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London gives way on consultant strike cover pay

Published on: 13 Jun 2023

London trusts have been told they can pay almost triple the usual rate for consultant cover during this week’s junior doctors’ strike.

In a win for the British Medical Association and senior medics in the capital, NHS England London has said that where needed, providers can pay enhanced rates to keep services safe. The capital had previously held out against demands for higher pay for consultants during the industrial action, while neighbouring regions did not.

HSJ understands every trust in the capital has now agreed to pay what the BMA asked in its rate card.

Barts Health Trust, the third biggest NHS trust in the country and second largest in London, was the first to break ranks and confirm it would pay an equivalent of the rates demanded by the BMA.

One hospital leader told HSJ: “Last week, Barts and Barking, Havering and Redbridge [University Hospitals Trust] caved and the rest of us have had to follow.”

Another said Guy’s and St Thomas’ Foundation Trust and Royal Free London FT, where London regional director Caroline Clarke was chief executive until recently, were the next to follow Barts.

Data seen by HSJ last week showed the proportion of consultants threatening to refuse cover varied widely between trusts. Around 1 per cent of Guy’s and St Thomas’ FT’s consultants signed a letter to this effect, compared to nearly a quarter of senior doctors at the Royal National Orthopaedic Hospital Trust.

NHSE London has stressed the consultant cover rates – which go from £161 per hour in the day to £269 per hour overnight – are for the period of industrial action only. The overnight rate is almost triple the previous NHSE rate, from November 2022, for unsocial hours for consultants working through trust banks of £93.34 per hour. 

A spokesperson for the NHS in London said: “Hospitals in London are working hard to prepare for upcoming industrial action and safe staffing is fundamental to this.

“We’re extremely grateful for the continued hard work of all our NHS colleagues in the capital during this pressured time.”

The row over whether to refuse cover has caused tensions between senior doctors, with some feeling threatening to withhold cover was wrong and others thinking it was acceptable in light of the erosion of their pay over recent years.

One hospital leader told HSJ: “The high ground shifted slightly as consultants started to say they wanted more money so they could donate to [the] BMA strike fund.” 

Another said their consultants were also donating the extra money to food banks.

The junior doctors’ strike begins at 7am on Wednesday and lasts three days until Saturday morning

The BMA is currently balloting consultants for a strike that would take place in July.

The BMA has been approached for comment.