According to the Department of Health and Social Care, resident doctors are now voting on a revised offer covering pay, working conditions and career progression. The British Medical Association opened the ballot on 18 June 2026 and it is due to close on 26 June 2026, with a simple majority required for the package to proceed. The department says the proposal was strengthened and clarified after feedback from the BMA resident doctors committee on the March offer. Strikes that had been scheduled for the same week were then called off, so the dispute has moved from industrial action to a formal membership vote.
The main structural change in the revised package is earlier pay scale reform. The Department of Health and Social Care says the new approach would bring forward changes first outlined in March, so resident doctors would move sooner to a system that offers more regular rises as they gain competencies and take on greater responsibility. That matters because the offer is not limited to a one-year uplift. The government is presenting it as a change to how pay develops across training, with progression linked more closely to capability and career stage.
On headline pay, the department states that resident doctors have already received a 28.9% increase over the last three years, which it describes as the largest rise anywhere in the public sector. Under the June 2026 offer, the department says resident doctors would receive an average rise of 4.9% this year and would be 35.2% better off on average than four years ago. The gains are weighted more heavily towards the start of the pay scale. First-year resident doctors would see an average rise of 6.2%, while second-year doctors would receive 7.1%, according to the government figures set out in the offer.
The proposal also addresses costs that fall directly on trainees. Mandatory Royal College portfolio fees and mandatory examination costs would be reimbursed, a change that the department says could return thousands of pounds to some doctors over time. Clinical academic resident doctors are separately covered by a higher flexible pay premium. Under the offer, that payment would rise to £10,000, reflecting the additional demands placed on doctors working across clinical service, training and academic work.
Career progression is a second major part of the package. The government says up to 4,500 additional training posts would be implemented over the next three years, including 1,000 next year, with 250 of those roles beginning in February 2027. The Department of Health and Social Care links that expansion to the Medical Training Prioritisation Act 2026, which it says is expected to halve competition ratios for this year's applicants. The department is presenting the measure as a response to training bottlenecks that can leave doctors unable to progress despite completing earlier stages of training.
The revised terms also cover doctors employed outside the main resident doctor contract. According to the department, locally employed doctors would gain more stability, a clearer route into higher training and improved terms and conditions. NHS national medical director Professor Francesca Swords used the announcement to acknowledge persistent frustrations over payroll errors and slow repayment of expenses. That is an important part of the offer's presentation, because it places administrative reliability alongside pay as part of the settlement rather than treating it as a separate management issue.
The government's message on industrial relations is direct. Health Secretary James Murray said the offer would not improve further and argued that, if it were rejected and strikes resumed, it would be operationally and financially impossible to keep the same package on the table. That warning is paired with service data. During the most recent round of strikes, NHS staff delivered 94.1% of planned care, but the department says each day of industrial action still affects patients and colleagues, adds pressure to the NHS budget and slows wider improvements to working conditions.
This means the vote is about more than an annual pay round. It combines pay reform, fee reimbursement, training capacity and contract changes in a single decision that will shape the next stage of NHS workforce policy for resident doctors. The government has also placed the ballot inside a wider recovery account, saying NHS staff are treating more patients than ever before and pointing to a waiting list that it says is 403,000 lower than in June 2024 and 171,000 lower than a year earlier. For resident doctors, NHS employers and patients, the immediate question is whether enough members back the June 2026 package by 26 June 2026 to close the dispute on the government's terms.