How much do NHS consultants actually get paid

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DH is senior registrar- surgeon. Few years time will hopefully be a consultant. We can view nhs pay scales online but there are extras always for unsocial hours. ie base top reg is £58,000 but currently getting £83,000 due to hours/ shifts etc.

If you are a consultant/ other half is/ knowledge of one please hit me with their/ your real gross salary per year with the add ons (not the base we can view online). So says online consultants start at £93,000 but what is the real starting salary with the add ons (as above top reg on £83K rather than £58k due to hours/ weekends/ on calls etc). Is it a similar percent uplift?

If you can, maybe share field and/ your years as a consultant.

Also any other info regarding overtime. Top he has ever accessed at mo on one rotation was £90 an hour for last min locum unsocial hours overnight at weekend as top rate reg. Normally much less than that. What about consultants if they were to do extra to cover a rota gap/ illness etc.

Curious what to expect at the end of this loooong road. Husband wouldn’t feel comfortable just asking people at work! If you’re happy to share would be grateful.

TIA

Sorry to be the bearer of bad news but consultants don't get paid any extra for unsocial hours I'm afraid - they have a reduction in how many hours they have to work in a session if it's a weekend, evening or overnight and generally have to do less of the unsocial hours than the registrars but there is no % premium on top. Consultants do job planning which you can read about on the BMA website but essentially their timetable is divided into 'sessions' or PAs, 10 per week in a whole time contract. A PA is 4 hours in hours, 3 hours out of hours. So if all a consultant's work was Monday-Friday in hours, they'd work a 40 hour week if full time, and if it was all out of hours 30 per week if full time (not that the latter would be likely to happen of course, most consultants would do up to 20-25% of their work out of hours although varies by speciality, specialities with 24/7 consultant cover of course it's more). Of course many do a lot of unpaid overtime but that's another matter entirely.

As additionals/extras, the most common is on-call availability supplement, that's usually between 3-5% depending on frequency of rota. In theory they should get paid or time back for work actually done on call if this isn't already in their job plan although many trusts will avoid doing this in various ways. Other common ones are London weighting, additional PAs (effectively contracted/guaranteed overtime, particularly used for things like waiting list initiatives, extra evening/weekend sessions effectively), CEAs (but these won't apply for new consultants unfortunately under the new deal), management allowances (if he takes on a leadership role). Of course lots of consultants have a private practice too which TBH is where the big bucks are...

Locum shifts for consultants may be available, it depends on the trust/speciality and they are usually quite well paid but he'd probably be better off exploring with his employer the possibility of regularly scheduled APAs if he wants the certainty and to fit these it at times that suit him rather than random weekend night shifts or whatever.

Thanks that’s helpful. He was just saying some trusts are ‘clever’ with PAs to attract staff. Pay for 12 but only in hospital 4 days so you have rest of time at home for all the admin. Whereas others will pay for 10 and you’ll be in all 10 and have admin on top. Heard much about creative use of PAs?

maxelly has said it all really.
Things may change with the new round of pay talks of course but Consultant pay has been eroded hugely in recent times - I was significantly less well off in real terms when I retired a couple of years ago than when I was first appointed as a Consultant and no, there's no extra for antisocial hours really. I remember chatting to some of the porters in our Trust on a particularly manic Christmas Day a few years ago and they said "Yeah...but triple time...you must be raking it in Doc" and couldn't believe it when I told them that no, I wasn't being paid any extra for spending over 20 out of 24 hours on Christmas Day physically working in the hospital but I would get a day off at some other point in the year, when it was convenient for the department of course.
Depends where you work, and your specialty, but you can make extra money by taking on extra clinical commitments, either regular or ad hoc, managerial or other non clinical responsibilities and private work. Though in my experience the stress associated with a medical management role my far outweighs the relatively small boost to the pay packet. Locums can be lucrative but obviously impact on quality of life.Some people make far more privately than they do in the NHS but that varies a lot according to location and specialty and it takes time to build up.
I was only working about 80% of full time for health reasons before I retired a couple of years ago and my NHS salary when I retired after 20 odd years as a Consultant was about £90k. I did have a fairly low level Clinical Excellence Award but had dropped my managerial role.

Don't they make up their money doing private work ? I know our paediatrician was always peddling his private clinics 🙄

That would not be allowed. Or at least it wouldn't have been when I was involved in job planning and it wasn't that long ago. Consultant contracts have to include at least the minimum requirement of Supplementary PAs to cover admin, educational activities etc. If you have additional non clinical roles such as a managerial role, College Tutor etc then additional SPAs are payable. But no substantive Consultant should be contracted for clinical hours only.

