Frequently asked questions about Staff and Associate Specialist contracts
March 2008
These are a selection of the most popular questions from the recent SASC Communications events. For a full list of FAQs (updated May 2008) agreed with NHS Employers please go to:
http://www.bma.org.uk/ap.nsf/Content/SAScontractnegotiationsFAQs
I am currently on an associate specialist contract of 38.5 hours per week but the new associate specialist contract is based on a working week of 10 Programmed Activities (PAs). Will my hours need to be rebased?
The existing associate specialist contract is based on a notional 38.5 hour week so it will need to be rebased to a 40 hour week, which will mean an addition of 1.5 hours paid work. If, however, you wish to remain on a 38.5 hour contract your pay will be calculated at 38.5 hours instead of 40 (0.96 WTE).
How will contracts for clinical medical officers (CMOs), senior clinical medical officers (SCMOs), hospital practitioners (HPs) and clinical assistants (CAs) be rebased?
Full time CMOs/SCMOs currently work 37 hours per week so their contracts will need to be rebased to 40 hours. If they choose to remain on a 37 hour contract their pay will be calculated at 37 hours instead of 40 (0.93 WTE).
Doctors who work part time (including CMOs/SCMOs, HPs and CAs) will be offered a proportionate number of Programmed Activities and their salary will be pro rata to that of a full time doctor.
What will happen if my current contracted hours do not exactly equate to Programmed Activities?
You can choose to take up the contract on the number of Programmed Activities (which have a nominal timetable value of four hours) and, if appropriate, half Programmed Activities (which have a nominal timetable value of two hours) nearest to your contracted hours of work.
You will need to agree with your employer an assessment of the hours that you undertake. For part time doctors transferring onto the new contract, any increase or reduction in hours will only be by agreement and will be paid appropriately. This will be undertaken as part of the prospective job plan discussion.
If I currently undertake fee paying services what will happen to these fees under the new contract?
Fee paying services are defined in Schedule 11 of both the specialty doctor and the new associate specialist terms and conditions of service. The general principle is that where fee paying services have been agreed as part of the job plan and occur within Programmed Activities then you will not be paid an additional fee. This is to avoid paying twice for the same period of time.
If you provide a fee paying service during a Programmed Activity, the default position is that the fee shall be remitted to the employing organisation (see Schedule 12 of the specialty doctor or the new associate specialist terms and conditions of service).
However, you may be able to retain a fee in certain circumstances (see Schedule 12 of both the specialty doctor and new associate specialist terms and conditions of service). For example you may be able to retain a fee if the employer has agreed that the fee paying service, (including any family planning work), carried out during NHS time causes “minimal disruption” to NHS work (this is the same for consultants). What constitutes ‘minimal disruption’ will depend upon the circumstances. If, for example, you were to see a full list of NHS vasectomy patients during Programmed Activity time, you would be expected to remit the fee to your employer. However, a single such patient added to a list may be considered by your employer to be “minimally disruptive” and you may be able to retain the fee. This example is for illustrative purposes only and will be for local discussion.
You can retain any fee that is paid for fee paying services carried out in your own time or during annual or unpaid leave. If such work is undertaken partly during Programmed Activity time and partly in your own time, a local agreement will need to be reached as to whether fees are partly or wholly retained or one or more Additional Programmed Activities allocated. For example, for work such as report writing (e.g. forensic psychiatry) relating to NHS patients.
Can I be required under the new contract to undertake family planning work?
It continues to be the case that you do not have to agree to undertake family planning work if you have ethical or other objections to doing so.
Will I be expected to work at locations other than my principal place of work?
Your principal place of work will be as set out in your contract. You may be required to work at any site within your employing organisation. This will be discussed with you and set out in your job plan.
Do I have to undertake non-emergency work out of hours and at the weekend?
For specialty doctors, it is expected that any requirement to undertake such work will be discussed as part of a job plan review. If you subsequently feel unable to agree such a job plan then you can seek mediation and, if necessary, lodge an appeal, in accordance with Schedule 5 of the specialty doctor terms and conditions of service.
