BMA Doctors Strike Ends in England: What the 2026 Pay and Jobs Deal Means for the NHS?

Last checked: 30 June 2026

Article status: The offer has been accepted and the current BMA resident-doctor disputes concerning pay and training places in England have ended. Several parts of the agreement still require detailed implementation by the Government, NHS England, NHS Employers, individual NHS trusts and the BMA.

Editorial note: This article was checked against the Department of Health and Social Care’s formal June 2026 offer, the BMA referendum result and grade-by-grade guidance, NHS Employers’ response and NHS England’s information for patients.

Important information: This article provides general information about NHS employment policy, industrial action and the implementation of a national agreement. It is not personalised medical, employment, legal, tax, pension or financial advice. Doctors should confirm their individual pay, contractual position and reimbursement eligibility with their NHS employer, payroll team or professional representative.

Resident doctors in England have accepted the Government’s June 2026 pay and jobs package, ending the current BMA disputes over pay and specialty-training places. The offer received 52.9% support, with 32,932 doctors voting and a turnout of 57.3%.

As detailed in the Government’s formal offer to resident doctors, the agreement includes pay-scale reforms, at least 4,000 additional specialty-training posts, up to 500 conditional posts, reimbursement of eligible professional costs and improved arrangements for locally employed doctors.

The headline 6.6% figure is an average increase delivered through pay and structural reforms by April 2027, not an immediate rise for every doctor. The Government estimates the average increase during 2026–27 at approximately 4.9%, with individual outcomes varying by grade and pay point.

BMA Doctors Strike Deal: Key Facts:

• Referendum result: 52.9% voted to accept and 47.1% voted to reject.
• Votes cast: 32,932.
• Turnout: 57.3%.
• Area covered: England only.
• 2026 DDRB award: 3.5%, effective and backdated to 1 April 2026.
• BMA headline figure: An average 6.6% uplift when the pay award and structural reforms are fully delivered by April 2027.
• Training-post commitment: At least 4,000 additional specialty-training posts over three years.
• Conditional training posts: Up to 500 more, depending on training capacity, service appetite and patient need.
• Professional costs: Eligible mandatory examinations taken from 1 April 2026 can be reimbursed, subject to the detailed rules.
• Membership and portfolio fees: Reimbursement is planned from 1 April 2027.
• Future pay award: The separate DDRB award for 2027–28 has not yet been determined.

Is the BMA Doctors Strike in England Officially Over?

Yes. The BMA’s Resident Doctors Committee in England accepted the Government’s offer after a member referendum, ending the current disputes over pay and training places.

A planned four-day strike in June 2026 was cancelled after the revised offer, which was then approved in an online vote. No further walkouts are planned under these disputes, though future industrial action remains possible.

The BMA says its broader pay-restoration campaign is not complete, arguing pay remains below 2008–09 levels by its measure. The Government uses a different comparison, stating average pay is 35.2% higher than four years earlier.

Does the agreement cover the whole UK?

No. The settlement applies to the resident-doctor disputes and employment arrangements in England.

NHS pay, workforce planning and industrial relations are handled separately in Scotland, Wales and Northern Ireland. The English agreement does not automatically change pay scales, contracts or training arrangements in the devolved health services.

“Resident doctor” is the current term for the group previously commonly described as junior doctors. These are qualified doctors working in foundation, core or specialty training and certain locally employed roles. They are not medical students.

Why Did Resident Doctors Take Industrial Action?

The dispute centred on pay, limited training opportunities, inconsistent employment conditions and mandatory career costs. These concerns are addressed in the Government’s formal June 2026 offer to resident doctors.

Real-terms pay concerns

The BMA argued that resident doctors’ pay had fallen significantly in real terms since 2008–09. While the Government disputed the union’s calculations, reduced purchasing power remained a key issue.

The accepted deal does not claim full pay restoration. Instead, the BMA says it represents enough progress to end the current dispute while continuing its campaign through future pay reviews.

Shortages of Specialty Training Places

Many doctors complete foundation training but cannot immediately secure a specialty training post, leaving some in non-training or trust-grade roles despite NHS workforce demand. The agreement aims to ease this by creating at least 4,000 additional specialty training places over three years, with the potential for 500 more.

Inconsistent Contracts for Locally Employed Doctors

Locally employed doctors (LEDs) often work in similar roles to trainee doctors but on different local contracts, which can affect pay progression and employment conditions. The deal includes plans to standardise LED contracts, improve competency appraisals and provide clearer pay progression.

Mandatory Professional Costs

Doctors often pay for required exams, memberships and training portfolios needed for career progression, with costs reaching several thousand pounds. The agreement includes employer reimbursement for eligible mandatory costs, subject to the final eligibility and claims process.

