“We are relieved that this dangerous cut to pay rates for extra work doctors do outside of their contract has been averted, but this issue is far from resolved,” he said.

“Without fair pay we run the risk that these shifts will go unfilled, leading to understaffed wards, burnt out doctors, and patients who suffer poorer and delayed care.”

The trust wrote to employees to apologise. The letter said: “We are committed to being open and candid with you … We have heard you.

“We recognise that the breadth of discussions around the level of risk these changes might carry were not broad enough, and that clarity of the consequent agreed exceptions, process for raising ongoing escalations and the authorisation mechanism for any enhanced rates, were poorly communicated.

“This is owned by the Trust Executive. We are sorry for any distress, upset and mistrust we have caused you.”

Doctors who attended the union meeting last week agreed to stop working overtime from the next day.

Several doctors at the trust, which runs the Queen Elizabeth, Good Hope and Heartlands hospitals in Birmingham as well as Solihull Hospital, told the BBC the decision had already impacted patient safety in intensive care.

UHB responded to concerns to say it needed to reduce the “unsustainable” amount of money spent on extra shifts.