The British government has proposed a 2.4% pay increase for doctors for the 2027/28 financial year. The Department of Health and Social Care (DHSC) and NHS England submitted this figure to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), an independent advisory panel, stating the raise could be implemented without compromising other health commitments.
The proposal follows a 2026 pay cycle in which the government eventually accepted a 3.5% increase recommended by the DDRB, which was higher than its initial 2.5% suggestion. The new 2.4% proposal comes as the government reports managing various financial pressures, including inflation, energy costs, and expenses related to industrial action.
Medical unions have rejected the proposal, with the British Medical Association (BMA) characterizing the figure as a pay cut. The BMA stated that doctors' salaries remain below levels from 20 years ago, while Unison's head of health, Helga Pile, noted that over 200,000 NHS employees currently earn less than the real living wage. BMA Council chairman Dr. Tom Dolphin said the proposal could lead to further industrial unrest, noting that consultants in England already hold a mandate for strike action.
The DHSC and NHS England noted in their submission that every 0.5% increase in pay costs for the NHS represents approximately £750 million. The government submission described this amount as the equivalent of more than 89,000 hip or knee replacement operations. The agencies stated they are currently managing risks from reduced immigration health surcharge income and other economic factors.
The day-to-day impact for patients would be felt through potential service disruptions if unions proceed with industrial action. The BMA has warned that the current proposal risks further industrial unrest. Additionally, the union argued that failing to meet pay expectations contributes to doctors leaving the NHS or the country, which could prolong patient waiting times for GP appointments and specialist care.
The knock-on effects of the pay decision will influence the independence and credibility of the DDRB, which must now review the evidence from both the government and the unions. A low settlement may also accelerate the government's use of non-medical staff to fill roles, a move the BMA claims could affect patient safety. The next steps involve the DDRB reviewing the submissions before making a formal recommendation to the government. A final decision on the 2027/28 pay award is expected after the review body concludes its assessment.