Senior doctors, known as consultants, have rejected an offer of a 4.95% pay rise on top of their annual 6% increase.
NHS consultants in England have narrowly rejected a pay offer from the government – meaning long-running strike action could continue.
The senior doctors received the offer last November of a 4.95% pay rise on top of the annual 6% increase, following a month of “intense negotiations” with the government.
At the time, the British Medical Association, which is the trade union for doctors in the UK, said it would ballot its members and if the offer was accepted, the BMA would call an end to strike action.
But 51.1% of its members have now voted against it.
The BMA’s consultants committee said it had rejected the offer in light of the ballot result, but was giving ministers an opportunity to improve it to a point that may be acceptable to members.
The agreement also sought to reform the pay structure for senior doctors, reducing the number of pay brackets and the time it takes to reach the top and making a clearer link between pay progression and experience.
Consultants in England have a mandate to take industrial action until June.
BMA consultants committee chair Vishal Sharma said: “The vote has shown that consultants do not feel the current offer goes far enough to end the current dispute and offer a long-term solution to the recruitment and retention crisis for senior doctors.
“However, with the result so close, the consultants committee is giving the government a chance to improve the offer.
“In the coming days we will be further engaging with consultants, and seeking talks with government to explore whether the concerns expressed by our members during the referendum process can be addressed.”
Health and Social Care Secretary Victoria Atkins said: “I hugely value the work of NHS consultants and I am disappointed that after weeks of constructive negotiations the BMA has, by the narrowest of margins, rejected this fair and reasonable offer.
She said the government was “carefully considering next steps”.
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The BMA said 23,544 consultants took part in the referendum on the offer, with a turnout of 64.8%.
A total of 11,507 voted in favour, and 12,037 voted against.
Medics from the Hospital Consultants and Specialists Association (HCSA) union also rejected the offer earlier this month.
The NHS in England has been beset by strike action for more than a year.
Walkouts by various staff groups including doctors, nurses, paramedics and physiotherapists have led to more than 1.3 million appointments, procedures and operations being rescheduled.
Consultants have staged four rounds of strike action in the current dispute, including an unprecedented joint walkout with junior doctors across September and October 2023.
Junior doctors in England are currently being balloted to see if they want to continue strike action in their long-running dispute over pay.
The BMA said its members are being asked if they want to extend industrial action for another six months.