‘The fight is not yet over.’

As consultants in England approved a hard-won deal to begin the process of restoring pay earlier this month, BMA consultants committee chair Vish Sharma, while welcoming the outcome, made clear he was in no mood for triumphalism. 

Consultants in England voted to endorse new terms, which will see a flattening in pay scales and a £3,000 uplift granted to those with four to seven years of service, on 5 April following months of unprecedented industrial action. 

Dr Sharma’s reaction to the deal, which also includes important reforms to the DDRB (Review Body on Doctors’ and Dentists’ Remuneration), illustrates the vigilant mindset doctors everywhere have adopted in the profession’s collective and continuing fight for fair pay and conditions.

‘We’ve reached this point not just through our tough negotiations with the Government, but thanks to the resolve of consultants, who took the difficult decision to strike, and did so safely and effectively, on multiple occasions, sending a clear message that they would not back down,’ said Dr Sharma.

‘This is only the end of the beginning, and we have some way to go before the pay consultants have lost over the last 15 years has been restored. Therefore, all eyes will be on this year’s pay review round, recommendations from the DDRB and response from the Government.’  

With industrial action continuing for junior doctors in England, and temporarily suspended for consultants and specialist, associate specialist and specialty doctors in Wales, the possibility of strikes also remains in contention for SAS doctors in England, and consultants and SAS doctors in Northern Ireland.

Meanwhile, GPs in England are preparing themselves for what could be a long struggle over fiercely disputed changes to the general medical services contract. 

Despite close to 100 per cent of the more than 19,000 GPs in a BMA referendum last month voting to reject the 2024/25 contract, which included a 70 per cent plus turnout of all GP contractor/partner members, the Government has, for the third time in as many years, imposed the terms, which will see a below-inflation 1.9 per cent uplift to national contract baseline funding for general practices in England. 

The parlous state of general practice was laid bare in February this year, when a BMA snapshot survey of just 10 per cent of practices in England revealed 57 per cent had battled with cashflow issues in the previous 12 months, with one in four practices forced to consider cutting staff to remain open.

BMA GPs committee England chair Katie Bramall-Stainer warned the decision to force through the contract with its grossly inadequate funding settlement meant many GP practices, already struggling financially and with understaffing and patient demand, faced the real risk of closure in the next six to 12 months.

She added, while the resounding referendum vote had not been a formal ballot on industrial action but rather a ‘temperature check’, the result demonstrated clearly that GPs were at ‘boiling point’, and her committee would soon be reaching out to GPs to inform them of next steps.

‘This contract, which the Government is choosing to impose upon us, is not safe,’ warned Dr Bramall-Stainer. ‘General practice has been demeaned, diminished, diluted, bullied and gaslit long enough. We are the bedrock upon which the rest of the NHS stands [and] the battle to save general practice has begun.’