Doctors are being denied time off for non-clinical work

Authors: Abi Rimmer 

Publication date:  18 Jul 2017

Doctors are finding it increasingly difficult to secure time away from their trusts to undertake national work with organisations such as the General Medical Council and the Care Quality Commission.

Last month Terence Stephenson, chair of the GMC, Bruce Keogh, national medical director for NHS England, and the UK’s chief medical officers wrote to employers asking them to look “favourably” on requests from doctors applying for absence to undertake non-clinical work.[1]

Phil de Warren-Penny, consultant psychiatrist and member of the BMA consultant’s committee, told The BMJ that trusts were less willing to allow consultants time off for work that was not aligned with their own objectives.

“National work, even if it’s within a job plan, doesn’t lend itself to clear objectives that are aligned with the trust objectives and the job planning process. If we knock on from that, it becomes a lot harder in many trusts to get that agreement from the employer organisation,” said de Warren-Penny.

“If we look at the broader NHS at the moment and think about the financial pressures, if you are allowing an individual to go and spend time doing things for the royal college, they are not delivering your clinicians’ objectives.”

He said that it could become even more difficult for doctors to undertake national work as more services fell under the scope of sustainability and transformation plans. “I can see chief executives on trust boards thinking that if there is a shift in the environment then we want our staff in with us, rather than taking any of the broader roles.”

Liam Brennan, president of the Royal College of Anaesthetists, agreed that the landscape for sanctioning non-clinical work was changing. “It’s definitely getting tighter,” Brennan said. “Fortunately, there are still many [trusts] that are supportive and see the wider benefit, but unfortunately there are some who say, ‘If there is no direct benefit for my organisation today then I don’t want to know.’”

He added, “I’ve got colleagues both on [the Royal College of Anaesthetists’] council and examiners who have to pay back time to do this sort of work, who have to do extra shifts at weekends and evenings to fulfil their contractual obligations. Some of them even take annual leave to do some of their duties on behalf of the wider NHS.”

Another concern, Brennan said, was that doctors might be deterred from doing non-clinical work because their employer did not support them. “All we can say to our members is put yourself forward for it and ask your employer before you apply,” he said.

A spokesperson for the GMC said that support for important national initiatives or roles such as college examining, committee work, or invited college safety visits was being affected by the shortage of doctors coming forward. “We have also found it difficult to secure the services of busy clinicians to support our work such as quality assuring doctors’ training,” she said.

In March Sue Bailey, chair of the Academy of Medical Royal Colleges, wrote to Keogh setting out what the academy saw as a growing problem. “The academy council and also our patient lay committee are increasingly concerned that declining participation of doctors and other clinicians in recognised activity for the benefit of the wider NHS outside of their employing organisations will damage the quality of work undertaken,” she wrote.

In April, NHS Improvement published new guidance on consultant job planning, which is being challenged by the BMA. The guidance said that that trusts “generally supported” external work, such as work for the royal colleges, NICE, and the GMC, but that the work should be agreed in advance, something that is not currently required.

“We were not consulted with on the guidance, and it creates a shift in the contractual provisions from the 2003 contract,” de Warren-Penny said.


  1. Letter to every employer in the health service throughout the UK. [Link]

Abi Rimmer BMJ Careers

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