What does the DDRB report say about NHS Employers proposals for the reform of the contract for doctors in training?
The DDRB was asked to make recommendations on new contractual arrangements for junior doctors, including a new system of pay progression which better links performance with pay. The DDRB are supportive of the proposals, as reflected in their recommendations highlighted here.
What does the DDRB report say about NHS Employers proposals for the reform of the consultant contract?
The DDRB was asked to make observations on the reform of the consultant contract to better facilitate the delivery of health care services seven days a week in a financially sustainable way. The DDRB are supportive of the proposals, as reflected in their recommendations highlighted here.
What was the government’s response to the DDRB report?
The government are supportive of the DDRB recommendations and now want to proceed to implementation of new contracts. This will require a new consultant contract for new starters to be implemented on 1 April 2016 and a new contract for doctors in training from August 2016.
What are our immediate next steps?
We will seek to discuss the conclusions of the DDRB report and the government’s response with the British Medical Association (BMA) at the earliest opportunity, with a view to seeking agreement on the implementation of our proposals, in line with the DDRB conclusions.
The government have set out a timetable to seek agreement with the BMA on the implementation of the proposed changes. This engagement will need to be concluded by September 2015 to allow for implementation against the timetable noted above.
What can your organisation do now?
The NHS must make best use of current resources to maintain and improve the quality and safety of patient care while managing ever increasing demand. Much of the current debate is focused on systems and structures and other longer term transformational change to safeguard the future of the NHS. However, for many trusts, the challenges are more immediate.
Employers should be doing a number of things:
- continue to use existing contractual mechanisms to help managers and doctors to work together to secure the best possible services for patients within the resources available to them. Employers must continue to assess whether they are using the provisions of the current contracts to maximum effect
- examine local capacity issues in respect of managing the introduction of new starters on the new medical contracts in line with the proposed timetable. NHS Employers will provide any necessary implementation guidance but this needs to be supported locally by staff engagement activities. The new arrangements are likely to cause some staff concern and this anxiety will need to be mitigated as far as possible
- medical staff leads need to develop and maintain links to existing medical personnel manager networks. These networks should be sources of helpful advice and support as our implementation plans develop
- beyond this initial implementation phase employers will also need to consider how they adequately support the increased level of investment required to effectively manage the range of medical contracts that will be in place. It is probable that for a period of time at least, employers will need to manage staff on the same grade with different contractual terms
- where employers have already moved to the introduction of local contracts for new starters (relevant to the consultant workforce where the provision that allows consultants the right to refuse non-emergency work out of hours has been removed) consideration will need to be given to any recruitment exercises that need to take place before the introduction of the new national contracts.
What impact will the DDRB conclusions have on industrial relations?
We will need to await the outcome of discussions with the BMA before commenting. We have a shared principle that patients deserve the same high quality of care across the entire week and our preference is to work in partnership with the BMA to give effect to the DDRB conclusions.
What will be the benefits of new contractual arrangements for employers?
Employers face a challenging environment as they seek to deliver efficiency challenges and generate more value from taxpayers’ investment in the NHS. Our proposals enables employers to access a reward system that better enables them to plan and deliver consistent high-quality services every day of the week.
Our proposals aim to make the consultant contract more supportive of the delivery of seven-day patient care and to make them financially sustainable for the future. They will also enable more effective support of junior doctors and dentists in their training and development during evenings and weekends.
What do you say to BMA claims that these proposals will result in unsafe care
We do not accept the BMA's statement that our proposals 'could jeopardise the safety of patients and doctors'. As our evidence to DDRB shows, patient safety is central to our proposals and doctors will continue to be afforded appropriate workplace protections and reward structure.
These safeguards range from the protection of existing contracted hours, the introduction of limits to protect against the most onerous working patterns and jointly agreed guidance to support the implementation of the new contractual provisions. Our proposals offer safeguards which go beyond those offered to non-medical staff under Agenda for Change terms and conditions of service, but only where it can be objectively justified. Details of the full set of our proposed safeguards can be found in our evidence to DDRB here.
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