Negotiating new contracts for doctors through a pandemic

Kathy McLean, Chair of University Hospitals, Derby and Burton and Non-Executive Director, Barts Health NHS Trust.

In this blog, Kathy describes her experience as management side chair for the SAS contract negotiations which started in February 2020 and continued throughout the COVID-19 pandemic. 

When I was asked to chair the management side team, for the negotiation of a new contract for specialty and associate specialists (SAS doctors), I had no idea that a pandemic was about to disrupt the way we would work.

Contract negotiations are usually done face to face in an intensive series of meetings. After only two face to face meetings restrictions to stay at home were put in place. This meant that our negotiations had to move to an online space or would need to be paused, for what we thought might only be a short time. There were no examples to turn to and so we had to decide on the best approach through our own discussions.

Across the NHS, many national pieces of work were placed on hold so efforts could be devoted to supporting the COVID-19 pandemic. We also considered whether, in this context, this work should continue. However, we all felt a real commitment on behalf of the doctors, patients and employers to do our best to press on.

Once we had made the decision, it didn’t take long for us to get into our stride in a new virtual negotiations space. There were concerns at the start whether it could even be possible to negotiate virtually, but we became increasingly competent at preparing at our pre-meets and respectfully negotiating in joint meetings with the BMA. 

National negotiations are always an intense period, meeting every two weeks, with a large amount of work going on behind the scenes to allow us to have informed discussions. We recognised that individuals, especially clinicians, had enormous work pressures in their own organisations and we had to be accommodating to those priorities. At every meeting we reviewed the feasibility of continuing and the attendance by both teams was remarkable.

We rapidly discovered there were some benefits to working online. Meeting on MS Teams provided us with much more flexibility. It enabled colleagues to attend for all or part of the meeting, where they might not have been able to do normally if it meant getting on a train to London or Leeds. It also allowed us to communicate with members of the team during the discussions which is not usually possible without taking breaks. Virtual negotiations of course had its drawbacks too, including missing out on the personal relationships we would have built over the break periods, the numerous hours of staring at a screen and the challenge of not always being able to gauge the room and how particular conversations were landing.

To overcome some of these obstacles we put other measures in place such as smaller chairs and secretariat meetings. These took place in the morning of negotiation days and in between the sessions, which helped us to build relationships, understand the position both sides wanted to achieve and to focus the main meetings. I held regular phone calls with my co-chair from the BMA to reflect on meetings and discuss some of the more difficult or sensitive issues. Building trust was a key part of the process.

Moving away from the logistics of negotiations and the added complexities of the COVID-19 pandemic, I think both parties should be very proud of what they achieved. The negotiations were undertaken in the spirit of partnership working, with both sides wanting to achieve a contract that worked for doctors, patients and employers. The timetable was extremely challenging but there was mutual determination to meet it and work together.

Whilst there is only so much a contract of employment can achieve, we were all fully aware of the challenges that the SAS workforce face. Where it was possible and appropriate, the teams tried to look beyond the terms and conditions, to acknowledge the cultural changes that need to occur. I hope that some of the changes we have implemented help to start some of the wider conversations that need to follow.

Looking back a year I am impressed with the way we were able to adapt to virtual negotiating. It is fair to say that there were times when I did not think or believe we would have the new SAS contracts published and ready for implementation from April 2021.

I am sure it has saved a lot of the usual associated costs, reduced travel time and was completed more quickly than most negotiations. It was a strangely enjoyable experience and I pay tribute to both the NHS Employers and BMA teams. 

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