Senior doctors are charging the NHS premium rates for overtime, as pressure to cut waiting lists is allowing some to make more than £200,000 a year from additional work. That is nearly double the average basic pay for a full-time consultant in England.
Many of the consultants earning the most are thought to be part-time, allowing them to work significant amounts of overtime for rates exceeding £200 an hour – more than four times normal pay.
In response, Health Secretary Wes Streeting told the BBC: “I don’t think the rates are acceptable. Every penny that goes into the NHS needs to be well spent. But the British Medical Association (BMA), the doctors‘ union, pointed out the NHS would not have to rely so much on overtime were it not for staffing shortages. And hospitals said covering for strike days and sickness had also been a factors.
Doctors paid up to £200,000
The findings come as the government invests more money in the NHS, to increase the number of appointments and operations it can offer – a key election promise made by Labour.As part of the Budget, the chancellor said the NHS would receive an extra £25bn this year and next – with reducing waits a priority. A key part of Labour’s plan is for staff to work evenings and weekends, to cut the backlog.
But the BBC News investigation raises concerns about whether this approach can deliver value for money. One senior NHS source said: “Consultants hold all the cards – they know we cannot make progress on the backlog without them.”
The source said consultants were in a “pretty unique position compared to other staff” because their contracts meant they could opt out of weekend work and then charge whatever their hospital was willing to pay for overtime.
They said it was not in the BMA’s interests to renegotiate these “outdated” contracts, more than 20 years old.
‘Artificial intelligence’
“What worries me is that the overtime costs are going to keep increasing with the need to tackle the backlog and this will breed resentment among other NHS staff who often work overtime for little more,” the source said.
They added that the NHS needed to hire more consultants, ask other staff to take on some of their work and invest in technologies such as artificial intelligence to lighten the load.
BBC News used Freedom of Information requests to hospital trusts and data supplied by NHS England to reveal what consultants working beyond their contracted hours was costing the NHS:
The overall overtime bill hit almost £1bn in 2023-24, up from £512m 10 years ago, albeit some of that rise is related to more consultants being employed
Six in 10 consultants work beyond their contracted hours, with average extra pay topping £27,000 a year
At least half of the 41 hospital trusts that responded to BBC News are now paying some of their consultants more than £100,000 in overtime
In 2023-24, Bradford Teaching Hospitals NHS Foundation Trust paid four consultants from its medicine speciality more than £100,000 in overtime payments.
One earned just above £208,000 in overtime for 128 days work. And during those shifts, their pay averaged £188 an hour.
The trust said “in common with most NHS trusts”, it had to rely on overtime payments to “manage waiting lists and to cover rota gaps and vacancies” and covering strikes had placed it under added strain. Medway NHS Foundation Trust confirmed it had paid three radiologists, who diagnose and treat patients using scans and tests, more than £150,000 in overtime – one of whom had earned above £200,000. It said shortages in this field meant it had to pay premium rates, sometimes on a scan-by-scan basis.
Source: BBC
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