Hospitals are being urged to urgently offer senior doctors salary top-ups to avoid an NHS crisis this winter.
NHS Improvement, which oversees how NHS trusts are run, wants hospitals chiefs in England to adhere to guidance brought in amid the pensions fiasco.
It says all hospitals should be giving cash to doctors who have quit the retirement scheme out of fear of high tax rates on their pensions.
The arrangement would mean doctors don't lose out on employer's contributions, which are worth 20.6 per cent of the pensionable salary.
But data obtained through Freedom of Information requests show the majority of hospitals are not offering the flexible pension policy.
Hospitals are being urged by NHS Improvement to immediately offer senior doctors salary top-ups to ease pension reform tension before a winter crisis
The Hospital Consultants and Specialists Association (HCSA) sent a request to all 153 acute trusts and foundation trusts.
Of the 108 which responded, just 10 trusts had a pension recycling policy, reports the Financial Times.
The HCSA has now said hospitals should be forced to offer cash payments, which are currently a voluntary policy.
This would be in lieu of employer pension contributions that they are no longer receiving - currently worth 20.6 per cent of their salary.
Claudia Paoloni, president of the HCSA, said: 'We have long warned that Treasury inaction on the pension crisis will fuel a winter crisis.
'And it seems that this is now dawning on the NHS at the highest level.'
Pauline Philip, NHS Improvement's director of urgent and emergency care, said: 'We are now signalling our expectation that trusts that have not done so already should make immediate use of the flexibilities available.
'Our most significant shared challenge relates to workforce availability — particularly nursing, and also the continuing impact of pensions taxes on doctors.'
Tens of thousands of staff have refused extra shifts out of fear the extra income will trigger hefty pension tax charges.
Patients across the country are already facing delayed, or even cancelled operations, because of crippling staff shortages in the NHS.
And waiting times are expected to get worse - the British Medical Association (BMA) warned yesterday the NHS will face its worst winter ever.
Ministers promised to reform the flawed pensions scheme in August. Under the existing system, introduced in 2016, anyone on more than £110,000 a year faces being hit by punitive tax bills.
GPs and surgeons earning six-figure salaries are among the hardest hit. Many have cut down on their hours to reduce the payments.
In fact, many senior doctors have stopped working extra shifts, including filling gaps on staff rotas.
The NHS Confederation, a body which represents leaders across the entire health system, has repeatedly called for