They don’t get paid overtime for unsociable hours - they reduce the number of hours worked to compensate.

My DH ( respiratory) physician doesn't do private, but he has got quite a few clinical excellence awards which bumps things up a bit. Not all consultants do private work.

@AgeingDoc you’ve been very open and please don’t answer if you don’t want to as I know it is very personal. I just wondered what your pension was when you retired? I’d estimate 45k a year? If it is around this figure do you feel it was worth it for all the hours you have put in over the years?

Now the cap has been lifted on the lifetime allowance do you think this will help Consultants in the long run considering the new NHS pension rules are not as favourable?

Not so much creative if by that you mean dodgy or breaking the rules in some way, but good, well managed trusts that want to attract and retain staff will run job planning in a very thoughtful, collaborative way, maximising their resources but also (a) allowing flexible and remote working where this is something individual consultants want (b) giving sufficient SPA time (supporting professional activity aka non clinical time, things like research, teaching, quality improvement, CPD). Increasingly hospitals are allowing SPA time to be done remotely/from home and of course telemedicine is a thing so remote clinics are sometimes possible too. If a day WFH at least a few times a month is something that your DH would want I would have thought that should be possible, although if he also wants to do 12 PAs not 10 he will need to be prepared to do long days and at least some extra evenings and weekends too. Of course I am talking 'good' trusts and services here which IMHO tend to be the larger teaching hospitals which are (relatively) well resourced, there are plenty of horror stories out there too of job plans cut to the bone, hundred of hours of unpaid overtime required, no compensatory rest even if called in while on call, bare minimum SPA time which consultants aren't actually facilitated to take etc etc. So if he's chosen a specialty where he can pick and choose his job rather than the other way around these are definitely questions to ask (the recruitment pack should come with a draft job plan and timetable and he can ask about flexible working maybe at interview stage?).

A lot of trusts/services annualise their job plans now and this is something that can work well for some flexibility, timetables/rotas can be organised into quite long/intense clinical weeks (on call, attending, consultant of the week, resident consultant, it's called different things) balanced out with shorter, outpatient/clinic and SPA focused weeks allowing for some remote working, some people hate this because the clinical weeks can be really demanding but it can sometimes work well around family/personal life too (I mean, obviously not as well as a predictable easy 9-5 mainly WFH but a consultant job is very rarely going to be that!). Bear in mind also that NHS annual leave provisions are pretty generous and he'll get 10 days study leave per year too which he should make sure to take if he can.

It was better than that @sumptuous though I would rather not go into detail.
But that's mainly because I had quite a lot of years in the 1995 scheme which was much better than the current scheme. I had to retire early on health grounds which did give me an uplift on what I would have got if I had stopped working at this age for other reasons. So I'm not sure my pension situation is that useful for other people to know as it's probably not typical.
I haven't really got any complaints about my pension and it's a lot better than my DH's after a similar number of years in a professional role in the private sector but I think the taxation issues do put people off working extra hours particularly later in their career. People reach a point where so much of their earnings are going to end up as tax that it barely seems worth it.
Personally, whilst of course pay, pensions etc are important, I don't think they are as important as working conditions. I loved my job and still miss treating patients but I was so ground down by the end of my career that even if some miracle occurred and I woke up restored to perfect health tomorrow I wouldn't go back. And that's nothing to do with money.

@AgeingDoc I was a nurse in the NHS and left due to the conditions. My son has just started a medical degree. I made him fully aware of the stresses of the job but he was determined so I supported him achieve his goals. I know he is privileged to be doing a medical degree in the UK and that his degree and training costs the tax payer hundreds of thousands of pounds but I do worry. However, looking at the state of the world today this generation has a lot to worry about.

It was ridiculous that Consultants actually ended up paying HMRC to work more hours who would do that! Work for a negative balance! Nobody in their right minds.

Good luck to him @sumptuous
I have to confess I was greatly relieved that none of my children wanted to follow in my footsteps as I wouldn't want them to have done so. Very few of my colleagues' children are at medical school either - a far cry from when I started and a high proportion of my peers had at least one parent or grandparent in the profession.
This is often touted as a sign of progress, and obviously it is good to have wider cross section of society represented but there is a generation of doctors' children who are looking at their parents' lives and saying "Not for me thanks" which is a worrying thing.
I am the first generation of my family to go to University and my parents were so proud of having a doctor in the family. Many of my friends are the same and virtually none of us want our children to study medicine. How did we get that change in just one generation? I'm not saying wages are irrelevant but I do think that if people are happy in their work and feel valued the financial aspects are less of an issue. But when your job is shit the financial recompense feels a lot more important.