Senior Doctors Earn Up To £200,000 Annually in Overtime to Address NHS Backlog, Investigation Reveals

A BBC News investigation has revealed that senior doctors are billing the NHS at elevated rates for overtime hours. This situation, driven by the imperative to reduce waiting lists, has enabled some doctors to earn over £200,000 annually from supplementary work. This sum represents almost twice the typical basic salary for a full-time consultant within England. It is believed that a considerable number of the highest-earning consultants are employed part-time. This arrangement permits them to undertake substantial overtime, with hourly rates surpassing £200, which is over four times their standard remuneration. In response, Health Secretary Wes Streeting informed the BBC: “I don’t think the rates are acceptable. Every penny that goes into the NHS needs to be well spent.” However, the British Medical Association (BMA), which serves as the doctors’ union, highlighted that the NHS’s extensive reliance on overtime would be mitigated if not for existing staffing deficiencies. Furthermore, hospitals indicated that covering for periods of industrial action and staff illness had also contributed to the situation. These revelations emerge concurrently with increased government investment in the NHS, aimed at expanding the availability of appointments and operations – a significant electoral pledge from Labour. Within the framework of the Budget, the chancellor announced that the NHS is set to receive an additional £25 billion this year and the following, with the reduction of waiting times identified as a primary objective. A central component of Labour’s strategy involves staff working during evenings and weekends to address the backlog. Nevertheless, the BBC News investigation prompts questions regarding the cost-effectiveness of this strategy. A senior source within the NHS commented: “Consultants hold all the cards – they know we cannot make progress on the backlog without them.” The source elaborated that consultants occupy a “pretty unique position compared to other staff” due to contractual terms allowing them to decline weekend shifts and subsequently bill their hospital for overtime at negotiated rates. They added that it was not advantageous for the BMA to renegotiate these “outdated” contracts, which have been in place for over two decades. The source further stated: “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.” They also suggested that the NHS should recruit additional consultants, delegate some tasks to other personnel, and invest in technological solutions like artificial intelligence to alleviate the workload. BBC News utilized Freedom of Information requests submitted to hospital trusts, along with data provided by NHS England, to ascertain the financial implications for the NHS of consultants working beyond their standard contracted hours: During the 2023-24 fiscal year, Bradford Teaching Hospitals NHS Foundation Trust disbursed over £100,000 in overtime payments to four consultants within its medicine specialty. One individual among them accrued just over £208,000 in overtime for 128 days of work, with their remuneration during these shifts averaging £188 per hour. The trust stated that, “in common with most NHS trusts,” it was compelled to depend on overtime payments to “manage waiting lists and to cover rota gaps and vacancies,” noting that covering for industrial action had imposed additional pressure. Medway NHS Foundation Trust verified that it had paid three radiologists, professionals responsible for diagnosing and treating patients via scans and tests, over £150,000 in overtime, with one of these individuals earning more than £200,000. The trust attributed the necessity of paying premium rates, occasionally on a scan-by-scan basis, to shortages within this specialized area. NHS Frimley Health Foundation Trust compensated two consultants in its endoscopy department, which conducts internal examinations, with over £180,000 each in overtime payments, aimed at addressing the treatment backlog. The trust commented: “We’re focused on ensuring we always provide value for money – and anything we spend is in proportion with the benefit it brings to our patients.” NHS Humber Health Partnership, an entity managing five hospitals, paid three consultants overtime sums ranging from £185,000 to £240,000. Chief medical officer Kate Wood stated that the expenditure on overtime had facilitated additional weekend operations, contributing to the reduction of waiting lists. She explained: “We assess the costs of these shifts against the risks of not having cover.” She added: “We have put patient safety first as that is our key focus. This is not something that is unique to us.” Worcestershire Acute Hospitals NHS Trust provided over £100,000 in overtime payments to three consultants, one of whom earned just over £198,000. Managing director Stephen Collman indicated that the trust was endeavoring to minimize “premium payments” when feasible. However, he noted that the necessity to cover staff sickness and unfilled positions left no alternative for maintaining services “running safely and effectively.” Several hospitals reported that overtime rates had escalated over the previous year, influenced by the notably high rates the BMA had advised its consultants to request for strike coverage. An official commented: “It created a new expectation of what they should get.” Conversely, BMA consultant co-leaders Dr Helen Neary and Dr Shanu Datta stated: “Unfortunately, a declining workforce in crisis and spiralling patient demand – which has led to sky high waiting lists – means that extra hours of work are essential to get the job done.” They further highlighted that a significant portion of this overtime occurred during unsocial hours, asserting that as “highly-trained and experienced professionals,” it was reasonable for them to value their time “at appropriate rates.” Danny Mortimer, representing hospitals on employment matters for NHS Employers, remarked: “In light of the difficult financial position of the NHS, health leaders are trying to bear down on extra-contractual premium pay rates.” However, he noted that straightforward solutions were absent, given the “critical role” consultants play in addressing waiting lists. An official from NHS England also indicated that the engagement of agencies, which can incur even higher costs, was decreasing. Nevertheless, it was stated that hospitals must provide rates that are competitive with those offered by the private sector. Copyright 2024 BBC. All rights reserved. The BBC bears no responsibility for the content of external websites. Information regarding our policy on external linking is available.