Removing the ‘opt out’ on the current consultant contract for providing non-emergency out of hours care remains the government’s priority during hurried negotiations.
NHS Employers, which is negotiating with the BMA on behalf of the government, says the ‘opt out’ inhibits service planning for employers and increases the rate of payment for out-of-hours work, even if it is rarely deployed.
The BMA and NHS Employers are back in talks after health secretary Jeremy Hunt threatened to impose contract changes on doctors if a negotiated deal was not in place by 11 September.
In addition to removal of the Schedule 3 Paragraph 6 (S3P6) of the 2003 contract, which the government believes is standing in the way of seven day services, the other big issues are pay and Clinical Excellence Awards.
Danny Mortimer, chief executive of NHS Employers, said: “The activity on social media recently from doctors working weekends across the country, told us what we know already; that weekend working is the norm for many.
“The issue isn’t whether consultants work on a Saturday and Sunday, but what work should be done, how often, how frequently, and at what price?”
He added: “The way we access care is already changing and doctors contracts’ need to change too.”
The BMA has said it will only give up Schedule 3 Paragraph 6 if contractual safeguards are put in place to protect consultants’ safety and work life balance.
Paul Flynn, chair of the BMA’s consultant committee, responded: “The Government has taken an aggressive stance on this, setting out a very tight timescale – agreement by 11 September to replace S3P6 with contractual safeguards – leaving all parties with a difficult task ahead.
“We will not be taking any rushed decisions; the last set of negotiations failed because of our concerns about how plans to introduce an extended seven day service did not adequately address issues of safety and work life balance, and we will need to see significant improvements in this area if we are to move forward.”
The committee’s executive will meet this week to assess progress and this will be followed by a full meeting of the committee in September.
The BMA junior doctor committee has refused to re-start negotiations with NHS Employers over a new contract for trainees.
Mortimer said: “We have started discussions with the consultants on their contracts and hope for an outcome which must be fair, but modernised and reformed to ensure that they reward those who make the greatest contribution, and in future, better reflect the position for staff working consistently in the most intense positions and during the most onerous times.
“A negotiated agreement, if it can be achieved, would be the best outcome for all parties, but we know that this won’t be easy.”
The government also wants pay progression to be based on performance, and to scrap local Clinical Excellence Awards.