Following the agreement reached on the junior doctors' contract we have updated our FAQs. This web page will feature the most frequently asked questions from employers and will be updated regularly. FAQs for junior doctors on the new contract can be found on the BMA website.
1. Should I be implementing any aspect of the junior doctors’ contract?
No. NHS Improvement wrote to HR and medical directors on 20 May asking that they continue to suspend work preparing for the introduction from 3 August of the contract published on 31 March. This position will not change until the results of the BMA referendum are known. The only exception to this is the appointment process for the guardian of safe working hours.
2. Will the new proposed new contract still be cost neutral?
Yes, overall the proposed new contract remains cost neutral other than additional pension costs to the NHS resulting from the increase in basic pay. There will, however, inevitably be some variation in costs seen at the individual employer level. Additionally, the Secretary of State has confirmed that accelerated training support will be separately funded from outside of the pay bill.
3. What can employers be helpfully doing between now and the outcome of the BMA referendum?
We very much welcome the agreement that has been reached on the proposed new contract and need to ensure that the BMA now have sufficient time to have a full and fair conversation with their members ahead of their referendum. This is why NHS Improvement has asked trusts to suspend work on preparing for the introduction from 3 August of the contract published on 31 March. Employers can helpfully facilitate this conversation by ensuring that as many doctors as possible are released to attend the regional events now being organised by the BMA. These will be advertised through normal BMA channels.
It is important that trusts resume with the appointment of the guardian of safe working hours and local BMA representatives have been asked by the JDC to support this process. The guardian should be appointed before 3 August.
4. Where can doctors get advice on the proposed new contract.
The BMA will be supporting their members with online information, a series of local roadshows, and through their normal communications channels and representative structure. Doctors, including those who are not members of the BMA, may still contact their own employer if they have questions about the contract. NHS Employers will be supporting employers to understand the new contract proposals through our normal channels but will not be able to answer queries from individual doctors at this time.
5. I need to start pre-employment checks now for new Foundation Year 1 doctors. How can I do this?
All new appointees to the first year of the Foundation Programme (F1 appointees) will be required to take part in a period of shadowing prior to starting work as a Foundation Year 1 doctor on 3 August 2016. As in previous years, this period of shadowing will need to be contracted for separately – either under a standalone contract of employment (on the existing 2002 contract terms) or under a contract for training as recommended by NHS Employers. Employers will need to undertake normal pre-employment processes to support the engagement of an F1 appointee for this shadowing period.
6. Can I resume any other work that would help my organisation to prepare for the implementation of the proposed new contract before the outcome of the ballot is known?
There is a clear agreement from all parties in the ACAS agreement that work to introduce the 31 March 2016 contract should now cease, with the exception of the appointment of the guardian of safe working hours. However, while not pre-empting the outcome of the BMA referendum, it is also important to all parties involved that, should there be a positive outcome to the referendum, employers are as prepared as they can be to proceed with the smooth introduction of the proposed new contract.
There is, however, work that employers will still need to do as part of their normal business processes. Some of this may also help employers to be prepared for the work that may be required following the referendum. This might include:
- financial modelling that could include the pay scenario outlined in the proposed terms and conditions
- normal annual / rolling review of current rotas which may also identify those rotas that would require amendment to comply with the proposed terms and conditions
- curriculum mapping to ensure that posts continue deliver the required learning outcomes as defined in approved specialty curriculum.
We would encourage employers to undertake such activities with sensitivity to the roles that their junior doctors might normally play in this work, and focus more on the preparation that can be done to facilitate effective engagement after the referendum result is known.
7. What process should we follow for the appointment of the guardian of safe working hours?
The following principles should be taken into account in appointing to the role:
- It is the employer’s responsibility to appoint the guardian.
- The appointment panel for the guardian should include the medical director or a nominated deputy, the director of HR/workforce or a nominated deputy, and two doctors in training, nominated by the local negotiating committee (LNC) or equivalent. At least one and if at all possible both of the doctors in training must be based in the appointing employer (or host organisation, if appropriate).
- The panel should reach consensus on the appointment.
- The recruitment process for the appointment of the guardian should otherwise follow local recruitment processes.
- The employer (and/or host organisation, if appropriate) will have discretion to set the guardian’s time commitment, taking into consideration the number of rotas and the number of doctors in training for whom the guardian will have responsibility.
- Employers / host organisations can choose to act collaboratively to make and share the appointment across a number of employers.
8. How has the ACAS agreement changed the duties, responsibilities and accountability of the guardian of safe working hours?
The core role for the guardian will remain the same following the agreement reached with the BMA on the proposed new contract, although some things have changed and some additional aspects of the role have been agreed.
- The guardian will now report quarterly to the trust board, rather than annually.
- A consolidated annual report will be included in the trust’s quality account, and details of the disbursement of fines included in the organisation’s annual report.
- The guardian and director of medical education (DME) will jointly establish a junior doctors forum (or Fora) to provide quality assurance and oversight over the work guardian.
- The guardian will oversee the imposition of fines where doctors miss 25 per cent or more of their breaks.
- New arrangements have been put in place to ensure that doctors in GP practice placements or in organisations with few trainees have access to a suitable guardian.
- Doctors will have the right to involve a representative from the BMA or other relevant trade union in any work schedule appeal process.
- The guardian will be subject to a performance management framework that includes feedback from doctors in training, and doctors will be able to raise any concerns they might have about the performance of guardian through the medical director.
- The guardian's oversight of safe working practices will also include associated equality and diversity issues.
The model job description and person specification for the guardian of safe working hours has now been update to reflect these changes to the duties, responsibilities and accountability and is available to download from the NHS Employers website.
9. What support will be offered to the guardians of safe working hours prior to them starting in their role?
NHS Employers will be hosting a training event for guardians in central London on 26 July 2016. We would encourage all appointed guardians to attend and would encourage organisations who may not have appointed by this date to enable their DME or medical director to attend the event to ensure that the learning can be then shared with the successful applicant locally.