Hospital consultants in England have offered to call off their strikes if they receive a pay rise of about 12% this year – double the increase that ministers insist is their final offer. Their proposal, and the disclosure of recent “constructive” conversations with the government, appear to be a conciliatory move by the British Medical Association (BMA) to end their pay dispute. It came as consultants staged another walkout over pay on Tuesday and prepared to take part in their first ever joint strike with junior doctors on Wednesday. Two days of stoppages this week by consultants and three days by junior doctors are expected to seriously disrupt services. The total number of appointments and operations cancelled since last December as a result of strikes by NHS staff will pass 1m. In a letter to Rishi Sunak, the BMA’s consultants committee made clear that the 33,915 consultants (senior doctors) it represents would stop their industrial action if they got a pay uplift of about 12% for 2023-24. Dr Vishal Sharma, the committee chair, told the prime minister in the letter: “We are … seeking a pay package for 2023-24 above the level of RPI inflation for the 12 months until April 2023 that ensures our pay is not eroded.” RPI inflation averaged 11.4% over that period. Sharma pointed to the deal that the Scottish government agreed with junior doctors in August, under which medics got a 12.4% pay rise this year, as a way of ending the dispute in England. “This is not dissimilar to the settlement in Scotland for junior doctors, which demonstrates that this is deliverable,” he said. The committee’s clarification that it wants a pay rise of about 12% is the first time it has put a figure on what consultants are seeking. In contrast, junior doctors have made clear since last year that they want an immediate 35% uplift to deliver “full pay restoration” and address the fact they their incomes have fallen by 26% in real terms since 2008. In another move that seems to signal flexibility on the BMA’s part, Sharma told Sunak that the committee was “willing to consider investment in non-headline pay areas, to help reach agreement”. That involves other financial issues affecting doctors, such as clinical excellence awards and fees they pay to take exams related to their professional development. However, the government rejected the union’s potential olive branch. A Whitehall source said: “The government has accepted the pay review body’s recommendation on doctors’ pay. As such, the pay award is final, as the prime minister has said.” About 150,000 doctors in England will receive extra money in their salaries this month after Steve Barclay, the heath secretary, decided to impose a 6% pay rise for consultants and an average of 8.8% for junior doctors. Confusion surrounds what exactly the “constructive conversations” that the BMA referred to in its letter to Sunak involved. The BMA said it could not elaborate on how many meetings its consultants committee had had or when until it had received “the government’s response to the letter and recent conversation”. The BMA’s letter added that resolution of the consultants’ pay dispute would also depend upon ministers agreeing that “the independence of our pay review body, the doctors and dentists review body, is fully restored in line with its founding principles”, as well as an above-inflation pay rise for this year. A No 10 spokesperson said: “I’m not sure what discussions are being referred to. It’s true that we have sought to have discussions with the BMA on non-pay issues. There have not been any, as far as I’m aware, discussions about pay with consultants. So I think we’ve been very clear [that ministers will not reopen pay talks].” Asked if the government was still refusing to let the Advisory, Conciliation and Arbitration Service mediate in the dispute unless doctors drop their pay demands, the spokesperson replied: “It’s wrong to conclude that would be a silver bullet in any shape.” Bosses of NHS trusts have said the four days of action by medics this week will put the service in a “dangerous situation” and delay the care provided to some cancer patients. The NHS Confederation chief executive, Matthew Taylor, said the ongoing strikes would mean that some patients will have had their operation cancelled three times, public frustration with widespread cancellations was growing and ministers seemed to regard NHS strikes these days as “business as usual”.