Working Arrangements

1. Working Arrangements Sean Tighe AAGBI Council Member Sean.tighe@nhs.net

2. Topical Topics! • SPA • Study/Professional Leave • Acting down • Resident on call/ shift working • Extra duty payments

3. SPA • 2003 Consultant contract; “Typically” 2.5 PA in a 10 PA contract • Now down to 1 SPA and 9 DCC in some Trusts! • Most SAS have < 1 “session” for personal development

4. SPA • How did this happen? • We were not doing it? • We let it? • We had no choice? • We wanted it? • How to maximise SPA; • Robust LNC? • Robust Colleges? • Robust individuals? • Robust job planning

5. SPA Action Plan • Use the new contract! • Do not be intimidated • Be robust at job planning • Have reliable diary evidence • Do not work for nothing • Drop commitments if not paid for • Use BMA/HCSA • Mediation, Appeal • Ensure new applicants know the SPA offer • Get REA/RCA support • Discourage applicants if not adequate SPA?

6. Study and Professional leave • “Paid” study leave is a contractual entitlement defined in 2003 contract • Max of 30 days in 3 years • With pay and expenses • The amount of expenses paid is not defined • Increasingly restricted budgets • Professional leave is discretionary • No obligation to allow any!

7. Study Leave Action Plan • Define CEPD requirements at appraisal and in PDP for revalidation • “with expenses” if possible • Get CD and MD signed approval of PDP • Apply for expenses in advance • If expenses refused either; • Refuse to go on S/L and then make formal complaint to CD, MD Clinical Tutor and LNC re revalidation failure • Include complaints in annual appraisal • Encourage colleagues to similar action • Write to RCA President re training and CPD implications • Involve BMA • Obtain trade sponsorship and warn of consequences • Fund it yourself and claim tax relief if doing PP • Formal grievance procedure • County court

8. Professional Leave • LNC agreement on allowance • Importance of wider contributions to NHS • Get sponsor to write to CE • Statements from National authorities • Stress individual negotiation with MD • Expenses rarely required

9. Professional Leave Action Plan • Plan ahead • Include in appraisal/PDP objectives • Give annual estimate to MD in advance • Negotiate with MD in advance • If exceed allowance; • Discuss with CD/MD • Annualise/ Flex SPA • Annualise DCC • Use AL or take unpaid leave • Arrange external funding to Trust

10. Acting down • Increasing requirement • Usually illness/accident/overslept/Rota confusion! • Different to resident on call or 1st on call • Irregular, unpredictable, short notice • Must be an LNC agreement in place • Base on BMA guidance • Exhaust alternative arrangements, eg locums • Executive approval • Need another consultant to take over O/C—paid 1 PA • 3 x PA or 2 x PA plus time off in lieu, or 2 x time off in lieu • EWTD; 11 hours rest next day, in addition

11. Shift working • Must be mutual agreement if appointed to another job plan • Mediate/Appeal if pressurised • Base remuneration on 2003 contract • May suit some

12. Resident on call • Not recommended by CCSC for consultants • Outside 2003 contract • Not cost effective • Very few PA’s left for elective DCC • May suit some! • All the time is working time • 4 PA for one night O/C • EWTD implications • Must have 11 hours rest, ideally consecutive • Can be delayed and taken “as soon as practicable”

13. Extra Duty Payments • Definition; irregular, temporary activity • Eg, WLI’s • Insist on parity with surgeons and all other consultants • If in paid SPA time • Declare when and where the SPA will be done and demand payment, or • Agree to “flex” SPA, without payment, or • Get DCC time back in lieu (Annualisation?)