Consultants in England have voted narrowly against an offer aimed at resolving a long pay dispute with the Government.

The British Medical Association said its members rejected the offer by 51.1%.

The BMA’s consultants committee said it had rejected the offer in light of the ballot result, but was giving the Government an opportunity to improve it to a point that may be acceptable to members.

Health and Social Care Secretary Victoria Atkins said the Government is “carefully considering” its next steps.

Dr Vishal Sharma, who chairs the BMA consultants committee, said: “The vote has shown that consultants do not feel the current offer goes far enough to end the current dispute and offer a long-term solution to the recruitment and retention crisis for senior doctors.

“It backs up conversations we’ve had with colleagues in recent weeks, who felt the changes were insufficient and did not give them confidence that pay erosion would be addressed over the coming years. In addition, they were concerned about the fairness of the offer and how it impacted different groups of doctors.

“There were also clear concerns about changes to professional development time, and time dedicated to teaching and research.

“However, with the result so close, the consultants committee is giving the Government a chance to improve the offer.

“In the coming days we will be further engaging with consultants, and seeking talks with Government to explore whether the concerns expressed by our members during the referendum process can be addressed.”

Medics from the Hospital Consultants and Specialists Association (HCSA) rejected the offer earlier this month.

Health and Social Care Secretary Victoria Atkins said: “I hugely value the work of NHS consultants and I am disappointed that after weeks of constructive negotiations the BMA has, by the narrowest of margins, rejected this fair and reasonable offer.

“I want to build on our progress on waiting lists and for us all to be able to focus our efforts on offering patients the highest quality care.

“The Government is therefore carefully considering next steps.

“We already know the kind of progress our NHS staff can make in the absence of strikes – waiting lists fell by more than 95,000 in November, the first month without industrial action for over a year and the biggest decrease since December 2010 outside of the pandemic.”

The NHS in England has been beset by strike action for more than a year.

Walk outs by various staff groups including doctors, nurses, paramedics and physiotherapists have led to more than 1.3 million appointments, procedures and operations being rescheduled.

Consultants have staged four rounds of strike action in the current dispute, including an unprecedented joint walk out with junior colleagues.

Junior doctors in England are currently being balloted to see if they want to continue strike action.

Sir Julian Hartley, the chief executive of NHS Providers, which represents NHS trusts in England, said trust leaders will “understandably feel dismayed”, adding: “They had hoped the dispute between the Government and senior doctors would be resolved but today’s narrow vote makes clear that a range of concerns still need to be addressed.

“All parties need to ensure that hard won progress towards an agreement is not lost but the spectre of further strike action continues to loom large over the health service should talks fail.

“These concerns will be amplified following this week’s announcement that junior doctors will be re-balloted on strike action and action short of strikes. Politicians and unions must find a way to end all disputes.

“More than 1.4 million appointments have already been delayed due to industrial action since December 2022, with many thousands more patients having had their care and lives disrupted.

“For the sake of patients, these figures can’t be allowed to keep climbing.

“Trusts and their staff are paying a high price too. Leaders are having to deal with the fallout from national disputes beyond their control while staff morale suffers hit after hit.”

Shadow health secretary Wes Streeting said: “Last week, Rishi Sunak was bragging that NHS doctors had accepted his pay offer. This vote shows he was trying to pull the wool over the public’s eyes.

“The NHS is in the second year of strikes. They have cost patients more than one million cancelled operations and appointments, and cost taxpayers £2 billion.

“It is long past time Rishi Sunak took personal responsibility and took charge of negotiations himself. The Prime Minister cannot continue to wash his hands of the crisis in the NHS.”

The BMA said 23,544 consultants took part in a referendum on the offer, with a turnout of 64.8%.

A total of 11,507 voted in favour of the offer, and 12,037 voted against. Consultants in England have a mandate to take industrial action until June.

Consultants were offered an average increase of 4.95% on basic pay on top of last year’s rise of 6%.

The HCSA urged the Government to engage in fresh talks following the BMA result.

HCSA consultants voted by 57% against the offer last week, citing concerns including further erosion of time for training and research, as well as the overall level of investment and unevenness of the award across the pay scale.

HCSA president Dr Naru Narayanan and general secretary Dr Paul Donaldson have written to the Secretary of State for Health and Social Care Victoria Atkins to urge her to address these points.

Dr Donaldson said: “We’ve been warning for weeks that flaws in this reform package could lead consultants to reject it.

“The Government now needs to acknowledge their concerns, get back round the table and agree a better deal to avoid prolonging this dispute.

“We hope they’ll choose the best path for all concerned and negotiate a refreshed offer.”