The Department of Health has now published the new terms and conditions of service it plans to impose on doctors in training from August 2016 onwards. You all know about the ongoing dispute with the BMA over this. You also have access to a number of guidance documents on the NHS Employers website which explain the new terms and conditions amongst other things. But what does your organisation need to do to be ready for the new contract as it is phased in from August 2016? This alerter concentrates on some of the key things your organisations will need to do to be ready to operate the new contract.
Remember these key dates
- End of April: re-map junior doctors' rotas and amend if necessary to comply with new shift rules
- End of May: work schedules for all posts agreed and signed off;
- 31 May: pay assessed for all work schedules;
- 8 June: deadline for employers to offer jobs to doctors for August;
- July: Guardians of Safe Working in post;
- 3 August: new contract introduced for F1 (please refer to NHS Employers summary of the new 2016 contract for implementation dates for other doctors in training).
As NHS Employers acknowledge, there is much to do and little time to do it. Here are some of the key steps that you need to take:
- Plan and create generic work schedules (see paragraphs 9-15 of the new terms and conditions);
- Prepare and provide personalised work schedules to each affected doctor in training. The doctor and educational supervisor are jointly responsible for personalising the generic work schedule according to the doctor's learning needs and opportunities within the post;
- Appoint a Guardian of Safe Working Hours before August. The Guardian cannot hold any other role within the management structure of the employer or host organisation. The Guardian's appointment panel has to include the medical director or a nominated deputy, the director of HR or a nominated deputy and two doctors in training nominated by the Local Negotiating Committee (LNC) or equivalent. The Guardian has to act as the champion of safe working hours for doctors in approved training programme. More details are set out in Schedule 6 of the new terms and conditions;
- Prepare for the pay protection calculations that will need to be carried out in line with Schedule 14 of the new terms and conditions. This is done by calculating the doctor's actual total new contract pay against his/her protected level of pay. If the former is lower than the latter, the doctor has to receive the actual total new contract pay plus an additional amount in pay protection sufficient to return his/her total pay to the protected level of pay. There is a pay calculator on the NHS Employers website to assist in doing this. We know that many employers have already been modelling the level of pay protection they may need to implement. We strongly advise that those who have not done such exercises do so as promptly as possible;
- Work with your payroll function to ensure that any set-up to operate the new pay arrangements under the new terms and conditions can be run through the Electronic Staff Records. It is obviously vital to carry out dummy runs to ensure that the system is working correctly and that everyone will be paid what they are due to be paid under the new contract;
- Ensure that you are all aware of the phased introduction dates and ready to operate them for each succeeding group of doctors in training on those dates;
- Ensure systems are in place and relevant staff are aware of and operate the new arrangements applying to pay progression (which will be linked to changes in levels of responsibility under the new terms and conditions);
- Ensure that payroll and other systems are in place to operate and pay the new premium time arrangements;
- Ensure all relevant assessments are made as to what on-call availability allowance each doctor in training is due. This will depend on the frequency of his/her rota commitment;
- Put in place systems and pay arrangements to ensure that other payments under the new terms and conditions, such as pay in exceptional circumstances to secure patient safety and penalty rates for pay for additional hours in breach of the Working Time Regulations limit, are in place;
- Ensure that rosters are compliant with the new limits on hours set out in details in Schedule 3 of the new terms and conditions. Core principles are that no doctor should be rostered for more than an average of 48 hours of actual work a week calculated over a 17 week reference period, no more than 72 hours actual work should be rostered for or undertaken by any doctor in any period of seven consecutive calendar days, no shifts should be rostered to exceed 13 hours and no more than five long shifts (more than 10 hours) can be rostered or worked on consecutive days. There are other protections to ensure Safe Working in Schedule 3 which must be taken into account and complied with;
- Ensure that you review and give consideration to the suitability of the model contract for doctors and dentists in training which is again available on the NHS Employers website;
- Communicate – with your current and future doctors and dentists in training, LNC, Educational Supervisors, payroll and local BMA (who may or may not engage). NHS Employers has a Communications Plan on its website.
So, there is much to do and a narrow window of time to do it in.