New consultants across the UK are being pressurised into accepting contracts with reduced time for supporting professional activities (SPAs) warn doctors’ leaders.
Both the BMA and HCSA say consultants are increasingly being offered contracts with 9 programmed activities (PAs) and only 1 SPA.
This contravenes the terms of the 2003 contract, which recommended a split of 7.5 PAs to 2.5 SPAs.
HCSA chief executive Stephen Campion said: “This started 18 months after the 2003 contract was introduced and is now becoming widespread. Up and down the country more and more trusts are seeking to dilute SPAs in favour of direct patient care activity.
“It has always been our concern that the 2003 deal was never going to be a national contract so long as trusts were at liberty to offer whatever terms they liked for new appointees.”
He said in one large foundation trust in the south of England he was able to persuade the medical director not to offer new seniors contracts with a 9PA/1SPA split but in other trusts negotiations failed.
Many consultants were accepting these new terms because they did not want to start a career with a disagreement with their clinical director. In some trusts, depending on the workload in different departments, new consultants were being offered contracts with varying amounts of SPA time.
“The thing that will upset many consultants is that after years of painstaking negotiation the contract that was finally agreed in 2003 is not worth the paper it is written on,” said Campion.
The issue recently came to a head in Scotland when the Workforce Directorate of the Scottish Executive Health Department issued guidance stating that NHS Boards should advertise new posts with a 9 PA/1 SPA split.
The BMA has protested to the Scottish Government and has boycotted a working group set up with employers to look into workforce issues.
Dr Charles Saunders, chair of the BMA’s Scottish consultants’ committee, said: “We simply don’t trust the employers. The only thing that would allow us to start trusting them again and have any faith in their behaviour is for the guidance they have issued to be withdrawn.”
He warned that diluting the time available for SPAs would impact adversely on education and training, audit, clinical governance, consultant development and patient safety.
It would also affect the ability of Scottish hospitals to attract and retain high quality staff and could drive some juniors to work abroad after completing their training.
Mr Paul Flynn, deputy chair and negotiator for the BMA consultants committee, said: “This is an area of great concern to us because the SPA is the part of a consultants’ job plan that enables them to ensure they are doing a high quality job.”
He said they had been receiving a steady stream of phone calls and emails from concerned members and were in the process of doing some work to ascertain the full extent of the problem.
“At the moment we don’t know how many people are actually just putting up with these new contracts because they don’t want to rock the boat. This will be the most important issue for me this year,” said Flynn.
The BMA is advising consultants to ask for a job plan review if they feel they are being short changed on their SPAs and to formally appeal the result if they are still unhappy.
The HCSA is urging consultants to check out the terms and conditions of any job before applying for it and to find out how many SPAs the outgoing consultant has been receiving. They can also negotiate the requirements of the job plan after accepting any post.
A NHS Employers spokesman said: “There are no plans to change the general provisions of the consultant contract in England which suggests a typical split of 7.5 PAs to 2.5 SPAs. However flexibility exists for employers to agree with consultants locally the exact proportion of time allocated to supporting professional activity as part of the overall job planning process.”
Tags: Consultant contract, SPAs
