The BMA has released a summary of the changes to the Junior Doctor Contract a head of members’ vote later this month:
- Pay protection: switching specialties and transitional
Pay protection retained for those retraining in shortage specialties, with a reduction in the qualifying period from 13 months to 6 months.
Pay protection for those switching to a specialty for disability or caring responsibilities – with no qualifying period.
Pay protection for all doctors employed on current contract (including F1s starting in August 2016) – at their prevailing rate immediately before transfer to new contract.
ST3 and above will have pay protection (including banding) until the earlier part of August 2022, or elapse of four years continuous employment (pro rata for LTFT), which we will be trying to ensure continues till CCT dates at the 2019 review.
Accelerated training support, with separate funding, for those returning to work after time out.
HEE-led review of transfer process within regions and defined travel times, for couples and/or carers.
Monitoring of equality and inclusion at trust level by the guardian of safe-working.
Designated flexible training champion at trust level.
Comprehensive equalities monitoring by early 2017.
- Guardian of safe working and ‘fines’
Report to the board quarterly on rota gaps and plans to reduce these.
Junior doctor forums to advise guardians at trust level.
Final stage appeal against disputed guardian decisions must involve a BMA-nominated representative (or other relevant TU rep). Specific instructions on how guardian fines must be spent – to benefit the education and training of junior doctors.
Transparent reporting on fines and expenditure in annual accounts, subject to JD forum scrutiny.
Two 30 minute breaks required in a shift over 9 hours to be taken separately (if combined must be taken in the middle of the shift).
If breaks are missed on 25% or more of occasions the guardian will fine at 2x the prevailing rate (all breaks to be paid as now).
- Flexible pay premia value increase
Flexible pay premia for emergency medicine, psychiatry and oral and maxillo-facial surgery increased to £20,000; split evenly in line with expected length of programme.
Premia continues if the doctor takes longer than expected to complete the programme (for example because of taking time out for maternity leave).
- Pay for all work done
Enshrined in the contract, including through post-event exception report.
Disagreements about approvals are overseen by the guardian.
Strengthened rules about time off in lieu.
- Locum work
‘First refusal’ clause has gone – locum work to be done exclusively via NHS staff bank (not covering voluntary work, eg St John’s Ambulance).
- Work done while on-call
On-call work includes any clinical or non-clinical work undertaken either on or off site, including telephone calls and travel time.
An allowance of 8% – regardless of frequency – for all time spent on-call, with pay at the prevailing rate (plus any night or weekend enhancements) for the hours of work done.
- Weekends and nights
A weekend allowance of between 3-10% of the whole base salary, for working more than 6 weekends a year, with the allowance increasing as the number of weekends worked increases.
Enhancement of 37% of basic pay for work at night, for shift starting between 8pm and midnight, finishing by 10am, for 8 hours or longer.
Enhanced rate for any hours worked after 9pm and before 7am, any day of the week.
No requirement to work more frequently than 1 in 2 weekends.
- Agreeing the contract going forward
If contract is agreed (following referendum) the unilateral variation clause will go and replaced by a clause requiring changes to be agreed by trade union, through joint negotiating committee (juniors).
Regular contract review with the first in August 2018.