CCSC proposals for a new consultant contract
CCSC Negotiating Subcommittee
28 February 2003
The CCSC believes that a new, nationally agreed consultant contract is essential to reward consultants who work hard, to control workload and to deliver a modern health service which provides the best possible care for its patients.
This document sets out key areas that need to be incorporated into a new contract. It is not a detailed example of such a contract, but draws upon consultants’ views of the best elements of the rejected framework document, as well as including some new proposals. The aim is to ensure that work done is recognised and rewarded, that excessive work can be reduced and that opportunities for part-time and family friendly working are available.
This is not intended as a basis for local negotiation of a contract improving on the rejected framework, as we know that trusts are unlikely to be allowed flexibility to deviate significantly from the framework document.
The key points of the new contract are listed below:
- A robust job planning process to take into account all consultants’ work
- Mutual agreement of the job plan and working patterns, with no imposition of unfair job plans or routine out of hours work
- A robust appeals process to underline job planning and pay progression
- Enhanced pay for routine out of hours work
- Automatic pay progression if basic requirements are met
- No differential treatment of new and established consultants
- Enhanced opportunities for part-time working
- Private practice to be governed by a code of conduct, to be agreed with the Department of Health
Job planning
There will be a new, mandatory system of job planning for all, including clinical academic staff. This will be informed by, but separate from, the appraisal process.
The job plan will be agreed with the consultant. Failure to reach agreement will result in the process described below. Job plans will not be imposed.
Job plans will set out a consultant’s duties, responsibilities, time commitments and accountability arrangements, including all direct clinical care, supporting professional activities (including teaching and audit) and other NHS responsibilities (including managerial responsibilities). It will be a contractual responsibility to fulfil these elements of the job plan.
Job plans will set out appropriate, identified and mutually agreed service and related personal objectives. Objectives will be expected to reflect different, developing phases in consultants’ careers.
For clinical academics, the job plan will be an agreement between the consultant, the university and the NHS employer.
The job plan will explicitly identify the resources that will be provided to support the consultant in the delivery of the job plan.
Failure to agree a job plan will result in an initial referral to the medical director. Failure to resolve the issue at this level will result in referral to an independent advisory panel, governed by national guidance. The following panel composition will ensure fair a hearing for the consultant:
- Two representatives of the trust, nominated by the chief executive or medical director (one of whom will chair the panel);
- One consultant representative appointed by the medical staff committee (agreed with the appellant);
- One consultant appointed by the BMA’s regional consultants and specialists committee;
- One independent external assessor appointed by the relevant medical royal college
Working week
The working week should be divided into programmed activities. These will account for:
- Direct clinical care: including ward rounds, clinics, theatre sessions, on-call etc;
- Supporting professional activities: including audit, teaching, research etc;
- Additional NHS responsibilities: which may be substituted for other work or remunerated separately;
- Other duties: external work that can be included in the working week with the employer’s agreement;
The basic working week will be 40 hours, divided between 10 four hour sessions. Subject to mutual agreement, the number of programmed activities can be higher or lower, to allow for part-time working or to account for heavy workload. However all programmed activities must be mutually agreed through the job planning process. Where work regularly exceeds the stated job plan, a job plan review will be invoked to address this. There is no obligation for routine work to be carried out beyond the agreed job plan.
Where the consultant wishes to contract for additional programmed activities beyond the basic 40 hour week, the total working week will not exceed 48 hours unless the consultant has exercised his/her right to opt out of the European Working Time Directive.
Additionally, routine work done outwith normal working hours (i.e 9am to 5pm) will be paid at enhanced rates.
Pay
There will be a new starting salary of £65,030 for a 40 hour week. There will be a subsequent system of pay thresholds, as set out below. Progression through these thresholds will be automatic if the consultant has:
- Satisfied the job planning and appraisal process;
- Followed the Code of Conduct on Private Practice (details being negotiated with the Department of Health);
- Made reasonable attempts to meet the requirements of the job plan;
- Not been found to have unsatisfactory performance through the disciplinary procedure process (details being negotiated with Department of Health);
If a consultant fails to progress through a threshold, there will be a right of appeal, initially to the medical director, and subsequently to an independent advisory panel, the constitution of which is set out above.
Pay thresholds at April 2003 rates:
£65,030; £67,100; £69,160; £71,230; £73,290; £78,190; £83,100; £88,000
Emergency work
This will be included in programmed activities set out in the job plan; emergency work will be the first aspect of the job plan to be agreed, with no arbitrary limit set on the proportion of the working week devoted to emergency work. Three hours of emergency work will be equivalent to 4 hours of routine work during weekdays (i.e. one programmed activity), while at weekends two hours of emergency work will be equal to one programmed activity.
Additionally, there will be a series of on-call availability supplements, worth up to 10% of base salary for the most intense and frequent rotas.
Private practice
The 10% rule will be abolished. There will be a new Code of Conduct governing private practice in relation to NHS work.
Sabbaticals
There will be a new flexible system of paid sabbaticals. The purpose of the sabbatical will be determined by the consultant. The details of this scheme are being negotiated with the Department of Health.
Part-time working
The system of job planning, and flexibility over the number of programmed activities worked should allow more options for part-time and flexible working. It will be the expectation that part-time and flexible working will be a realistic option for most consultant posts. National guidance will be drawn up defining the circumstances in which this will not be possible. All employers have an obligation to consider flexible working for parents with young children. NHS trusts will be obliged to consider any request for part-time or flexible working, and to give clear, written reasons if this denied. There will a right of appeal to an independent advisory panel, governed by national guidance.