The British Medical Association (BMA) is to recommend junior doctors in England accept a fresh pay offer after negotiations with the new Labour government.
The move follows almost two years of industrial action by junior doctors as negotiations with the previous Conservative government stalled.
The BMA and government have also agreed to change the name of junior doctors to resident doctors to better reflect their work.
If accepted by members, the total pay increase across the two years of the dispute will be 22.3% on average.
It comprises an additional 4.05% for the pay year 2023-24 on top of the average 8.8% previously awarded, taking last year’s pay rise to an average of 13.2%. This will be backdated to April 2023.
Separately, the recommendation of the pay review body – the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) – and subsequent government award for 2024-25 would give junior doctors an average 8% increase across junior doctor grades.
Included in the deal are commitments from the government to work with the BMA to streamline the way in which junior doctors report when they have worked additional hours to ensure they are paid for the work they do, and to reform the current system of junior doctor training and rotational placements, taking into account training bottlenecks.
The BMA and Department of Health and Social Care have also agreed to change the name of junior doctors to resident doctors from September to better reflect their expertise.
As part of the deal the government said it “acknowledges concerns raised by the BMA and other parties that the medical profession is not as attractive a career prospect as it once was”.
And it has asked the DDRB to consider in its annual recommendations the overall reward package and career progression for junior doctors “to ensure that medicine is an attractive and rewarding career choice to deliver our consultants and GPs of the future”.
The BMA added its junior doctors committee (JDC) has chosen to recommend that members accept it.
The agreement also included the government accepting a wider 5.5% pay rise for all public sector workers which will apply to other health workers.
Representatives from nursing, radiographers and other trade bodies welcomed the developments but warned there need to be further steps to support their workforces and fix the NHS.
Should never have taken so long to get here
JDC co-chairmen Dr Robert Laurenson and Dr Vivek Trivedi said: “We are announcing that almost two years into our dispute we have received an offer from the government that our committee thinks merits consideration by our membership.
“It should never have taken so long to get here, but this offer shows what can be achieved when both parties enter negotiations in a constructive spirit.
“This offer does not go all the way to restoring the pay lost by junior doctors over the last decade and a half. However, we have always said that we did not expect to get there in one go.
“This offer, combined with the recommendation of the pay review body today, changes the current trajectory of our pay, even though there is further to go yet.
“We are recommending that members vote for the deal. We believe that this is the best offer available at this moment in time and that the inclusion of the additional reforms make the package a good step forward for our profession, acknowledging there is still more work to be done in the future.”
The pair added they recognised the speed and effort put into this round of negotiations which they believed showed the beginning of a government that was learning to treat doctors with more respect.
“There is a catastrophic NHS workforce crisis that needs addressing and they at least appear to recognise that fixing pay must be part of the solution,” the pair continued.
“The last 20 months have shown what happens when a government refuses to engage with the reality of real-terms pay cuts. That has to stop now.
“This deal is a start: it means we can begin to restore our value and return to a strong workforce and high quality patient care. There is still a way to go but this government has shown it can learn from mistakes of the past. We recommend members vote yes.”
The details of the referendum for members will be announced shortly and should it be approved, the current dispute will be concluded and the mandate for strike action in England will end.
Fair pay restoration
Royal College of Nursing general secretary and chief executive professor Nicola Ranger said: “When it comes to pay in the NHS, all professional groups deserve a clear route to fair pay restoration – making up for a very serious loss of earnings in the last 15 years.
“Stagnant salaries at a time of spiralling prices forced too many to leave and deterred others from joining.
“We do not begrudge doctors their pay rise. We work together closely, in the interests of our patients. What we ask for is the same fair treatment from government.
“Our members will vote on whether they see today’s announcement as enough of a start on our journey. When the full details are released, it must show that the funding is being made available to the NHS and all employers who deliver NHS services.
“Nurses are the ever-present, safety critical workforce across the whole of health and care. Our wages do not reflect that and still won’t after today.
“We will be pushing government to show us their plans for improving NHS pay – it is vital to recruit and retain nursing staff, fill tens of thousands of vacant nurse jobs and give people the care they deserve.”
Government must foot the bill
Dean Rogers, director of industrial strategy for the Society of Radiographers, said: “We are pleased that the government has agreed to the above-inflation rise recommended by the Pay Review Body. We will be consulting our members about the offer in the coming weeks.
“The health secretary has said that the 5.5% pay award will be funded through system allocations. The SoR is clear that the government must foot the bill for any pay award – otherwise we’re simply robbing Peter to pay Paul.
“Nevertheless, this is a welcome step in the right direction – but it is only the first step on a very long and often neglected road. There is much further to go – there has been a long history of derisory pay awards that have only served to exacerbate the workforce crisis in the NHS.
“While we appreciate the pay increase, one above-inflation pay award will not undo 15 years of underfunding and devaluing of NHS professionals. Even with the current increase, NHS salaries still look as though they’re designed to encourage people to leave.
“Had radiographers’ pay kept up with average total pay since 2008, they would be earning an average of 26% more than their current salary.
“The NHS is broken, and the SoR wants to help the government repair it. In the future, we’ll be looking to see the government provide above-inflation pay awards to maintain and restore the value of NHS pay.“
Divisions in NHS must not emerge
In its own statement trade union Unite said its member NHS staff have suffered real terms pay cuts and have been neglected for over a decade.
“Nationally this has created huge recruitment and retention issues, which is a direct result of staff being tens of thousands of pounds worse off in real terms,“ it continued.
“The government has rightly recognised this with restorative pay rises for junior doctors.
“It’s imperative to ensure that we are not dividing NHS workers and creating even greater differentials between different groups.
“The NHS after all is made of many workers from ambulance workers to health visitors to biomedical scientists. All are vital and all deserve pay restoration.
“Health workers being offered less than half of what junior doctors have been offered is not good enough. It will certainly not deal with the recruitment crisis in the NHS.
“The PRB process has today been proven to be broken beyond repair. We cannot have a situation where restorative pay awards are offered to some and not to all.
“Unite’s health members will have the final say on whether they believe this is an acceptable pay offer through a ballot.“