Home » Campaigns » DDRB: For a truly independent pay review system
DDRB:   For a truly independent pay review system

Year upon year, we have seen doctor’s pay eroded through inadequate pay awards, arising from a politically controlled and opaque process.

We are calling for transparency, representation of the medical profession and true independence from government to restore faith amongst doctors. We must fix the pay review process.

Currently, the DDRB panel is appointed by and directly accountable to the UK Secretary of State for Health, and there are no requirement for any board members to come from medical or trade union backgrounds, nor to reflect the diversity of the profession.

HCSA is one of several parties which submit evidence to the DDRB and this is the main opportunity to make hospital doctors’ voices heard in the process. The DDRB is constrained by a requirement to consider government budgets and inflation targets, but the impact of pay deflation on the profession is discounted as beyond the terms of reference.

Once the DDRB reaches a recommendation, this is made privately to the UK and devolved governments with no disclosure to other parties. Doctors first become aware of the DDRB recommendation when the government chooses to publish it.

The government also has final say on whether to implement the recommendation. In fact, the DDRB outcome has been implemented in full on the due date by the UK government in less than half of the pay rounds of the last 41 years.

Recently, we have seen cases of DDRB self-limiting – making pay recommendations designed to be acceptable to government, at the expense of the medical profession.

The government also has control over the timetable and chooses when to release the pay outcome. Typically, this has come on the last week of Parliament, stifling scrutiny.

The process must change to reverse pay erosion. Join HCSA in calling for reform of the DDRB.

We're calling for:


The timeline and process should be instigated by DDRB independently. The final report should be published in the public domain at the point when it is disclosed to government ministers.

Representation for the medical profession

DDRB members must demonstrate medical and trade union experience, as well as reflecting the diversity of the medical profession.

True independence from government

Governments should not be allowed to set the DDRB remit. DDRB Members should be appointed through an entirely independent process without political involvement. Members should not be accountable to government ministers. The DDRB should not be required to assess the funds available to the health department and to consider the government inflation target. Governments should be required to implement its recommendations.

We're calling for

  • Transparency and independent DDRB control of the timeline and process
  • Representation from the medical profession on the board
  • True independence from government for the pay review process