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Letter to Directors of Public Health England about Commissioning a Patient Led NHS – PCT reconfiguration

April 2007

Dear Colleague

Commissioning a Patient Led NHS – Primary Care Trust (PCT) Reconfiguration

As you are aware the reconfiguration of PCTs and the appointment of Directors of Public Health (DsPH) are currently taking place as a result of Commissioning a Patient Led NHS (CPLNHS). The CPLNHS Human Resources Framework (HR), published in December 2005, provided overall guidance for addressing the HR implications for the reorganisation of Strategic Health Authorities (SHAs) and PCTs. Paragraph 61 of the Framework referred to additional HR guidance for the appointment of DsPH, with the result that in June 2006 a supplementary HR Framework was published which was an agreed joint document between NHS Employers and the Trade Unions (including the BMA).

The appointment process for PCTs is based on the new configured SHA. Reconfigured PCTs are due to be established on 1 October 2006 and as a result those of you who are DsPH will be going through or will have gone through a recruitment process already. In terms of the appointments process the HR Supplement states:

All substantive DsPH in those PCTs which will cease to exist on 30 September 2006, will be required to apply for a DPH post(s) in a new reconfigured PCT(s) within the new SHA area, unless the post:
as described in paragraph 68 of the CPLNHS HR Framework, is not changing from the one to which the individual has been permanently appointed, through national, open competition and appropriate AAC processes (for example, the geographical area of responsibility remains exactly the same);

or, unless the individual:cannot meet the condition outlined in paragraph 22;

• has opted into an alternative PCT director pool (i.e. other than DPH);
• has opted into a pool at the tier below PCT director level in line with the provisions of the CPLNHS HR Framework;
• has resigned from his or her post;
• has volunteered for redundancy and had the application accepted.

The process should be in line with the NHS (Appointment of Consultants) Regulations 1996 and Advisory Appointments Committees (AACs) will apply. Where the appointment is being made jointly with one or more local authorities, the appointments panel must include appropriate LA representation in line with the NHS (Appointment of Consultants) Regulations 1996.

The Framework stipulates that there will be three outcomes for candidates arising from the selection process:

• Some DsPH will be appointed as designate DsPH for the new PCTs and will take up posts on the establishment date of the PCT(s);
• Some DsPH will be offered a post, subject to the condition of achieving the appropriate registration
• Some DsPH will not be appointed. In line with the CPLNHS HR Framework, these individuals are guaranteed employment until the end of June 2007 (or until the end of March 2007 in the case of SHA DsPH) to maximise the chances of finding alternative employment.

Since the publication of the Framework, the Committee of Public Health Medicine and Community Health (CPHMCH) has been active in lobbying the Department of Health and the CMO as well as the recently appointed DsPH for the Regions and SHA HR Directors to ensure that those of you who are DsPH and who are unsuccessful in the application process for DPH posts will be able, should you so wish, to secure consultant posts. We are also seeking clarification from the Department and taking legal advice with regard to redundancy arrangements and how and when they should apply.

In the regions, the BMA has been involved in local joint consultation arrangements through SHA HR cluster groups. If you are not aware of what is happening in your area I would urge you to contact AskBMA 0870 60 60 828 which will direct you to your BMA regional centre to find out more.

Individual DsPH and consultants who are members of the CPHMCH are, of course, affected by this reorganisation and therefore share the same concerns as their colleagues across the country. It is therefore vital to have the support of your trade union and professional association at this time and we urge members who have such concerns to get in touch with their regional centre through AskBMA and for non members to consider joining the Association which you can do by contacting 0207 383 6176.

I hope this is helpful.

Dr C Spencer Jones
Yours sincerely
Committee for Public Health Medicine and Community Health