Joint contract implementation teams protocol
10 May 2004
Dear Colleague
Following the letter of 25 March 2004 from the Minister of State for Health, John Hutton, and the Chairman of the BMA's Central Consultants and Specialists Committee (CCSC), Paul Miller, which announced the establishment of joint Consultant Contract Implementation Team (CCIT) and CCSC teams to help NHS organisations resolve outstanding difficulties with local implementation, the attached protocol has been developed between the BMA and the CCIT to set out how these teams will operate.
If you have any questions concerning these joint implementation teams please contact the CCIT at CCITEnquiries@doh.gsi.gov.uk or the CCSC at info.ccsc@bma.org.uk or tel: 020 7383 6838.
Yours faithfully
Martin Woodrow
CCSC Secretary
CCSC-CCIT Joint Implementation Team Protocol
Protocol to help trusts, PCTs and health economies resolve outstanding difficulties on local implementation of the consultant contract
1. Introduction
1.1 In their letter of 25 March 2004, addressed to SHA Chief Executives, The Rt Hon John Hutton, Minister of State for Health and Dr Paul Miller, Chairman, BMA Central Consultants and Specialists Committee (CCSC) announced that the CCSC and the NHS Modernisation Agency’s Consultant Contract Implementation Team (CCIT) would make available a joint team to work with NHS organisations to help them resolve any outstanding difficulties on local implementation.
It is important that all parties are clear as to the purpose and remit of this process and this protocol seeks to provide that clarity.
1.2 The joint teams will be able to consider contract implementation issues related to consultants working for NHS employers in England (whether directly employed or working under honorary contracts).
2. Aims:
2.1 The aims of this support process are:
- to encourage a partnership approach to job planning and implementation of the new contract
- to facilitate the process of resolving local difficulties
- to look at relevant policies, procedures and training, not individual job plans, but generic issues around job plans
- to advise NHS organisations on related best practice
3.1. Referral
3.1.1 It is expected that referral will be made jointly by the employer and the Local Negotiating Committee (LNC). In Trusts without an LNC the second joint referring body shall be the medical staff committee (or equivalent) or in the absence of any such body a BMA Industrial Relations Officer (IRO).
3.1.2 Should a circumstance arise where reasonable efforts have been made locally to engage the other part but have been unsuccessful, either side may engage the “good offices” of a CCIT/CCSC team. In such circumstances the joint team will seek to broker agreement to a referral. This must not be used as a mechanism to delay or bypass the normal local arrangements, including engagement with the Strategic Health Authority.
3.1.3 Both the employer and the LNC shall provide a written statement setting out their perception of the nature of the problem and outlining what steps have already been taken to resolve the issue.
3.1.4 Trusts seeking support from CCIT/CCSC must be able to demonstrate that they have previously sought advice on the difficulties in question from the SHA. (It is expected that local and health economy-wide support be available). Consultants and LNCs must first have sought advice from their IRO.
3.1.5 The referral can be made to the BMA CCSC or to the CCIT (or both simultaneously). All referrals will be referred on to the other organisation if not initially referred to both.
3.2. Acceptance of a referral
3.2.1 All referrals received by either CCSC or CCIT will be considered in the first instance by Martin Woodrow on behalf of the BMA and either Dr Liz Scott or Dr Ashley Fraser on behalf of CCIT. The CCSC and CCIT together will determine at their joint discretion whether or not to accept a referral.
3.2.2 The criteria for acceptance are as follows
- There is evidence of a significant difference of opinion between the Trust management and the LNC that it has not been possible to resolve through the normal employee relations machinery at a local level and where the issue(s) extend beyond isolated individuals.
- There is evidence that the Trust or the LNC has apparently adopted an aberrant, perverse or inappropriate interpretation of one or more of the terms and conditions of service.
- Excessive and unjustifiable delay by either side.
4. Supporting team
4.1 Once a referral is agreed as appropriate for joint support from CCIT/CCSC, a team will be assembled to provide the support and terms of reference will be agreed by the CCIT/CCSC team in consultation with the parties.
4.2 No visit to, or involvement with, a referred Trust will commence until terms of reference have been agreed and all supporting information has been received.
4.3 The Trust will be required to identify a lead Executive Director and the LNC to identify a lead consultant. These two individuals will be the first points of contact for CCIT/CCSC.
4.4 The supporting team will have two co-leaders, one from CCSC Reference is made throughout this document to the CCSC. It is understood that, where the referral relates to the honorary NHS contracts of medical academic staff, then the BMA’s Medical Academic Staff Committee will provide the lead BMA member and, where it relates to community or public health consultants, the Committee for Public Health Medicine and Community Health will do so. and one from CCIT. Each team will normally consist of two people from or nominated by CCSC and two people from or nominated by CCIT, although the co-leaders are able to co-opt additional members as they deem appropriate.
4.5 It is for the co-leaders to agree with the NHS organisation how the support process will be undertaken, including the production of any note of agreed outcomes.
5. Terms of Reference
5.1 Terms of reference will be agreed between the supporting team and the parties. The terms of reference will direct the operation of the team and will focus on helping organisations find solutions to job planning and contract implementation problems.
6. Process
6.1 The support may include any or all of the following to identify problems and help organisations find solutions:
- A review of the Trust’s Implementation Plan to identify risk factors affecting contract implementation and benefits realisation
- A review of the Trust’s job planning training and procedures
- A review of the Trust’s financial assumptions and costing, and assistance in understanding the national assumptions
- A review of the extent to which the Trust has utilised evidence-based practice from other areas.
7.1 The parties will normally provide all necessary supporting material no later than 10 working days prior to the CCIT/CCSC team visit. This will be agreed in advance between the CCIT/CCSC team co-leaders and the Trust lead, and will be sent directly by the Trust to the CCIT Business Manager and Martin Woodrow at the BMA.
7.2 Supporting material may include:
- Organisational structure charts
- Trust business plan/LDP
- Funding assumptions and calculating spreadsheets
- Implementation plan
- Local job planning policies and procedures
- Training programmes for medical managers
- Evidence of job planning training
- Consultant contract policies, procedures and documentation
- Other information or materials as necessary
9.1 A verbal report will be provided to the lead Executive Director, the lead consultant, the SHA and the IRO as soon as possible. This will normally be followed up by a written report.
9. Expenses and Time Off
9.1 The Trust shall pay the reasonable travel and subsistence expenses of the visiting team. It is expected that any member of the support team who is a NHS employee shall be granted reasonable time off with pay for this activity.
Paul Miller
Jonathan Fielden
BMA, CCSC
Ashley Fraser
Liz Scott
CCIT