The Government has made further concessions to junior doctors In England in a bitter dispute over a new contract, a leaked letter reveals.
Sir David Dalton, who has been drafted in by the Government to move forward talks with the British Medical Association (BMA), has offered more concessions on premium rates of pay.
The issue of when ordinary "plain" time pay stops and premium rates of pay kick in has proved a major sticking point in the dispute.
Currently, 7pm to 7am Monday to Friday and the whole of Saturday and Sunday attract a premium rate of pay.
An offer from the Government in November said doctors would receive time-and-a-half for any hours worked Monday to Sunday between 10pm and 7am, and time-and-a-third for any hours worked between 7pm and 10pm on Saturdays and 7am and 10pm on Sundays.
But in a new offer, dated January 16, Sir David said that, as part of an overall agreement, a premium rate of pay could kick in from 5pm on Saturdays rather than 7pm.
Furthermore, premium pay could start at 9pm Monday to Friday rather than the original offer of 10pm.
The letter, leaked to the Health Service Journal (HSJ), also said NHS Employers would "consider any proposal" from the BMA for a "cost neutral single blended rate for all unsocial hours periods", which could apply on a Saturday for those trainees who work one in three Saturdays or more.
The letter also promises that a trainee will never be rostered to work consecutive Saturdays. Any trainee who works one in three Saturdays or more "will be paid an enhanced rate for all of the Saturdays they work", it added.
The letter to the BMA's junior doctors' committee chairman Johann Malawana went on: "You also made it clear that trainees are concerned that there would be occasions when their work schedule may compromise their training if it included too high a frequency of Saturday work.
"Our offer includes a safeguard that should these circumstances arise then a trainee can request a rapid review of that schedule and a response to ensure that training is not compromised."
The letter said that NHS Employers "are clear that payment of plain time for shifts starting on a Saturday after 7am is fundamental".
It added: "We have clarified that this must be applied to a substantial element of Saturday, and for a substantial number of the trainee workforce.
"This will enable the NHS to be more responsive to the needs of patients and to support safe and reliable care across the seven day week.
"It will enable cost effective deployment of staff across seven days, consistent with investment in NHS services and growth in the NHS workforce, including medical trainees."
The BMA has called off a strike planned for next week while talks continue through the Advisory, Conciliation and Arbitration Service (Acas).
A joint statement from the BMA and NHS Employers issued earlier said: "Talks are ongoing and the focus now is on making progress in those talks.
"Differences remain on some key areas but we are committed to addressing these privately in talks through Acas."