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Consultant reform package:   Ballot of consultants in England

It’s time for HCSA members to have their say on the consultant reform package.

The electronic ballot is now open to all HCSA consultant members. It will ask whether you ACCEPT or REJECT the offer.

Next steps will be guided by the vote of the membership. If members vote to accept the offer, this effectively closes the pay dispute for HCSA. If members vote to reject, HCSA executive will consider this carefully in light of the live strike mandate.

The package includes:

  1. Pay spine reform
  2. Progression gateways replacing automatic progression
  3. The end of future LCEA awards and protections for existing old-style LCEA holders
  4. Changes to possible use of Supporting Professional Activities time
  5. Enhanced shared parental leave
  6. Limited DDRB reforms

Before voting, members are advised to familiarise themselves with the entire package using the briefing available for download.  

Since the offer was made, the Department of Health and Social Care have written to HCSA President Dr Naru Narayanan to give clarification on the intention behind changes to the definition of uses of Supporting Professional Activities (SPA) time. Read the letter.


Watch the presentation on the package


Ballot FAQs

Should I accept or reject the offer?

HCSA’s executive has not been able to take a formal position to accept the offer. The package as it stands is complex. Pay spine reform would give uplifts for most members, but comes in conjunction with some concerning aspects, namely the introduction of progression gateways and changes to SPA. It is for HCSA members to decide whether they accept or reject the package as a whole. 

How do I vote in the ballot?

Members will receive a link by email to an electronic survey. If you are a consultant member working in the NHS in England and have not received the email, please contact

How long is the ballot open?

The ballot is open from 14th December 2023 until 14th January 2024. This is to maximise the opportunity Consultant members have to participate.

What will happen once the ballot closes?

If members vote to accept the offer, this effectively closes the pay dispute for HCSA. If members vote to reject, this will be considered carefully by HCSA executive in light of the live strike mandate.

I have a question regarding the offer

HCSA has published a briefing which is available for download here. We can also send you a recording of our webinar on request. If you cannot find the answer to the question or would like to request access to the webinar recording, email for help.