For associate specialists, non emergency work out of hours and work at the weekends will only be scheduled by mutual agreement and you will have the right to refuse such work.
Under the specialty doctor and new associate specialist contracts how may I contract for any Additional Programmed Activities (APAs)?
The full time contract will be for 10 Programmed Activities (40 hours) and part time contracts will be less than 10 Programmed Activities. If you are offered and agree to undertake any APAs these will be contracted for separately and clearly state their purpose and duration. Flexibility exists for the APAs to be worked regularly or as required over the course of the year. Please refer to NHS Employers APA guidance.
If I assimilate on to the specialty doctor or new associate specialist contracts what happens to my incremental date?
If you assimilate on to the new contract you will retain your existing incremental date.
I cannot recall my incremental date. What should I do?
You should consult the relevant member of staff in your employer’s HR Department who will be able to advise you of the date that you started in the grade.
Will there be re-grading to AS after 31 March 2009 in the new contract?
No. If the new contract is accepted there would be no new AS appointments after 31 March 2008 and no re-grading applications will be considered after 31 March 2009 when the Window of Opportunity closes.
Will it be possible for AS to move to another AS post after April 2008?
No. If the contract is introduced the AS would become a closed grade after 31 March 2008.
Are thresholds the same as points?
No. There are two “thresholds” on the payscales under the new contract, and to pass through these doctors will need to meet a range of criteria aimed at assessing their skills and experience. Thresholds are expected to be more transparent than points as there are set criteria and an appeals mechanism. All Specialty Doctors and Associate Specialists are expected to pass through threshold One. Threshold 2 is more challenging than Threshold One, reflecting the higher level of skills and experience required from a doctor working at that level. Payments should be automatic unless payroll are informed otherwise.
Doctors should not be penalised if any element of the relevant incremental or threshold criteria have not been met for reasons beyond their control. Therefore, if the doctor has been prevented by any action or inaction on the part of the employer from satisfying any element of the incremental or threshold criteria they will not be prevented from moving through the relevant increment or threshold. Employers and doctors will be expected to identify problems affecting the likelihood of meeting objectives as they emerge, rather than wait until the Job Plan review.
What is the criteria for passing Threshold One as a Specialty Doctor?
Threshold One lies between points 4 and 5 on the payscale. All doctors will progress through this threshold unless they have demonstrably failed to comply with any of the following criteria:
Participated in job planning:
- Making every reasonable effort to meet the time and service commitment in their job plan and participating in the annual job plan review
- Meeting the personal objectives in the job plan, or making every reasonable effort to do so
- Working towards any changes identified in the last job plan review as being necessary to support achievement of joint objectives
- Satisfactory participation in the appraisal process in accordance with the GMC’s requirements set out in ‘Good Medical Practice’
- Undertaking of 360 degree appraisal/feedback (in the year preceding threshold one); and
- For those doctors undertaking private practice: taking up any offer to undertake Additional Programmed Activities in accordance with Schedule 7 of the Terms and Conditions of Service and meeting the standards governing the relationship between private practice and NHS commitments set out in Schedule 10 of the Terms and Conditions of Service
Threshold Two lies between points 7 and 8 on the payscale. The requirements for passing this threshold reflect the higher level of skills and experience required from a doctor working at this level.
Doctors will pass through Threshold Two if they meet the following criteria:
a) The Threshold one criteria, set out above
b) Demonstrating an increased ability to take decisions and carry responsibility without direct supervision
c) Also, demonstrate contributions to a wider role, for example, meaningful participation in or contribution to relevant :
- Management or leadership
- Service development and modernisation
- Teaching and training (of others)
- Committee work
- Representative work
- Innovation
- Audit
What is the criteria for Associate Specialists to pass threshold 2 on their new contract?
Associate Specialist doctors will pass through Threshold Two if they meet the following criteria:
d) The Threshold one criteria, set out above
e) Demonstrating an increased ability to take decisions and carry responsibility without direct supervision
f) Providing evidence to demonstrate their contributions to a wider role. This could include:
- A proven ability to lead a team
- Regular completion of audits to demonstrate high quality work
- An ability to innovate within their area of specialisation
- Evidence of involvement in the wider management role
- Leading involvement in research
- A leading role in teaching
If I work 10 sessions, can I negotiate for an additional PA?
