Survey of Defence Medical Services doctors - Final report
January 2008
Introduction
The BMA’s Armed Forces Committee (AFC) was established to consider matters relating to the medical branches of the armed forces and the medical branches of the reserve armed forces and so far as possible, to ensure that medical officers serving in the medical branches of the armed forces are not disadvantaged in relation to their civilian counterparts. The main focus of the AFC’s work has traditionally been the production of evidence to the Armed Forces Pay Review Body (AFPRB). This year we are keen to gather up-to-date information on issues facing all branches of practice, including both regulars and reservists, to provide robust and relevant evidence to the AFPRB.
Summary
- The BMA’s Health Policy and Economic Research Unit (HPERU) was commissioned by the Armed Forces Committee to undertake a survey of DMS doctors from all branches of practice (both Regulars and Reserves) on a range of issues relating to working lives of these doctors. A total of 375 completed responses to the questionnaire were received during November/December 2007. This report presents the findings from this survey.
- Respondents to the survey represent each of the three services: half were from the Army, a third from the Royal Navy and a fifth from the Royal Air Force. Four in five respondents were male and the average age was 40 years.
- A third of respondents were general practitioners (GPs), a third were junior doctors and a quarter of respondents were consultants. The most popular hospital specialties included anaesthetics and occupational medicine.
- Two in five respondents were on a full career commission, 29 per cent on an intermediate career commission and a quarter on a short service commission. Only 6 per cent of respondents were in the Reserves.
- Respondents of all grades (excluding Reserves) were asked to estimate the average number of hours per week they spent on a range of duties. The average time spent on all duties (including clinical work, admin, military non-clinical duties, paperwork and teaching) across all grades was 52.6 hours.
- The average number of days spent on deployment in the last year by all respondents was 34.3 days, but ranged from 21 days for junior doctors to 50.8 days for GPs. Other than time spent on deployment, respondents spent an average of 36.6 days on military activities in the last year.
- Two in five junior doctor respondents were working on a current banding of 2A or 2B and a further third did not know their current banding. A third of junior doctor respondents worked full shifts and a fifth worked partial shifts. The average reported number of hours of actual work carried out each week over a rota was 50.3 hours, and but the average reported hours on duty each week over a rota cycle was 48 hours.
- Consultant respondents worked an average of 11.4 Programmed Activities (PAs). The median rota commitment for rota duties was 1 in 7. Less than a fifth reported that they were currently in receipt of a clinical excellence award (CEA).
- Most GP respondents reported that they provided out-of-hours cover and all of these GPs reported that they use a cooperative to provide cover for the out-of-hours period. The average frequency of duty in the out-of-hours period was reported as 7.6 times per month. A quarter of GP respondents reported currently working as trainers and most intended to continue working as a GP trainer.
- Only 20 respondents were identified as being doctors in the Reserves. Respondents reported an average of 19.7 days spent on military training in the last year. Half of respondents in the Reserves have been mobilised since 2001.
- The desire of all respondents to practice medicine was somewhat greater than their desire to serve in the Armed Forces. Respondents were most dissatisfied with ‘overstretch’, ‘impact on spouse’s career’, ‘separation from family and impact on family life’ and ‘quality of accommodation’. The majority considered the ‘service lifestyle and ethos’ to be a positive aspect of service life.
- The DMS are currently involved in a greater degree of active service than many would have forseen a few years ago. Whilst a third of respondents reported that this had strengthened their desire to serve in the Armed Forces, this had weakened the desire to serve in the Armed Forces for 35 per cent of respondents.
- Respondents were asked about their future plans with regard to the DMS. Separation from family and the impact upon family life and overstretch were the main factors cited by respondents as influencing their morale to the extent that they would or have considered leaving the Armed Forces.
- Only a third of respondents reported no plans to leave the DMS, but almost two in five had plans to leave in the next 5 years. Most respondents who intended to leave the DMS, planned to do so through the end of a short or medium term commission or through premature voluntary release (PVR). Among those respondents who were not retiring at the end of a full commission, the main reasons for leaving the DMS included family/partner commitments and operational commitment/turbulence.
- Respondents were the asked if they planned to leave the Armed Forces, whether they would consider taking a commission in the Reserves. Only one in ten respondents reported that they intended to or were thinking of doing so.
- While two in five respondents reported satisfaction with their pay and allowance package, more than a third were dissatisfied.
- Only a third of respondents reported being on the new Pension scheme. Respondents who were on the old pension scheme were more likely to be satisfied with their Armed Forces Pension scheme arrangements, compared with those respondents on the new pension scheme. Three quarters of respondents stated that their Armed Forces Pension was important to their length of service decisions.
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