Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment he has made of the effect of proposed new NHS contract arrangements on areas where doctors routinely work long hours.

The proposed new contract arrangements are informed by recommendations and observations by the independent review Body on Doctors’ and Dentists’ Remuneration (DDRB). The DDRB’s standing remit includes a requirement to consider the need to recruit, motivate and retain doctors.

NHS Employers are working with the British Medical Association to finalise agreement on an amended consultant contract, which will provide fairer terms and conditions that are better suited to a seven day National Health Service and go further than the existing arrangements to reward those who contribute the most and who work the most onerous hours. The proposals include a suite of safeguards designed to protect the wellbeing of doctors and to support patient safety. This includes no requirement to work more than 13 weekends in a year – effectively 1 in 4 weekends - (employers’ proposal); and no requirement to work more than a 40 hour week without consent.

This is part of a more professional contract overall that would support consultants as clinical leaders and engage consultants with the objectives of their employer. Features include a spot salary set at a rate that would allow consultants to reach a level of basic pay in an average of five years that would currently take 14 years, the introduction of locally driven performance payments that would reward excellent performance in year, would provide potential earnings of overall £120,000 for an average experienced consultant and offers three years of transitional protection for those who move onto the contract.

The proposed new contract for doctors and dentists in training will introduce stronger limits on working hours with: 48 weekly hours on average (56 for those who opt-out of Working Time Regulations); a maximum of 72 hours in any week (lower than the current 91); no shift rostered to exceed 13 hours; no more than five long shifts consecutively; no more than four night shifts consecutively; and no more than seven consecutive on-call periods. It will also introduce work schedules tailored to individual educational needs and a strong system requiring the employer to review when hours or training opportunities vary from the work schedule.

The contract will ensure that pay relates more fairly to actual work done; increase basic pay, recognising the professional nature of the role in a seven day NHS: and pay a higher rate for work at the most unsocial times. In addition, flexible pay premia will apply for: general practitioner trainees, to maintain current earning levels; other shortage specialties who would otherwise lose out under the new pay structure; those switching to shortage specialties; clinical academic trainees and public health trainees undertaking PhDs etc; and those undertaking approved academic/other work that benefits the wider NHS and improving patient care.