Junior doctors have secured changes to their contract deal in the wake of the huge row with government in 2015 and 2016, including annual 2 per cent pay rises and extra money for working weekends and night shifts.

Trainee medics will vote on the proposed changes in a special referendum which will run until 25 June. If the deal agreed with NHS Employers is accepted it will formally end the dispute between the British Medical Association and the NHS.

The contract dispute led to the first strike action by junior doctors in 40 years. The four separate strikes caused tens of thousands of outpatient appointments and elective operations to be cancelled.

The Department of Health and Social Care told HSJ the funding for the proposed changes – costing £90m – would be met from NHS England’s existing budget settlement. It’s unclear at this stage how NHS England will disseminate the funding to trusts.

Two of the main achievements that the government and NHS won in the 2015 row – changes to pay banding and weekend working – will remain in place under the new agreement.

However, the government has now agreed to pay substantially more to junior doctors through the new deal, in several areas which it was not willing to do in 2015-16.

Proposed changes in the deal agreed now with the BMA include:

  • Additional pay for doctors working the most weekends.
  • An enhanced rate of pay for shifts that finish after midnight and 4am.
  • A new nodal pay point for senior registrars at ST6 and above to recognise senior decision makers.
  • Tougher fines for trusts that breach rules with fines paid to guardians of safe, working calculated at 4x the NHS Improvement locum rate rather than the salary of the doctor.
  • Annual pay uplifts of 2 per cent a year to 2023.
  • £1,000 extra for all less than full time trainees.

NHS Employers said the changes would equate to an annual investment of around 2.3 per cent a year for the four years.

Danny Mortimer, chief executive of NHS Employers, told HSJ the big win for employers in the new discussions was the return to a normal working relationship with the BMA and the insertion of a fifth nodal pay point for senior registrars.

He said: “This agreement enables us to finish things we weren’t able to do in 2016, particularly the fifth nodal point which we just couldn’t afford to do in the negotiations three years ago and Simon Stevens and the secretary of state have put money in to make that and other improvements possible.

“What the NHS and finance directors and workforce directors are getting in return is normal service; we have been in dispute with the junior doctors’ committee now for five years. We haven’t had a properly functioning working relationship like we have with every other union and that make it harder to solve problems that arise.

“The fifth nodal point recognises the most senior trainee doctors in many specialities, who are close to becoming a consultant. Properly recognising the contribution of these really important members of the team is the right thing to do, and there is a real productivity benefit also. That is something we wanted to do three years ago and it’s really positive that we can achieve it now.”

The chair of the junior doctors committee, Jeeves Wijesuriya, said the BMA wanted to agree changes to the contract to ensure it was fairer.

He said: “The proposed deal contains significant enhancements to further improve the pay, conditions and training opportunities for junior doctors across the NHS and are a result of a new collaborative, constructive negotiation process that has learned from the mistakes of the past.”