What Does the 2026 Pay and Jobs Deal Include?

The agreement brings together a range of measures designed to address pay, career progression and working conditions for resident doctors in England.

The package has five broad components:

1. Pay and nodal-point reform.
2. Reimbursement of specified mandatory professional costs.
3. Additional specialty-training posts.
4. Reforms for locally employed and less-than-full-time doctors.
5. New industrial-relations and implementation arrangements.

The main measures include:

• A 3.5% DDRB pay award effective from 1 April 2026.
• Additional pay-scale reform phased across 2026–27 and 2027–28.
• At least 4,000 additional specialty-training posts over three years.
• Up to 500 further training posts if specified conditions are met.
• Reimbursement of the first two attempts at each eligible mandatory Royal College or faculty examination.
• Reimbursement of mandatory membership and portfolio fees from April 2027.
• An increase in the Clinical Academic Flexible Pay Premium from £5,600 to £10,000 from April 2027.
• Enhanced competency appraisals for locally employed doctors.
• More standardised LED contracts and greater use of substantive employment.
• Equal opportunities for annual competency reviews for eligible less-than-full-time doctors.

Together, these measures aim to provide a more structured, sustainable and transparent framework for resident doctors’ pay and career development.

How will resident doctors’ pay change?

Resident doctors covered by national arrangements receive the accepted 3.5% DDRB award, backdated to 1 April 2026. Further nodal-point reforms are added to this award, with individual increases depending on grade and pay point.

The Government’s published increases are:

• 6.2% for FY1
• 7.1% for FY2
• 5.1% for ST1 or CT1
• 5.1% for ST2 or CT2
• 3.5% for ST3 or CT3
• 4.5% for ST4 or CT4
• 4.5% for ST5
• 3.5% for ST6
• 4.5% for ST7
• 4.5% for ST8

These figures compare the 2026–27 scales with 2025–26. Further structural increases are planned for some pay points in April 2027.

The main headline figures measure different periods:

• The Government’s 4.9% average broadly reflects 2026–27.
• The BMA’s 6.6% average includes the DDRB award and reforms completed by April 2027.

Neither figure means every doctor immediately receives the same increase. The separate 2027–28 DDRB award remains unknown and is not included in the confirmed April 2027 figures.

How many new specialty-training posts are guaranteed?

The agreement guarantees at least 4,000 additional specialty-training posts over three years.

At least 1,000 are planned by August 2027, including:

• 250 posts starting in February 2027.
• A further 750 posts by August 2027.

The remaining 3,000 minimum places are expected over the following two years. Up to 500 further posts may be added, depending on training capacity, service demand and patient need.

It is therefore accurate to describe the commitment as at least 4,000 and up to 4,500 posts. A Training Allocation and Distribution Group will help decide where posts are created and which specialties receive them, based on workforce and patient needs.

What support is available for examination and professional fees?

The agreement funds the first two attempts at eligible mandatory Royal College or faculty examinations required for specialist training.

Reimbursement applies to qualifying examinations taken from 1 April 2026 and covers eligible doctors in training and local employment in England. The Government, NHS England and the BMA will agree the final list of eligible examinations. Doctors will claim reimbursement through their employer.

From 1 April 2027, eligible mandatory membership and portfolio fees will also be reimbursed, although doctors may need to pay them upfront.

What changes are planned for locally employed doctors?

The agreement includes several reforms for locally employed doctors:

• Eligible LEDs may be offered repurposed 2016-style contracts by September 2026.
• From August 2026, substantive contracts should be offered unless a fixed-term arrangement is justified.
• An enhanced appraisal system is planned by October 2026 to recognise competencies gained outside training.
• A national LED contract is expected by February 2027, with implementation targeted for April 2027.

The reforms aim to improve contract consistency, job security and pay progression. However, they do not guarantee immediate increases, as outcomes will depend on competencies, appraisals, contract terms and final guidance.

How Much Could Resident Doctors Earn Under the New Agreement?

The following table shows the Government’s published basic salary scales. The figures exclude payments for nights, weekends, additional hours, on-call duties, flexible pay premia and other supplements. They are not take-home-pay estimates.

