With a new pay offer for NHS staff announced this month, the Nuffield Trust shared analysis of real terms changes to resident (junior) doctors’ pay at the request of the Sunday Times. The chart is an update from our previous commentary on NHS pay and is part of a broader set of research on the pay review process and doctors’ earnings.
The government has offered resident doctors a 5.4% average pay rise this year
(consisting of a 4% pay rise and a £750 cash sum) - more than other doctors, nurses and teachers – after pay rises worth 22% over the previous two years. However, looking further back, the BMA are concerned that real-terms pay has eroded over a 17-year period.
Our analysis shows how calculations on changes in pay over time are sensitive to the inflation measure chosen (CPI or RPI) and the baseline year. Of course, real-terms pay is just one measure and should not, on its own, be used to conclude whether pay is fair and appropriate.
As well as this, calculations differ based on whether increases to pay are indicated by headline pay settlement figures or using actual earnings, and whether inflation figures used are at year-end or averaged across the whole financial year. It is also important to note that wages across the wider economy have generally fallen compared to inflation in recent years.
Estimates of resident doctor real-terms pay trend to 2025/26 based on headline pay settlement
ChartNuffield Trust Researcher, Lucina Rolewicz said:
“You can paint a very different picture of real-terms changes to resident doctors’ pay packets over time, depending on the methods you use. It’s important to look at a range
of baseline years to get a more complete understanding of what has happened to pay. For example, if you look at what’s changed since 2008, pay erosion appears much
worse than if you looked at the changes since 2015 in isolation. Against the CPI
measure of inflation, this can make the difference of showing a 4.7% fall in pay since 2008 or a 7.9% increase since 2015.
“Comparing changes to pay at the same point in time, using different measures of
inflation, also results in very different answers. For instance, resident doctor pay has fallen by 4.7% since 2008 against CPI, but has decreased by 17.9% over the same period when using RPI.
“Given the importance of the debate for doctors, their colleagues, patients and taxpayers, it is crucial that we look at all the ways that pay can be seen to have changed.”