Up to 2 Additional PAs can be negotiated via the job planning process.
At what rate will I be paid for working during the out of hours periods?
Specialty Doctors and Associate Specialists on the new contract will be paid time and a third for out of hours work. This can be given by time off in the week/ 3 hour sessions/ or extra pay. The supplement is pensionable.
What will happen if my current salary is higher than it will be under the new contract?
It is envisaged that the vast majority of doctors will receive an increase in pay under these arrangements. However, pay protection arrangements on assimilation for those who require them are as follows: subject to the work contracted for in the new contract being of the same time and nature as work done under the old contract, then any remuneration paid to an individual doctor under the national contract in force at the time will be protected. Protection will be at mark time of the value of payments as of 1 April 2008 plus the value of any annual pay increase recommended by the Doctors and Dentists Review Body and accepted by the Secretary of State for Health on behalf of the Health Departments in Great Britain for 2008/09 only.
If on assimilation I pass a threshold - do I need to meet any criteria?
No. It is not necessary to meet criteria to pass a threshold on assimilation. If you pass a threshold within the first year following assimilation you would still need to meet criteria but you would have 12 months in which to do so. Your pay would then be backdated to your incremental date.
What if SAS doctors do not want to take up the new contract?
Doctors can vote yes in a ballot and still decide to remain on your old contract. There can be no obligation to change your contract.
What will happen to Non standard / Trust Grades and those on non standard contracts? Will they be offered the contract? What about those in those in Foundation Hospitals?
The current negotiations will not apply to those doctors who are on non standard contracts. We hope that the new contract package will be sufficiently attractive for employers and those on local contracts to want to take up. We believe that the new contract should be applicable to those on local contracts as this will avoid exploitation in future. We will be encouraging Trusts to use the new contract if we think it is an improvement. However, there is no obligation for employers to offer this contract to those not already on national contracts. Foundation Trust also have the freedom to set their own contractual terms but if the vote is positive we would expect Foundation Trusts to implement this contract.
Where can we find more details on the phasing arrangements?
This is a complex topic. The Governments in England, Ireland and Wales have announced phasing arrangements for the contract. You can see a detailed explanation of these, including examples here: http://www.bma.org.uk/ap.nsf/AttachmentsByTitle/PDFSASdocumentation1007/
Scotland has separate transitional arrangements which allow eligible doctors who move on to the new contract on 1st April 2008 to be moved on to the pay point that they would have been on had the contract been implemented from 2 April 2007. You can see more about these here:
http://www.bma.org.uk/ap.nsf/content/supcontinfoforScot
Have you got details of the monitoring arrangements for the new contract?
SASC requested further details from the Government in December. We know that these will utilise the Electronic Staff Record to check salaries and that this will be presented to DDRB in future evidence. We have asked for discussions on how monitoring would work and NHSE have recently clarified that they are looking into this. SASC wrote to Nic Greenfield (Director General of Workforce at the Department of Health) to request more information again on 22 February 2008. No response has yet been received.
Is there money in the financial allocation for regrading in the window of opportunity?
There is £4 million set aside as part of the joint financial modelling for regrading within the Window of Opportunity. However, this is not ring-fenced in anyway and is given to Trusts as part of the combined financial package budget on implementation. Financial reasons should not prohibit regrading in this time but regrading will be in accordance with the standard regrading procedures, as outlined in Annex 2 to EL(97)25. Trusts in Scotland should refer to NHS MEL(1998)3, appendix paragraph 11-17.
I am applying to regrade within the Window of Opportunity. Should I also be applying to the Specialty Doctor grade whilst I await regrading?
SASC would suggest that those doctors who are applying to regrade to the new Associate Specialist grade should also apply to the Specialty Doctor grade as you may not receive the result of your regrading application for some time. If you apply to become a Specialty Doctor first then you will be guaranteed the back pay and you are likely to receive your pay increase sooner and possibly assimilate to a higher point on the Associate Specialist Scale.