This was discussed at the BMA Consultants Conference and Committee recently (see my previous posts)

Mike Henley has given a blog which is a useful read

Chief BMA negotiator Rob Harwood discussed the current state of the Consultant Contract negotiations at the Consultant Conference last Wedneday. The following is adapted from his talk by me.

The background to why the BMA is negotiating

The government wants to introduce a more seven day working service and change the pay structure include Clinical Excellence awards. This followed on a number of reports by NAO and Public Accounts Committee which criticised the current contract. This eventually les to the DDRB report including the review of CEA. If the BMA and its members do not agree a deal there is the threat of imposition. But there may be some gains for consultants.

What does the government want

The government is insistent on wanting to remove Schedule 3 Paragraph 6 (S3P6) of the current Consultants Contract to facilitate seven day working. The government want to move to a new pay performance system and removing automatic pay progression. All this to be done in a cost neutral envelope.


There would be a maximum of 40 hrs (10PAs) work and limits on weekend and unsocial hours . Adequate rest provision and the provision of appropriate Occupational Health would be in the new contract. The BMA and Employers are aligned on many aspects of Safeguards but not on some. The BMA wants the majority of consultants to support the changes. Not in agreement of 11th PA for doing private work.. The employers want a maximum of 10 weekend days of routine work. The BMA wants 8 days maximum and no elective work if on a 1 in 10 rota. The thirteen weekend maximum is a new protection

Consultants pay arrangements

The figures are uncertain as the BMA is yet to receive a final offer from HMG/Employers. Both sides have put forward a long term cost neutral proposal compared with the current contract. The BMA “asks” are different from the Employers proposal due to the difference around transition funding. The BMA believe that transition costs to move consultants to a new contract should be funded from outside the pay envelope (ie consultants should not pay for change). The Employers disagree on that and as a result Employers are finding money for transition with the current pay envelope. Thus the Employers figures for base pay is lower than the BMAs, though the overall structure of the pay offer is the same.

Base pay

BMA indicated they wanted base pay prioritised. A flatter structure would better suit a CARE pension scheme. The Employers proposal are a two point pay scale:-

A lower starting salary of ~£71k rising to £74.4k by 2020

Reach pay point 2 of £95k at year 5  rising to £103k by  2021

Access to Paypoint 2 is achieved by a performance gateway

Consultant unsocial hours

Out of hours work would increase to meet seven day service but with no new money. Currently we have a supplement with PAs done, 3 hours of PA’s outside of plain time. During negotiation it became clear to keep Saturdays as unsocial hours it was not possible to have an hourly based system. The BMA has jointly proposed a system of an availability supplement in addition to work done decided by a matrix of hours worked and on call frequency.

The new plain time definition would be Monday – Friday 7 am to 9 pm

 Rob Harwood then presented two slides comparing current and possible pay. These were complicated in the least to note down accurately.

Consultants Performance Pay

The funding available for performance pay is contingent on decisions made on CEAs. Broadly the design of the scheme will be split into 3 pots

Individual           Team     Organisational


There would be a minimum of 2 SPA written into the contract for new starters.

There would be an improved Study Leave clause in the contract.

An appeals panel decision is now binding. There would be better Sabbatical provision.

Consultant CEA awards

The Employers/Doh do not believe CEA are contractual. Employers want a system of local awards that are not permanent and not pensionable. Local awards currently held would be lost though with some protection (the latest position on this is 6 years)

Is it a good deal ?

There are some potential benefits such as a schedule of safeguards for out of hours work, a fair an faster pay progression better for CARE, improvement in SPA study leave appeals panel decisions and sabbaticals. Money shifted from other pots into basic pay.

The negatives are loss of S3p6 and potential for more weekend working, the replacement with CEA with a new system may be disadvantageous to some, uncertainty over earnings.

What happens next

There are transition issues and more meetings are to follow following a recent meeting with Ben Gummer. There has to be a sign off from the Secretary of State and the Treasury. Material will be produces for the BMA membership will be surveyed in March or April. The UK-Consultants Committee will then meet to consider the results.

If we do not reach a deal

The government can easily introduce a new contract for new consultants but hinges on people accepting the new offers. Imposing changes on current contract holders is more difficult but not impossible as they could fire and rehire or introduce primary legislation. The risk for 2003 contract holders is loss of uplift and uncertainty over CEAs.