What's been proposed
The Review Body on Doctors' and Dentists' Remuneration (DDRB) is the independent body that recommends doctors' pay each year, and in England its recommendation covers resident doctors, SAS doctors, consultants, GPs and dentists. The government sends it evidence first, and this year's sets out the 2.4% plan. Anything more would have to be found within the existing health budget, and every extra 0.5% costs about £750 million.
The backlash
The BMA has called it a pay cut and warned that undervaluing doctors risks more strikes. Moreover, consultants in England already voted for strike action in July, with 76% in favour, giving them a mandate to strike for 12 months.
How it compares with inflation
Inflation was 3.1% in August, so 2.4% is below it today. The Bank of England expects inflation to average about 2.4% in 2027/28, the year this rise covers, so the rise only keeps pace if inflation falls as forecast. That's far from certain: the Bank says the risks are that inflation ends up higher, with energy prices from the conflict in the Middle East already pushing up household bills, and if it does, 2.4% is a pay cut in real terms. It's also below the average 3.0% pay settlement businesses are reporting for 2027.
If inflation stayed at today's 3.1%, a 2.4% rise would be £289 a year less than one that kept up for an FY1, and £1,054 less for a consultant at the top of the scale.
Full-time basic pay, England. The first bar is pay from April 2027 before the 2027/28 rise: for resident doctors it already includes the second stage of nodal point reform from this year's pay deal. Inflation is CPI for August 2026, 3.1%. The figure at the right is how much less a 2.4% rise is than one that matched inflation.
Where pay restoration is up to
The BMA's pay restoration campaign is about getting doctors' pay back to what it was worth in 2008. By its measure, which uses RPI inflation, resident doctors' pay in England was still nearly a fifth behind 2008 levels even after this year's pay deal.
In April 2027, resident doctors also get the second part of this year's deal, which takes the average rise from 4.9% to 6.6%. So with a 2.4% rise, pay would only edge forward, to about 19.1% behind 2008 levels. A rise that matched RPI inflation would take it to 18.3%, and that only stops the gap growing. To catch up, pay rises have to beat inflation: getting back to 2008 levels within five years would take rises of about 7.7% a year, if RPI stays at 3.4%.
Basic pay awards for resident doctors in England against RPI inflation each April, the BMA's method, with its figures to 2024/25. 2025/26 uses the ONS's April 2026 RPI. 2026/27 is this year's deal, an average 4.9%, with RPI to April 2027 taken at August 2026's 3.4%. 2027/28 adds the deal's April 2027 stage (taking the average to 6.6%) and then the 2027/28 rise, with RPI at 3.4% again.
| Year | Pay in real terms (RPI) |
|---|---|
| 2008/09 | 0.0% |
| 2009/10 | −3.6% |
| 2010/11 | −7.5% |
| 2011/12 | −10.6% |
| 2012/13 | −13.1% |
| 2013/14 | −14.4% |
| 2014/15 | −15.1% |
| 2015/16 | −16.2% |
| 2016/17 | −18.3% |
| 2017/18 | −20.1% |
| 2018/19 | −20.9% |
| 2019/20 | −20.3% |
| 2020/21 | −20.3% |
| 2021/22 | −26.1% |
| 2022/23 | −31.7% |
| 2023/24 | −25.1% |
| 2024/25 | −22.6% |
| 2025/26 | −20.8% |
| 2026/27 | −19.6% |
| 2027/28, with a 2.4% rise | −19.1% (estimate) |
| 2027/28, matching rpi inflation | −18.3% (estimate) |
What happens next
The DDRB will look at evidence from the government, the BMA and others before it makes its recommendation, and the government then decides whether to accept it.
Sources: DHSC and NHS England: written evidence for the DDRB, pay round 2027 to 2028, BMA: Proposed pay cut for doctors 'beggars belief', BMA: consultants vote for industrial action in England, BMA: Government offer to resident doctors in England (June 2026), with each grade's pay from April 2027, BMA: Resident doctors in England accept Government offer on pay and jobs, BMA: pay erosion methodology for resident doctors in England and ONS: RPI all items index (CHAW) and its 12-month rate (CZBH)
