Junior Doctors Contract BMA Review

BMA JDC Meeting

December 2018

Back to the BMA Junior Doctors Committee (JDC). I have been away for a year and there was one massive change since I left. There are now 4 surgical trainees in the room! Admittedly I am one of them and the ASiT rep is another but that is still significant progress.

Winter Pressures Crisis – Dr Sarah Hallet, chair of Education and Training subcommittee, reiterated that the BMA will not condone the movement of trainees and that the winter pressure crisis was predictable. The BMA strongly condemn those responsible for the failing in workforce planning.

However, the BMA accept that this is likely to happen irrespective of the BMA issuing such a statement. As such they have provided some guidance on what to do if it happens to you. The key points are;

  1. Your current indemnity should cover you but contact your indemnity company

  2. The trust must be in OPEL 4 before moving trainees, having exhausted all other measures first.

  3. Any movement of trainees must be passed through the Postgraduate Dean for your region

  4. Trainees must only be moved to areas where they feel competent and safe to work, there is an expectation that if a trainee says they are not competent for that duty then that will end the matter

  5. Any and all missed training opportunities should be exception reported to provide documentation for ARCP and potential punitive action against poorly performing trusts

The published statement is here.

With regards to Orthopaedics I asked about safeguards for craft specialties where we are heavily hit at both Core and Specialty training levels. Our Core trainees are easy targets to be moved as their curriculum states they should be able to manage the acutely unwell medical patient meaning they should be competent to cross cover A+E. For specialty trainees the main problem is movement and cancellation of training lists as we saw across the country last year. Dr Hallett is aware of these issues and they are making up a large part of the BMA working group looking at winter pressures.

BOTA and AsiT have since issued a statement which can be found here.

Foundation Programme review – The Foundation Programme is currently being reviewed and we were given an update on what may happen. There is particular interest in the F3/4 years that so many people take before moving in to core training. This is common in surgical specialties and there are thoughts that supporting these years centrally would be beneficial. The idea of a well organised, optional, LTFT F3 year with funding for further qualifications such as a PGCert may appeal to many and work to keep them in the UK. The BMA will continue to resist any move to lengthen mandatory time in the foundation programme.

There was also discussion about the necessity of recruiting people into hard to fill places. The main discussion here was around incentives. This has been trialed, where trainees get £7000 per annum (pro rata for 6 months), to train in Carlisle at present.

2018 Contract Review – The 2016 Junior Doctors Contract in England is currently being reviewed. The BMA recently ran a survey of junior doctors working under the 2016 contract in England to get their opinions on where the contract is performing well and where it can be better. This was open to all junior doctors, not just BMA members.

Working on this the JDC have broken it down into 5 separate working groups each of which has its own priorities set by a vote amongst the JDC executive. The working groups are

  1. Workforce

  2. LTFT –

  3. Pay –

  4. Safety and wellbeing

  5. Training and education

Some of these issues are being resolved in consultation with the government. Of particular relevance to us is the senior decision maker allowance, pay protection and NROC payments. The senior decision maker allowance is likely to be introduced as a fifth nodal point in the contract for senior trainees.

There are still ongoing discussions around when pay protection will be extended to. For those of us on the 2002 contract this is key as we could potentially take a large pay cut in a years time when it runs out. However, the JDC are fairly confident that this is something the government recognises and may be willing to address, with more updates to follow during negotiation in the new year.

Non Resident on Call (NROC) is another issue being discussed. This is a difficult issue as both sides agree that the current system of NROC payments does not work but it is difficult to find an acceptable system. If anyone has any good ideas then please bring them to me or your local BMA rep.

Some of the other issues where progress is being made include moving towards annual leave being calculated on a hourly basis, how the government’s pledge of £10 million for facilities should be allocated, ensuring that rotating trainees are protected in the same way permanent staff are with regards to parental leave and LTFT training and clarification of acceptable rostering guidance. This is a long slow progress, but improvements are being made to the contract and the JDC team are continuing to work very hard at this. Any items not agreed by both sides in the review process will be put forward for the respective teams to review in the formal negotiations in the new year.

DDRB – Earlier this year the Doctors and Dentists Review Board proposed a derisory pay increase for doctors to the government. The JDC have condemned this heavily and called for the DDRB to be drastically overhauled. It was initially set up as an independent pay review body but, is felt to have become heavily influenced by the government. The BMA as a whole have decided to continue engaging with the DDRB in a limited capacity for now but are keen to see reform at the DDRB prior to future recommendations.

Today JDC voted to put forward a protest statement to the DDRB for 2019. The language of this is yet to be agreed but will lay out the level of pay erosion we have suffered against inflation and request that our pay is bought up to redress this. The hope is that the other branches of practice within the BMA will do the same and this show of unity and dissatisfaction will help to nudge the DDRB to reform.

This is just a summary of the main issues discussed in the meeting. I would like to say that the current BMA JDC group are clearly working very hard and seem to be making good progress at trying to improve the lives of junior doctors across the whole of the UK.