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‘National’ action to curb huge jump in consultant overtime rates being considered by NHSE

Published on: 26 Jun 2023

NHS England is considering a national response to the increased overtime rates charged by medical consultants - especially those undertaken during the ongoing junior doctors strikes.

A letter from NHS England chief workforce officer Navina Evans to NHS trust CEOs seen by HSJ said the national commissioning board was “aware of the concerns raised by [increased] rates for consultants”, which followed new rate-cards issued by the British Medical Association. The letter acknowledged the increased “financial pressure” the service was coming under as a result.

In London overtime rates can be up to three times more than was previously paid for an overnight shift. Hospitals in London had agreed not to pay the higher rates during the first two junior doctor strikes, but reversed their position after Barts Health Trust broke the agreement, citing patient safety concerns. London providers have complained that trusts in neighbouring regions were offering medics higher rates.

Trust leaders told HSJ they had received no formal national direction on whether or not to pay the rates, although HSJ understands that until very recently it was NHSE’s view that overtime pay rates were a matter for local negotiation. Some CEOs contacted by HSJ wanted to NHSE to intervene, while others feared this might make matters worse. 

In her letter Dr Evans wrote: “I have been discussing this issue directly with NHS leaders and am working to understand what national support would be helpful. They have confirmed with me that an information collection would be useful to better understand the financial impact of the BMA rate card and to estimate the average rates for additional consultant activity by different medical specialties. This information would be really important as we consider options for responding to the concerns that have been raised.”

She added the information would be “really important as we consider options for responding to the concerns raised”.

The BMA confirmed on Friday that a five-day strike, the fourth this year, would take place from 13 July 2023. The ballot on a strike by consultants closes later this month.

NHSE made no comment.

Dr Evans’ letter reassured trusts their pay data would not be made public. She said: “Any information we receive from your organisation will be immediately anonymised and we expect the information could be reasonably withheld from any external requests on grounds of commercial sensitivity.”

The Daily Telegraph yesterday reported junior doctors could be offered £1,000 to call off the July strike, following a recommendation from the pay review body, along with a six per cent pay increase for this financial year. Early indications from the BMA junior doctors committee is that this would not be accepted.