*Updated 5 March 2024*
This fact sheet sets out the Department of Health and Social Care’s position on strikes by NHS staff.
CONSULTANTS
The government and unions representing consultant doctors in England have reached an agreement to put a revised offer to union members following constructive negotiations.
The British Medical Association (BMA) and Hospital Consultants and Specialists Association (HCSA) will recommend the offer to their members and put it forward for a vote in the coming weeks.
What has changed from the original offer from November?
- The principles and aims of the updated offer remain the same. This is a reform offer that:
- invests in modernising the consultants’ pay structure – reducing the number of pay points and the time it takes to reach the top of the pay scale;
- improves equalities through pay scale reform and introducing enhanced shared parental leave;
- improves pay progression arrangements, which link pay progression and evidence of skills, competencies and experience.
- delivers some reforms to the Review Body on Doctors and Dentists Remuneration (DDRB) – the pay review body for doctors.
You plan to make significant changes to the Review Body on Doctors’ and Dentists Remuneration (DDRB). Does this mean you accept the DDRB process is not currently independent?
- The PRB process is the established process for determining pay uplifts for all public sector workers, including NHS Staff. The Government is committed to ensuring that the pay setting process and the DDRB operates effectively.
- We have always been open to considering any refinements that can be made to the DDRB process.
Does this mean that no more strikes will happen now?
- No further strike action for consultants will be called by the BMA Consultant and HCSA Executive Committees while members are being consulted.
- If this offer is accepted, the current dispute will have ended and there will be no further industrial action taken by consultants in England.
Why did consultants reject the offer the first time round?
- We hugely value the work of NHS consultants and we were disappointed that union members narrowly rejected the original offer which was arrived at after weeks of constructive negotiations.
- The union membership was clearly divided – we estimate that across both unions, only around 600 votes made the difference in getting this over the line. This shows there was a substantial amount of support for the original offer.
- However, we recognised that members still had a number of substantial concerns and we were keen to listen and address these in the revised offer.
JUNIOR DOCTORS
What is your response to data showing over 1.4 million appointments have been rescheduled because of industrial action?
Health and Social Care Secretary Victoria Atkins said:
“The impact of strikes on patients cannot be overstated, with thousands more patients suffering delays to vital treatment as a direct result.
“I want to see NHS staff treating the patients who need their care, not standing on picket lines.
“I am extremely grateful to all the frontline workers who provided vital cover to safeguard patient care over the course of these strikes, and to NHS leaders for their dedication in protecting urgent and emergency care, including time critical services like cancer surgery.
“Now that this latest round of industrial action is over, I once again urge the BMA Junior Doctors’ Committee to demonstrate they have reasonable expectations so we can come back to the negotiating table to find a fair deal that works for the NHS, doctors and patients.”
Why did talks end and how much did you offer?
- The latest offer tabled was equivalent to 3% new investment for doctors in training across the NHS, over and above the pay settlement for 2023-24 which has seen doctors in training receive pay rises of between 8.1 and 10.3% depending on their stage of training.
- The BMA Junior Doctors Committee made the decision to walk away from talks by calling strike action. Talks were making constructive progress and we urge the committee to reconsider their decision, call off their strikes, come back to the negotiating table and discuss appropriate reforms to the pay scales for doctors in training.
How much do doctors in training get paid?
- The government accepted the recommendations of the independent pay review bodies in full giving eligible doctors and dentists a pay rise.
- This means that basic pay points for doctors in training are between 8.1% and 10.3% higher in 2023-24 compared to 2022-23, an average increase of around 8.8%.
- The award increased basic pay for a new full-time F1 doctor to £32,397. On average, Foundation Year 1 Doctors have additional earnings worth around 30% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings of around £40,800
- The award increased basic pay for a new full-time F2 doctor to £37,303. On average, Foundation Year 2 Doctors have additional earnings worth around 34% of basic pay, covering payments for additional activity and unsocial hours payments, this is expected to result in average total earnings of around £47,700 in 23/24.
- The most experienced doctors in training, in the new pay point that was created as part of the refreshed Junior Doctor contract, have a full-time basic pay of £63,152 in 2023-24. This is 8.1% higher than in 2022-23
- The maximum basic pay as a doctor in training depends on the specialty they train in, but once they are qualified, they have opportunity for career advancement into roles in the consultant, Specialty and Associate Specialist, or general practice workforces, potentially earning significantly more.
- Doctors in training who are also members of the NHS Pension Scheme receive a pension contribution worth 20% of their salary.
Details on the DDRB recommendations
- Doctors in training were in a multi-year pay and contract reform deal, between 2019-20 and 2022-23.
- The doctor in training pay and contract reform deal saw all pay points increase by a cumulative 8.2% between 2019-20 – 2022-23.
- For 2023-24 we uplifted pay points for doctors and dentists in training (c. 67,000 doctors) by 6% plus £1,250 on a consolidated basis. This means that basic pay points for doctors in training are between 8.1% and 10.3% higher in 2023-24 compared to 2022-23.
