Offer for the consultant workforce in England

Unions representing consultant doctors in England put the government’s offer to its members.

27 November 2023

The government and unions representing consultant doctors in England have reached an agreement to put an offer to union members following constructive negotiations. 

The offer will invest in modernisation of the consultants’ pay structure, and with effect from 1 January 2024 will include the following changes:

  • reducing the length of time taken to reach the top of the pay range (14 years down from the previous 19 years) 
  • reducing the number of unique pay points in the pay scale (four points down from previous eight)
  • increase to the starting salary for a consultant
  • increase to the pay at the top of the pay scale.

To support the changes to the pay system new pay progression arrangements will be introduced on 1 April 2024 to ensure there is a clearer link between pay progression and evidence of skills, competencies and experience.   

Local Clinical Excellence Awards

  • The contractual entitlement to access an annual awards round will cease. This will take effect from 1 April 2024. This change is being made as funding for Local Clinical Excellence Awards is being redeployed into supporting main pay changes. 
  • Consolidated LCEAs awarded prior to reform in 2018 will be retained and these awards shall remain pensionable and consolidated. The value of these awards will be frozen. The review process for these awards will be removed. Funding released through the future attrition of consolidated LCEAs will not be reinvested.

BMA rate card (consultants)

  • As part of this agreement, the BMA agrees to continue its position of not promoting the BMA rate card for consultants in England whilst talks are ongoing and for the duration of a referendum on the offer. If this deal is accepted by the membership, the BMA will withdraw the rate card with immediate effect. The BMA reserves the right to re-introduce the BMA rate card for consultants if there is a future industrial dispute.

Other changes 

  • An introduction of shared parental leave into the consultant contract, aligning with the terms and conditions which are operating across the majority of the NHS Workforce.
  • Supporting professional activities (SPA)

    The definition of supporting professional activities will be expanded, to specify work to support some NHS priorities.

    From 2024, by agreement between consultant and their employer, additional SPA time beyond that minimum level which is required for revalidation and appraisal, may be allocated to service improvement/quality improvement work to support NHS priorities such as:

    • urgent and emergency care
    • elective recovery
    • delivery of the NHS Long Term Workforce Plan
    • major conditions strategy.

    However, this does not permit reallocation of SPA to direct clinical care. 

    Existing job plans and ongoing work streams will be affected by this change only by mutual agreement. Consultants and employers will continue to work together to set job plans that meet their mutual priorities.

  • Changes to the operation of DDRB processes
    • The government will review and make changes to the DDRB processes, with the aim to implement so they are in place for the 2025/26 pay round.