Senior doctors in England will be consulted on taking industrial action if the government’s 1% pay rise offer is not improved.

The British Medical Association says it will ask members about stopping paid and unpaid overtime if there is not a figure nearer 4%.

The Royal College of Nursing has already said it will consider balloting over industrial action.

It has called for a 12.5% pay rise this year.

Pay review bodies covering most NHS workers have made recommendations which have not yet been published.

In England, ministers must decide whether in the light of those reports they will increase their proposed 1% offer.

Industrial action by consultants would involve stopping paid and unpaid overtime, which would affect patient clinics and attempts by hospitals to reduce waiting lists, the BMA says.

It argues that senior doctors are exhausted and feel undervalued because of previous below inflation pay rises.

If industrial action is taken it would be the first by consultants since the 1970s apart from a day of action over pensions in 2012.

Mike Henley, a consultant urologist in the East Midlands, says consultants’ pay has been steadily eroded compared to other salaries in the public sector.

“I want to get back to fairness. Like everyone, I would rather not stop doing overtime,” he says.

“But consultants do incredibly busy and stressful jobs – and we are underpaid compared to lawyers, for example.

“I don’t expect to be paid like someone working in the City, but I don’t expect to have a third of my pay removed either.”

Mr Henley said the pandemic had made his job even more difficult and caring for patients had become more complex.

“For many, its been like wartime medicine,” he says.

The Department of Health said the government was committed to a wage rise for NHS staff, including consultants, when pay increases elsewhere in the public sector had been paused.

The health department recommended the 1% pay award to the independent panel that advises the government on NHS salaries. It would cover nearly all hospital staff, but not GPs and dentists.

Nurses have described the proposed pay rise as “insulting”, with unions threatening strike action and warning that the “pitiful” rise may lead staff to quit their jobs – worsening staffing issues in the health service.

Talks on pay are underway in Wales where the government has said it will not set a 1% ceiling on pay awards.

In Northern Ireland all NHS staff have been offered a £500 bonus this year. Bonuses have also been offered in Scotland where longer-term pay negotiations are ongoing.

Consultants, at the top end on NHS salary scales because of their years of medical experience and leadership, have not been minded to get involved in public pay disputes till now.

The possible overtime bans could slow down attempts to reduce hospital waiting lists.

This could be seen as sabre rattling and a bid to sway ministers ahead of their wage announcement.

But it is indicative of the likely level of anger across the NHS workforce if the government response to the pay review bodies’ recommendations is not far off the original 1% proposal.

Additional reporting by Ella Wills.