17 / 10 / 2014 12.14pm
Senior negotiators at the NHS Employers organisation have expressed their significant disappointment at a decision by the doctors’ trade union body the British Medical Association (BMA) to walk away from talks on doctors’ contracts.
The BMA’s late night announcement via social media channels on Thu 16 Oct that it had decided to cease negotiating with NHS Employers on both the consultants’ and junior doctors’ contracts, came despite an agreement only hours earlier that further joint work on the consultants’ contract would be done next week.
The experienced NHS Employers negotiating team said that the BMA’s announcement on Twitter at 9:15 pm that it was withdrawing from talks was “a complete surprise and a huge disappointment”. It was quickly followed by tweets on behalf of the BMA junior doctors’ committee that it too was to withdraw from contract discussions, without notice.
Director of Employment Relations and Reward at the NHS Employers organisation, Gill Bellord said:
“This is a hugely disappointing way to conclude a year and a half of serious discussions. All our talks with the BMA have been aimed at ensuring safer working hours for doctors in training, as well as providing them with stability of pay and agreed work schedules that take account of educational needs. Underpinning all of this is the essential need to deliver safe care for patients.
“Our work with the BMA over the past 18 months had reached the stage of detailed discussion on contract changes that are fully justifiable because they would enable employers to organise clinical services so that patients can access high quality services every day of the week. Throughout all of these negotiations, we have been offering safeguards to protect the wellbeing of individual doctors, so it is a source of personal and professional disappointment that the BMA team feel able to throw our joint progress so far out of the window, and to walk away from what is currently on the table.”
The offer relating to the consultants’ contract which the BMA has walked away from includes:
- maintaining a negotiated national framework and the BMA’s role in collective bargaining
- a maximum 40-hour contract, unless extended by mutual agreement
- no requirement for the majority of consultants to be contracted for more hours than they are currently contracted for
- maintain the current lifetime earnings potential
- accelerated access to higher pay - consultants will be able to access higher levels of pay earlier in their career than is possible under the current pay scales, as long as they meet all necessary access criteria
- introduction of a fairer way to reward consultants who work frequent and intense shift patterns
- continued access to a national clinical excellence award (CEA) scheme, by competitive application
- transitional arrangements that provide protection to existing pensionable pay
- local clinical excellence awards to be incorporated into the consultants’ contract as part of revised performance payments structure. As this will be a contractual entitlement all consultants will be considered for a pay award against jointly agreed access criteria
- jointly agreed safeguards (set out in the contract and supported by jointly agreed guidance), to ensure consultants are provided appropriate protections where service changes are necessary to deliver seven day services
- a commitment to move towards consultant-led services which will require a growth in the consultant workforce
- greater emphasis on clinical engagement when determining service delivery priorities with a duty to consult being placed on employers
- strengthens the job planning process and puts it at the heart of the process for determining the appropriate clinical activity to support local service delivery
- limits the number of weekends that consultants will need to be available for work, without mutual agreement
- maintain an environment where education, training, innovation and research by both NHS and academics can flourish
- no changes to any of the core contractual entitlements – including redundancy, maternity, sick pay, leave entitlements, requests for flexible working.
The current offer on the table for the junior doctors’ contract includes:
- an hours-based model of pay, with pay relating to work done
- increased basic pay
- pay progression linked to accepting a post at a higher level
- pay protection during transition
- a basic full-time working week of 40 hours
- maximum hours of 48 per week on average, and a cap of 56 hours per week on average for doctors who opt out of WTR
- an extension of plain-time working, with a higher rate for unsocial hours - the degree of extension and the rate for unsocial hours had not been decided and was still under discussion
- an on-call availability allowance
- a maximum of 72 hours in any seven consecutive days (lower than the limit suggested by the BMA)
- no more than four consecutive night shifts
- no more than five consecutive long day shifts
- a work schedule for each post, mapped to the curriculum and setting out both training opportunities and service commitments. This would be personalised to the job holder and reviewed regularly and also on request
- system for reporting exceptions (eg work overruns) which would trigger a work schedule review
- system for resolving work schedule issues, including appeals process
- business travel expenses in line with Agenda for Change, but also retaining the provisions on relocation and removal expenses for trainees
- removal of the current four-month eligibility period for sick pay
- a joint commitment to press for better information for trainees ahead of their placements. This cannot technically be done via the contract but is a priority for employers as well as trainees
- potential to increase pay via work schedule review where there is a regular requirement for additional hours.
A spokesperson for the NHS Employers organisation said it expects that, as a consequence of the BMA’s actions, the Department of Health is likely to want to consider what steps the Government can and should take to move forward, and that local employers are also expected to consider whether they need to make changes to both contracts by other means. The NHS Employers organisation will make a formal report to health ministers in the coming weeks.