Grade or pay point	2025–26 basic salary	2026–27 basic salary	April 2027 structural salary before the unknown 2027–28 DDRB award
FY1	£38,831	£41,226	£41,226
FY2	£44,439	£47,610	£47,610
ST1 or CT1	£52,656	£55,355	£55,534
ST2 or CT2	£52,656	£55,355	£56,925
ST3 or CT3	£65,048	£67,325	£67,325
ST4 or CT4	£65,048	£67,998	£69,345
ST5	£65,048	£67,998	£71,415
ST6	£73,992	£76,582	£76,582
ST7	£73,992	£77,348	£78,660
ST8	£73,992	£77,348	£80,730

By the end of the structural reform, increases compared with the 2025–26 scales range from 3.5% at certain pay points to 9.8% at ST5. The future 2027–28 DDRB award would be added after it has been determined.

A doctor’s actual salary may also change when they progress between grades. Progression is not determined solely by the calendar date: it may depend on completion of the relevant annual review, competency requirements or enhanced appraisal.

Net pay will vary according to:

• Tax code.
• National Insurance.
• NHS Pension Scheme contributions.
• Student or postgraduate loan deductions.
• Additional hours and shift supplements.
• Flexible pay premia.
• Salary-sacrifice arrangements.
• Individual working patterns.

Doctors should use their official contract, employer pay circular and payslip rather than applying the headline average percentage to their previous take-home pay.

How Could the Agreement Affect NHS Staffing and Patient Care?

The immediate benefit is greater operational certainty. NHS organisations no longer need to prepare for the cancelled June walkout or further action under the resolved disputes.

The Government estimates that each strike day by resident doctors costs the NHS approximately £50 million. Strike planning can also require rota changes, additional cover and the postponement or rearrangement of appointments and procedures.

Greater stability for NHS hospitals

Without scheduled strike action, hospitals should have greater certainty when planning:

• Elective operations.
• Outpatient appointments.
• Diagnostic services.
• Emergency cover.
• Staff rotas.
• Training and supervision.
• Annual leave and temporary staffing.

This does not mean every previously disrupted appointment will automatically return to its original date.

Patients should follow the latest letter, text message, NHS App notification or direct communication from their provider. An appointment should be attended unless the NHS has specifically said it has been cancelled or rearranged.

Could the deal improve recruitment and retention?

The agreement may improve retention by addressing more than just pay. Additional training places, standardised LED contracts and competency-based pay progression could strengthen career development, while reimbursing mandatory professional costs may reduce financial pressure.

However, recruitment and retention also depend on factors such as workload, working conditions, career opportunities, housing costs and burnout. The deal does not address all of these challenges.

Will NHS Waiting Lists Now Fall?

Ending industrial action removes one source of disruption, but it does not guarantee shorter NHS waiting lists. Waiting times also depend on:

• Clinical staffing levels.
• Nursing and healthcare capacity.
• Hospital beds and diagnostic services.
• Social care and patient discharge.
• Funding and productivity.
• Training and supervision capacity.

The agreement may support NHS recovery, but individual trusts will still need funding, guidance and time to implement the changes effectively.

Why Does the Settlement Matter to UK Employers and Business Leaders?

The agreement offers a wider workforce-management lesson: salary problems often become more serious when they are combined with blocked progression, inconsistent contracts and compulsory professional costs.

The package attempts to address:

• Pay.
• Skills recognition.
• Career progression.
• Contract consistency.
• Employment security.
• Professional expenses.
• Training capacity.
• Employee representation.

These principles can apply to employers outside healthcare. A technology, engineering or professional-services business may successfully recruit graduate employees but still struggle with retention if there are too few opportunities to move into more senior positions.

Similarly, requiring employees to pay personally for compulsory qualifications may make a role less financially sustainable, even where the headline salary appears competitive.

Employers should therefore examine the complete employee journey:

• Is career progression clear?
• Are assessment criteria transparent?
• Are comparable employees treated consistently?
• Are compulsory costs reimbursed?
• Do employees receive appropriate supervision?
• Are new responsibilities matched by pay and support?
• Can staff raise concerns through credible processes?

The NHS agreement also demonstrates the importance of implementation. Announcing a new contract or career framework does not guarantee employee confidence. Trust will depend on whether pay changes appear correctly, reimbursement claims are processed, training posts are genuinely created and contractual reforms are applied consistently.

Which Claims About the BMA Doctors Strike Could Be Misleading?

Some headlines and social media posts may oversimplify the agreement. Here are some common claims and the facts behind them:

• “Every resident doctor gets a 6.6% pay rise immediately”: No. The 6.6% is an average over time, and individual pay increases depend on grade and pay point.
• “All doctors will receive a 6.6% rise in 2026–27”: Not exactly. The Government refers to an average increase of around 4.9%, while the BMA’s 6.6% includes changes completed by April 2027.
• “All 4,500 training places are guaranteed”: No. At least 4,000 are guaranteed, with up to 500 more depending on capacity and demand.
• “The deal applies across the UK”: No. It only covers resident doctors in England.
• “All professional costs will be paid automatically”: No. Reimbursement depends on eligibility and the claims process.
• “The BMA has achieved full pay restoration”: No. The BMA says the agreement is progress, but its wider campaign continues.
• “There will be no more doctors’ strikes”: Not necessarily. Future disputes remain possible.
• “NHS waiting lists will fall immediately”: No. Waiting times also depend on staffing, funding and NHS capacity.

