Job Planning for Consultant Medical Staff on the Pre-2003 Contracts
Consultants in post prior to 2003 could elect to remain on “Hospital Medical and
Dental Staff Terms and Conditions (July 1994)”, or move to the new “Terms and
Conditions – Consultants (England) 2003”. Consequently, a number of Trust
consultants on the pre 2003 contract have work patterns and commitments that are
affected by these terms and conditions. The following is an explanation of the pre
2003 national contract terms and conditions for consultants and the relationship to
job planning.
Consultant on the pre 2003 contract are required to work sessions or Notional Half
Days (NHDs) with a NHD regarded as the equivalent of three and a half hours,
flexibly worked; a PA (under the new contract) has a nominal timetable value of four
hours.
Consultants on pre 2003 contract may hold either a whole-time or maximum part time
contract. A maximum part–time practitioner is paid ten elevenths of the whole-time
salary. Consultants on both contracts are expected to have a minimum work
commitment equivalent to ten NHD. However those on whole time contracts are not
allowed to have private income exceeding 10% of their salary for; they must declare
their private income and if it exceeds 10% for 3 years they must convert to maximum
part-time. Aside from earning slightly less the maximum part-time practitioner also
has to work longer to build up pension and increments are lower.
Until around 1980 there was no firm definition of how consultants on an old contract
used their NHDs. However subsequently guidance was introduced that between 5-7
NHDs (depending on speciality and intensity of work) had to be carried out in fixed
facilities (i.e. theatres, outpatient setting). The remaining 3-5 NHDs were to be used
for flexible commitments (multidisciplinary meetings, administrative work, teaching
etc).
Since (DCC) PAs in the new contract include an element for administration activities
directly related to DCC work, for example, multi-disciplinary meetings about direct
patient care, referrals and notes it would be misleading to equate a NHD fixed
commitment with a DCC PA in terms of activity, as the two do not correspond
exactly. It is also worth noting that in contrast to SPAs you cannot specify that
consultants on the old contract must be ‘in the hospital’ for their flexible
commitments. NHDs can include a 30min (out of the 3.5hrs) allowance for travel time
between hospital sites (including private hospital) where appropriate.
Neither the old or new (2003) contract are “hours based” contracts. Rather they both
reflect an expectation that the contractual duties will be undertaken in a spirit of
professional flexibility with regard to time, location, content and duration of agreed
activities. In practice the contractual distinctions between “PAs” and “NHDs” or
“sessions” should not have the effect of introducing restrictions and limitations on
flexibility that did not previously exist.
The following duties should be taken into account when formulating the pre 2003
contract holder job plan: “out-patient clinics, ward rounds, operating procedures,
investigative work, administration, teaching, participation in clinical audit,
management commitments, emergency visits, on call rota commitments, and so on,
including occasional visits to outlying hospitals or other institutions for consultations,
diagnosis or operative work.”
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The job plan is required to identify the nature and timing of consultant’s fixed
commitments. Notice is required to change the nature of the fixed commitments. If
consultants can show they have a private practice commitment that would be
impacted by change in time then notice period required is longer. The fixed
commitments can be annualised therefore avoiding issue of holidays always being
taken on days of fixed commitments.
The job plan is subject to review each year and revisions may be proposed by either
the individual consultant or their Clinical Director/ Clinical Lead or/and general
manager.
A job plan should be completed for each consultant based on the same principles
which apply to staff on the current consultant contract and in line with the Trust’s
Policy on Job Planning, with the exception of NHDs and hours per session.
In addition to the above guidance on job planning, adherence to the standards set
out in “A Code of Conduct of Practice for NHS Consultants” applies to consultants on
both the 2003 and the old contract.
A consultant on the old contract retains the right to request transfer to the 2003
contract terms and conditions of service at any time. Transfer is subject to agreeing a
job plan on a prospective basis. The commencement date of the new contract is a
matter to be agreed between the consultant and the Trust.
June 2013
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