Do doctors in training get paid £15.50 an hour as the BMA claim?
- This comparison is misleading as it only applies to basic pay for doctors in training in their first year.
- It fails to take into account other payments or premia doctors may be eligible for or the significant pay progression doctors in training receive with experience.
- Full time doctors in training earn around £47,600 on average in basic pay.
- They also receive a pension contribution worth 20% of their salary.
SAS DOCTORS
Are you negotiating with SAS doctors?
- We value the vital work of SAS doctors and it is disappointing they have rejected the offer we made to them following weeks of constructive talks with the BMA.
- This offer would have realigned 2021 contracts pay scales, improved career progression, and supported the NHS to create more specialist roles.
- This offer was separate to the pay award for 2023-24. In July 2023, the government accepted the independent pay review body recommendations for 2023-24 in full for SAS doctors, uplifting pay for those on the pre-2021 contracts by 6% and those on the 2021 contracts by 3%, on top of the increase for 2023-24 already agreed as part of their multi-year deal.
- We are carefully considering next steps.
AGENDA FOR CHANGE STAFF
What’s your position on Agenda for Change staff?
More than one million NHS workers on the Agenda for Change contract, including nurses, midwives and paramedics, received a pay rise in the summer: Over one million NHS staff to receive pay rises from today - GOV.UK (www.gov.uk)
Will you reopen pay talks with the Royal College of Nursing (RCN)?
- We hugely value the hard work of NHS nurses, which is why we provided a 5% pay rise and two significant one-off awards – worth over £2,000 on average for full-time nurses.
- This deal was accepted by the NHS Staff Council and the RCN recommended it to their members.
- We continue to work collaboratively with the RCN and other unions to deliver a series of agreed reforms to improve working conditions, but we will not be re-opening negotiations on pay.
- We have asked the independent Pay Review Body to make recommendations on pay for 2024/245 and encourage all unions to take part in this process.
- Pay awards for 2024/25 should strike a balance between providing a fair and reasonable offer for our public sector workers whilst delivering value for the taxpayer and being mindful of the wider economic situation.
- We have recruited more than 50,000 extra nurses compared to 2019 – hitting our target early – and the Long Term Workforce plan will ensure the NHS has the staff it needs over the next 15 years so patients continue to receive the best possible care.
What are the details of the Agenda for Change deal?
- Following an agreement between the government and Agenda for Change unions, more than 1 million workers have already received pay rises backdated to April, as well as two one-off payments worth at least £1,655 for full-time staff.
- Eligible workers on the Agenda for Change contract, which includes nurses, paramedics, 999 call handlers, midwives, security guards and cleaners, received the pay rise.
- The Agenda for Change deal includes:
o a non-consolidated award of 2% of an individual’s salary for 2022-23.
o a one-off NHS ‘Backlog Bonus’ worth at least £1,250 per person but will be determined based on how much experience staff have and based on an individual’s pay band.
o For 2023-24, the government is giving eligible Agenda for Change staff a 5% consolidated increase in pay, worth at least £1,065.
o In addition, the lowest paid staff saw their pay matched to the top of band 2, resulting in a pay increase of 10.4%.
- Further information is available here: Over one million NHS staff to receive pay rises from today - GOV.UK (www.gov.uk)
What other commitments were made alongside the Agenda for Change deal?
- There were a number of non-pay elements as part of the deal, aimed at supporting the career development and wellbeing of NHS staff.
- Through the jointly owned Programme Board, DHSC and the NHS staff Council will oversee all non-pay elements of the deal which include:
o looking for ways to improve nursing career progression
o a review of safe staffing guidance in order to develop a national evidence-based policy framework
o improving support for newly qualified healthcare registrants
o exploring the factors driving increasing rates of agency spend in the NHS
o looking for ways for the pay setting process and NHSPRB to operate effectively
o agreeing amendments to T&Cs to ensure that existing NHS staff will not suffer a detriment to their basic pay when they undertake apprenticeships as part of agreed career development
o considering how the job evaluation system can be consistently applied
o working with the Social Partnership Forum to identify ways to tackle and reduce violence against NHS staff
- considering the application of a cap to redundancy payments of £100,000 and over.
Workforce
What are you doing to expand the workforce and boost retention?
We have a record number of doctors, nurses and other healthcare staff working in the NHS – including more than 50,000 nurses compared to 2019, hitting the government’s target early.
We have published the first ever NHS Long Term Workforce Plan setting out plans to train, retain and reform the workforce, putting the NHS on a sustainable footing into the future.
Backed by more than £2.4 billion in government investment, it sets out how the NHS will address existing vacancies and meet the challenges of a growing and aging population by recruiting and retaining hundreds of thousands more staff over the next 15 years and reforming the way we work.
For more information on the Long Term Workforce Place, see our blog here: NHS Long Term Workforce Plan fact sheet - Department of Health and Social Care Media Centre (blog.gov.uk)
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