University Hospitals Birmingham NHS Foundation Trust has been criticised for setting up a medical workforce that differs from the rest of the NHS and introducing a sub-consultant grade.
UHB has created 40 new roles for doctors alongside its training grades, the most senior of which is called a specialist consultant.
The pay and terms and conditions of the specialist consultant role are based on the 2003 consultant contract. But the salary only mirrors that of the consultant contract for the first five salary increments (£74,504 to £83,829) after which it doesn’t progress.
Dr Mark Porter, deputy chair of the BMA’s consultants committee, said the creation of a new workforce model was “tragic” and undermines the intentions of the national training system - to produce consultants of a consistently high standard.
He said: “Doctors with the qualifications to be an NHS consultant will be taking up a job with similar responsibilities but on worse terms and conditions of service and pay, and without the same prospect of advancement.”
But Dr David Rosser, medical director of UHB, said the specialist consultant role is intended to help “a small number” of senior registrars move on to the specialist register.
He said the role will help the trust retain a number of doctors, originally from overseas, who are struggling to secure consultant positions because of bureaucracy or non-recognition of their specialties. It is also targeted at senior doctors who may or may not have their CCT and are happy to be more clinically focused than a typical consultant.
The number of supporting programmed activities will be negotiated separately for each position. Rosser said the SPAs will range between the 2.5 and 1 depending on how clinically-oriented the role is.
Describing the workforce development as “contractual honesty”, Rosser explained that all the new roles were being introduced to retain and develop doctors. The new posts would not replace training roles and will have more training opportunities than traditional trust grade positions. Their intention is to bring people back into training, he said.
Rosser said: “I can see why the BMA are taking the stance they are - but I disagree with them. Over the years, the BMA hasn’t done enough to improve trust grade posts. The national training scheme is too inflexible to allow a large, complex trust like us to change and develop our services as we need to.”
The trust is committed to keeping these roles at under 10% of the medical workforce. “They’re the grease in the cogs of the mechanism and not a major step away from national training scheme,” said Rosser.
The BMA’s Porter said: “The big question people considering these posts need to ask themselves is - will the training be recognised?”
Hospital Dr recently reported that an alternative specialist grade is currently being road tested by David Grantham, head of programmes at NHS Employers. A briefing paper says there is a need for the grade to soak up the increasing numbers of doctors completing their training.
