Consultant Contract. Position as of September 19 th 2015 Peter Maguire, BMA Specialty Lead for Anaesthetics, AAGBI Linkman Meeting

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1 Consultant Contract Position as of September 19 th 2015 Peter Maguire, BMA Specialty Lead for Anaesthetics, AAGBI Linkman Meeting

2 Background Negotiations on Consultant Contracts paused in October 2015 DoH (England / Wales / Northern Ireland) and NHS Employers referred the contractual situation of seven day working to DDRB DDRB reported July 16 th 2015: Parliamentary Summer Recess

3 DDRB Report Independent Report Some aspects liked (especially the need for contractual safeguards on working hours / need for rest) BMA keen to progress safeguards with contractual surety Other aspects less palatable Contained Observations and Recommendations

4 Political Situation SoS for Health, England, Jeremy Hunt required rapid response to this report or a move towards imposition of a new contact Political deadline announcement relating to health / NHS / contract changes at Conservative Party conference in Manchester 3 rd / 4 th October 2015 Absolute red line the removal of Schedule 3 Paragraph 6 from current and future consultant contracts Tight deadline for scoping / initial meetings / potentially negotiations

5 Schedule 3 Paragraph 6 Specifically allows consultants to opt-out of elective / routine work at weekends / unsocial hours. Range of views within BMA some see it as verging on irrelevant (Anaesthesia) since consultants already busy covering emergency work and no capacity to do extra work. Others see it as the only barrier to being overworked, especially at weekends Politically would be a game changing announcement if removed Practically would change the way waiting list initiatives are used and paid for

6 What would a seven day service look like? BMA supports seven day Urgent and Emergency Care Does not support seven day Elective Care Where will finances come from for elective work? Where will finances come from for support staff / infrastructure? Is an elective service a good use of resources? Is this an attempt to dismantle / restructure the NHS Massive reconfiguration of service where will blame lie???

7 Timetable (Consultants) Initial Secretariat / Staff meetings High Level Meetings CC Officer Meetings with NHSE / DoH BMA / NHSE / DoH August 26 th Initial formal CC Executive Meeting On the table 4 days of joint meetings September 2 nd 9 th 2015 CC Meeting 10 th September Next Steps

8 Absolute Deadline Friday 11 th September By this date there must have been agreement to relinquish S3P6, effective immediately There must be a series of negotiations to agree Pay Reform Pay Progress Safeguards Seven Day working CEAs Conclusion December 2015 Ballot January 2016

9 New Contract Implementation April 2016 Failure to agree: Forced implementation of new contract for new start consultants Those in post: May remain on current contract (with incremental progression) but no pay uplift, removal local CEAs, enforced move to new contract if moving to a new job

10 Pay on a New Contract Lower basic pay for new start consultants Perhaps no access to rewards scheme in first 5 years of employment? Is this a Sub-Consultant Grade???

11 Pay Scales To be finalised? Lower start salary Perhaps 70 After 5 years access, related to performance, targets to a single higher salary point Perhaps 90 Significant change to administration of CEA replacement locally and nationally

12 Views within BMA Concern for future consultants Concern for those with local CEAs Separate issue for NI as these have not been awarded for years Separate issue for NI Devolution on verge of collapse Wales Government side involved, BMA side not involved Should we be talking at all given the extremely tight deadlines? Should we allow imposition and have a robust alternative strategy?

13 CC Meeting 10 th September Extraordinary meeting Decision on Next Steps? Engage or Disengage with negotiations? Ministerial Deadline of 11 th September (Day following meeting) Opinions of grass root doctors on social media well noted Wide range of committee member views aired Consensus difficult to achieve Between a Rock and a Hard Place

14 Background Junior Doctor Contract The DDRB report was commissioned following the breakdown in negotiations between the BMA and NHS employers. JDC had to agree to all recommendations before resuming negotiations. The JDC subsequently announced they would not re-enter contract negotiations with NHS Employers.

15 Background: Scotland The Scottish Cabinet Secretary for Health, Wellbeing and Sport, Shona Robison has stated that the Scottish Government will not seek to impose a new contract on junior doctors.

16 JDC concerns with DDRB Over 99% of the 4500 doctors who responded to a BMA poll felt that the recommendations were not acceptable. Three red line issues for the JDC were: The extension of routine working hours (evening and Saturday) Reduction in pay progression Removal of safeguards

17 Safeguards Key JDC argument is the removal of safeguards. Hours monitoring and banding - financial mechanism to ensure trusts do not over work junior doctors. Interestingly the heads of terms actually suggested that banding should be replaced (point 5.5). Proposed exception reporting is bureaucratic and as it stands it does not penalize employers financially.? Scope for negotiating this aspect of the contract.

18 What can the Government do? Legally the Government can impose a contract although it would probably be from August Short-term contracts will obviously be affected (change trust -> new contract). However those on longer contracts (e.g. Liverpool) are still not immune. To push this through without losing face the Government would have to garner public sympathy, i.e. demonise doctors.