source said: “It looks like a really good deal. I will be very surprised if it’s not accepted.”
Although the 4.95% extra increase only applies from January, the BMA stressed that it meant some consultants would have gained an increase of as much as 19.6% in their salary between the end of the 2022-23 financial year in March 2023 and start of the 2024-25 financial year next April.
Consultants have 20 different pay bands. Under the deal, some of them will receive no extra pay at all as a result of the 4.95%, because of what their already earn, while others – mainly the higher paid – will get an uplift of 10.59% or 12.8% for those three months. The BMA had entered the talks seeking a 12% rise for all consultants for the whole year.
Under the deal, consultants will also see their starting salary rise, will reach the top of their pay scale five years earlier than now and will be able to take enhanced shared parental leave for the first time. The parties have agreed to the phasing out of the long-established system of local clinical excellence awards.
Sir Julian Hartley, the chief executive of the hospitals group NHS Providers, said the strikes over the last year had brought unprecedented disruption for the NHS. Consultants have staged four walkouts since July, withdrawing their labour for nine days in all.
“Over 50 strike days have led to 1.2m appointments for planned care being pushed back and cost the NHS an estimated 31.4bn through lost income and staff cover,” Hartley said.
Ministers, NHS leaders and senior BMA figures hope that if consultants accept the deal, it will encourage junior doctors to also moderate their demands and reach a deal. They have been striking since the start of the year in pursuit of their claim for a 35% pay rise to compensate for a 26.2% erosion in the value of their salaries since 2008-09.
Sunak said: “Ending damaging strike action in the NHS is vitally important if we want to continue making progress towards cutting waiting lists while making sure patients get the care they deserve.”
The Guardian disclosed last month that the government and BMA had begun holding secret talks to try to agree a deal before winter.