Today I have attended the BMA’s consultant contract road show in Liverpool for an update from the BMA on the consultant contract negotiations.
The negotiations have centred around three major points:-
Unsocial hours arrangements
The government have insisted upon the new contract removing the clause in the consultant contract (section 3 paragraph 6) that allows consultants to opt out of elective work within premium time (Saturday and Sunday). The issue that the BMA have with the removal of this clause is that it would potentially double up the number of weekend workers. This has lead to the BMA suggesting the following safeguards:
All work in premium time would prioritise urgent care over elective. No changes to consultant job plans to include weekend elective activity without a departmental consultant majority in favour of doing so, limits to number of weekends worked in either elective or urgent care to 13 per year (can be single day weekends e.g. working Saturday but not Sunday would still count as one of the 13 weekends), ensure adequate rest post premium time shift and adequate occupational health provision for consultants who feel unable to work nights or weekends.
Outstanding issues in this bracket are that the BMA wish to ensure that any consultant working >1/10 on call rota should not be asked to undertake more weekend work.
As with the junior contract the figures are not confirmed or likely to be right but at the current standing the consultant pay scale would change significantly. At present a new consultant can expect to start on around £80,000 per anum rising incrementally year on year until the fifth year as a consultant. At this stage the increments become longer rising at a further 3 points creating an 8 point pay scale. Under new proposals the starting salary would drop to £71,000 (possibly £75,000 situation unclear) which would remain static until year five. At this stage there is a progression gateway assessed based upon things like appraisals, audits, research, numbers etc. you would progress onto the second pay point at around £99,000. This overtakes the old contract and by front loading the pay the lifetime earnings remains essentially the same.
The second area for pay arrangements is in the form of clinical effectiveness awards. These are unique in the public sector in that they are regular payments that are pensionable. NHSE and the DH want to remove them and replace them with a rolling award that can be retained or lost. This would be for either individual, team or organisation excellence for a maximum term of 6 years.
Unsocial hours payments
This will be consultant specific. The BMA & DH have thrashed out a complex matrix that will look at your on call commitments (1/4, 1/5-1/8, >1/9 or no on calls) then look at the average hours per week worked on call (i.e. in hospital) creating an additional part of the salary. This is both an availability allowance and an hours worked allowance.
Study leave is to become standardised and all courses or conferences required for appraisal from departmental lead or appraiser would be fully funded. Also improved access to study leave.
A minimum of 2 supporting clinical activity sessions (SPA) for new starters would be allocated however there were reservations from the crowd that SPA sessions were being turned into clinical sessions due to waiting lists and backlogs.
Lastly the BMA have requested better access to sabbaticals for consultants in order to make the process much more accessible.
The potential gains for consultants include:
Contractual safeguards for out of hours working
Faster pay progression
Improvement to the number of SPA sessions
Money shifted into basic pay from other areas
The Potential losses for consultants include:
Loss of the opt of weekend working
Replacement of clinical effectiveness awards
Uncertainty over earnings