Junior doctor contract is to be renegotiated

Authors: Helen Jaques 

Publication date:  21 Dec 2012


Junior doctors’ pay and conditions will be renegotiated after a report by NHS Employers branded the current contract “no longer fit for purpose.”

NHS Employers proposes negotiating a new contract for junior doctors that would be based on the need to deliver more flexible working patterns and that recognised and rewarded trainees for clinical competences rather than simply hours worked. The recommendation comes in a scoping report that included input from employing organisations and the BMA.

Pay for trainees should be weighted more towards basic pay than banding, NHS Employers suggests, to reduce the financial risk to employers and the variability of income of doctors in training. The prospect of local or regional pay and conditions was rejected by NHS Employers, a conclusion the BMA described as “reassuring.”

The government has accepted the main recommendations of the report and will use its proposals as a basis for discussion with the medical profession and NHS Employers in early 2013.

The health minister Dan Poulter said that change to doctors’ contracts was “long overdue.” He said, “Reviewing the contracts will ensure that doctors have the right training and rewards to look after patients from the moment they are newly qualified until the day they retire as an experienced consultant.”

In 2009 the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) encouraged the four UK health departments to commission a review of hours, banding, and pay for doctors in training.

NHS Employers published its report into the junior doctor contract this week, having submitted it to the government in June 2011. The report observes that the current contract, implemented in 2000, achieved its goal of reducing average hours worked by trainees. However, the contract is inflexible and has created opposing financial incentives for employers and doctors in training, it says.

NHS Employers says that employers see the pay banding system as unpredictable and expensive and that limits imposed by the European Working Time Directive have pushed down overall pay for trainees. It also argues that the contract emphasises hours worked rather than clinical objectives, to the detriment of high quality training.

Commenting on the proposed changes, Ben Molyneux, chairman of the BMA’s Junior Doctors Committee, said, “We need terms and conditions that better recognise the professionalism and vital contribution of junior doctors to the NHS. The scoping document is now three years old, and we need to move on quickly to consider the impact of the huge changes being made to the way medical training is funded, delivered, and regulated.”

The process for renegotiating the contract would take at least 18 months, NHS Employers has said. This would allow around two months for cross-government, UK-wide agreement on a mandate, a minimum of 12 months for negotiation between employers and the BMA, and three months for consultation with employers and BMA members.

Helen Jaques news reporter BMJ Careers

 hjaques@bmj.com

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