What Happens Next After Resident Doctors Accepted the Deal?

Now that the deal is accepted, attention shifts to putting it into practice effectively and consistently across the system.The focus now moves from negotiation to implementation and careful delivery.

Key expected milestones include:

Expected Period	Planned Action
From 1 April 2026	Pay award and first-stage reforms take effect
From 1 April 2026	Mandatory exam reimbursement begins
August 2026	Greater use of substantive LED contracts
February 2027	First 250 additional training posts begin
1 April 2027	Second phase of pay reforms and membership fee reimbursement
By August 2027	At least 1,000 additional training posts in place

The Government, NHS England, NHS Employers and the BMA will oversee implementation through a new industrial relations committee. NHS trusts must update payroll, contracts and appraisal systems, while doctors should wait for official guidance on reimbursement eligibility.

The long-term success of the agreement will depend on timely implementation, additional training opportunities, fair employment practices and consistent delivery across NHS organisations.

Conclusion

England’s resident-doctor dispute has ended, but the agreement’s success will depend on delivery. The pay reforms, additional training posts, professional-cost support and improved contracts could strengthen recruitment, retention and career progression across the NHS.

However, implementation will take time, and not every doctor will benefit in the same way. For patients and employers, the deal offers greater stability, while leaving wider workforce pressures, waiting lists and future pay questions unresolved

Frequently Asked Questions

Does the resident-doctor agreement apply outside England?

No. The settlement concerns resident doctors and the resolved BMA disputes in England. Scotland, Wales and Northern Ireland have separate NHS pay and industrial-relations arrangements.

When will doctors receive backdated pay?

The applicable 2026–27 changes are effective from 1 April 2026. The date on which arrears appear may depend on national pay instructions and payroll processing by the doctor’s current or previous NHS employer.

Does every doctor receive a 6.6% pay rise?

No. The 6.6% figure is an average covering the DDRB award and structural reforms fully delivered by April 2027. Individual increases vary by pay point.

What is the difference between a junior doctor and a resident doctor?

Resident doctor is the updated term for the group previously commonly called junior doctors. They are qualified doctors working in foundation, core, specialty and certain locally employed roles.

Are all 4,500 specialty-training places guaranteed?

No. The firm commitment is a minimum of 4,000 additional posts. Up to 500 more may be provided if there is sufficient training capacity, service appetite and patient need.

Which examination fees will be reimbursed?

The agreement covers the first two attempts at eligible mandatory Royal College or faculty examinations required for completion of specialist training. A formal list and detailed claims procedures are expected as implementation progresses.

Will doctors have to pay membership fees upfront?

The formal offer says doctors will remain responsible for initially paying eligible membership and portfolio fees before seeking reimbursement from their employer.

Does the deal guarantee that an LED will enter specialty training?

No. It creates more training places and possible progression routes, but entry will continue to depend on eligibility, recruitment, assessment, competition and the availability of suitable posts.

What should patients do about appointments previously affected by strikes?

Patients should follow the most recent instructions from their NHS provider. They should attend unless the hospital or clinic has confirmed a cancellation or replacement date.

Can the BMA continue campaigning for higher pay?

Yes. Acceptance ends the current disputes in England, but the BMA has said that its broader objective of pay restoration has not been completed.

How We Checked This Article?

This article was checked on 30 June 2026 by:

• Reviewing the Government’s full June 2026 offer rather than relying only on press-release summaries.
• Comparing the Government’s pay presentation with the BMA’s grade-by-grade explanation.
• Verifying the referendum result through the BMA’s published voting figures.
• Separating the guaranteed 4,000 training posts from the conditional additional 500.
• Checking the implementation dates for pay, examinations, professional fees, LED contracts and training posts.
• Distinguishing basic salary from gross earnings and take-home pay.
• Reviewing NHS Employers’ response for implementation considerations.
• Checking NHS England’s public guidance on appointments and industrial action.

Where the Government and BMA use different measures, both positions have been attributed rather than presented as a single uncontested figure.

This article should be reviewed when the Government, NHS England, NHS Employers or the BMA publishes detailed implementation guidance, the final reimbursement rules, the national LED contract or the 2027–28 DDRB pay award.