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BMA agrees to end ‘rate card’ demands under pay deal

Published on: 27 Nov 2023

The government has reached an agreement with union leaders over consultants’ pay that will now be put to members, including a commitment from the British Medical Association to cease promoting its controversial ‘rate cards’ for overtime shifts.

Although there would be no change to the headline pay increase of 6 per cent previously offered and rejected by unions, the agreement would see an additional investment of around 3.5 per cent into the pay scale structure.

This would increase the starting pay for new consultants, increasing the top pay point, and shortening the length of time it takes to reach the top of the pay scales by five years. It means many consultants will have had pay rises of more than 12 per cent by January 2024, compared to 2022-23.

It is unclear whether the NHS would receive additional funding to cover this.

Meanwhile, another 1.5 per cent will be transferred into consultants’ basic pay from the current “local clinical excellence awards” scheme.

The deal will now be put to BMA members, as well as those of the Hospital Consultants and Specialists Association, with an agreement that no further strikes will be called during that consultation period.

Other elements of the deal include:

  • The BMA agreeing to end the promotion of its controversial “rate card” – which advises doctors on how much to charge for overtime or locum work, including cover during strikes, and has substantially pushed up shift costs;
  • A joint review of the pay review process for doctors, looking at the appointments of members to the review board, the timing of the round, terms of reference, and the data provided to the body on which it bases its recommendations;
  • New pay progression arrangements to ensure there is a clearer link between pay progression and evidence of skills, competencies and experience;
  • Enhanced shared parental leave, bringing consultants in line with other NHS staff; and
  • Scrapping “local clinical excellence awards”, which have been seen to contribute to pay inequalities, and the money going into basic pay instead.

The BMA said in a statement: “While this offer does not deliver all that the BMA has asked for, significant progress has been made. We expect to put this formally to members via a referendum that will likely open in mid-December and run until late January 2024.”

In a statement, the Department of Health and Social Care said: “The government was clear that the headline pay uplift for 2023-24 was settled through the pay review body process. This offer builds on that and focuses on measures that will address consultant concerns while introducing contractual reforms…

“This is in addition to the significant reforms to pension taxation, the BMA’s number one ask, in the spring budget earlier this year.”

The agreement to cease the promotion of the BMA “rate cards’ will be widely welcomed by NHS leaders, who have previously raised concerns around the rates being unaffordable.

Matthew Taylor, chief executive of NHS Confederation, said: “NHS leaders will hope that BMA and HCSA members will vote to accept the offer made to them by the government so that further disruption to patient care can be brought to an end.

“Also, they hope that this development will set an important precedent in other parts of the medical workforce which are in dispute with the government on pay. With winter around the corner, the last thing health leaders will want is fresh walkouts to lead to thousands more appointments and procedures needing to be cancelled during what is typically the NHS’s busiest time of the year.

“It is important that local budgets are protected for this and any further developments on pay and that the commitments in the long-term workforce plan around growing the NHS’s headcount continue to be supported.”

It follows several rounds of strike action by consultants since the summer, including joint action with junior doctors.

No deal has been reached on the junior doctors’ pay dispute.