BBC News used Freedom of Information requests to hospital trusts and data supplied by NHS England to reveal:

• Many of the consultants earning the most are thought to be part-time, allowing them to work significant amounts of overtime for rates exceeding £200 an hour – more than four times normal pay.
•  The overall overtime bill hit almost £1bn in 2023-24, up from £512m 10 years ago, albeit some of that rise is related to more consultants being employed. 
• Six in 10 consultants work beyond their contracted hours, with average extra pay topping £27,000 a year.
• At least half of the 41 hospital trusts that responded to BBC News are now paying some of their consultants more than £100,000 in overtime.
• Some hospitals said overtime rates had been driven up over the past year by the particularly high rates the BMA had told its consultants to ask for to provide strike cover.

In response, Health Secretary Wes Streeting told the BBC: 'I don't think the rates are acceptable. Every penny that goes into the NHS needs to be well spent.'

BMA consultant co-leaders Dr Helen Neary and Dr Shanu Datta said: ‘The BBC's analysis of the FOI data from just 41 hospital trusts in England throws up misleading, but headline-grabbing payments - payments made to a very small number of doctors. They fail to explain that these payments may have been to agencies for long term locums, for example. It is highly misleading for the BBC to describe long term locum arrangements which trusts have established to deal with a shortage of doctors as "additional work" or "overtime".

‘The headlines distract from the real story which is that around 60% of all hospital consultants work some overtime, and have done for at least the past 14 years according to the FOI data, and for nowhere near those rates of pay. Many senior doctors work way beyond their contracted hours for no extra pay, but where they are paid at rates over and above their basic pay, this is to reflect the often unsocial hours - nights and weekends. The BBC states that at least half of the 41 trusts who replied to the FOI are "paying their consultants more than £100,000 in overtime." What the BBC doesn't make clear is what work is being undertaken, for how long and over what time span, and the source data has not been made available for any scrutiny.'

An NHS England official told the BBC that the use of agencies was falling, but hospitals had to offer rates that were competitive with the private sector.