Support for Implementation of 2016 Junior Doctors Contract in General Practice
Acute teaching hospital trust, the Royal Free London NHS Foundation Trust, provides support for GP trainees under the 2016 Junior Doctors Contract. With a focus on ensuring safe working environments, they assist in navigating the complexities of the new contract to support trainees in their journey to becoming General Practitioners. The Royal Free London NHS Foundation Trust is dedicated to delivering excellent healthcare and workforce development in partnership with HEE and NHS Employers.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Wessex / Thames Valley HEE 2016 Junior Doctors Contract General Practice support provided by the Royal Free London NHS Foundation Trust on behalf of NHS Employers
Wed Like to Introduce Ourselves Acute teaching hospital trust employing c.10,000 staff Currently Lead Employer for GP trainees in two HEE regions for c.900 Trainees across north London Very well versed in engaging a large number of trainees in a short space of time. Currently implementing the Junior Doctor 2016 contract, including the appointment of a Guardian of Safe working who is responsible specifically for GP s Working with NHS Employers nationally to ensure the new Junior Doctor Contract is fit for purpose for trainees in GP settings
Wed Like to Introduce Ourselves Our mission is to assist HEE with their objective to support the delivery of excellent healthcare and health improvement to the patients and public of England by ensuring that the workforce of today and tomorrow has the right numbers, skills, values and behaviours, at the right time and in the right place Our support and employment model has been developed to provide the assurance to feel confident that trainees can be supported through their employment life cycle. This gives them every opportunity to safely, and successfully make the journey from a Doctor in Training to General Practitioner. Among our team: one of the chief negotiators for employers during the contract talks, and the former chair of the pan-London contract implementation group
Junior Doctors Contract 2016 This contract was agreed between NHS Employers and the BMA - albeit BMA members subsequently narrowly voted against it, for a variety of reasons Neither you as trainers / practice managers nor HEE were the authors of the contract but it is generally seen as a fair contract and it is incumbent on us all to implement it Change is nearly always difficult, especially when it is as radical as this but we need to make it work nevertheless We will do our best to help and navigate you through this process HEE is also there to guide you through the training aspects of the change
Why Introduce Into Your GP Practice? It is an enabler to meet the needs of a 24 hour, 365 day NHS while being fairer, providing safeguards for doctors and integrating service and training requirements through the work scheduling process It brings GP trainees onto the same terms as their hospital-based colleagues, ending the previous mismatch that occurred when trainees move between training settings. NHS Trusts in Wessex and Thames Valley are already utilising the 2016 contract for trainees, including GP trainees hosted by hospitals; if GP practices fail to follow suit, then trainees will keep transferring from 2002 to 2016 and vice versa when they move into and out of GP practice. The vast majority of GP trainees will lose salary over their total time in GP practice if they remain on the 2002 contract during this time. Failure to implement could over time deter prospective trainees from applying to Wessex or Thames Valley if they cannot be guaranteed a 2016 contract.
Junior Doctors Contract 2016 Implementation Schedule for the 2016 TCS December 16 FYIs February/ Psychiatry trainees (all grades), Pathology trainees (lab based) (all grades), April 17 Paediatrics trainees (all grades), Surgical trainees (all grades) taking up next appointments and FY2s/GP trainees sharing rotas with these trainees August/ All remaining trainees taking up next appointments (all grades) and all new October 17 starters (all grades) In simplistic terms, by August 17 it is strongly recommended that all GP trainees, from the start of their next contract of employment should be offered a contract on the 2016 terms.
If there were a lead employer the position would be . Triangular relationship between Host organisations, Lead Employer and HEE. Lead Employer Host HEE Junior Doctors 2016 Contract
Where there is no lead employer Relationship with GP Practice for the provision of advice on support in respect of the implementation of the 2016 Junior doctors contract only. Lead Employer Host HEE Junior Doctors 2016 Contract
Junior Doctors Contract 2016 As GP Practices outside of a Lead Employer relationship, your responsibilities will be; Produce and issue a work schedule to trainee Calculate the basic pay for the trainee Identify and calculate pay protection Advise payroll provider of pay Adhere to work schedule and manage safe working hours Engage a Guardian of Safe Working Manage exception reporting The following slides take you through the above requirements in more detail
Work schedules All trainees should normally be issued with a generic work schedule by the GP Practice at least 8 weeks before starting post. If you haven t done this yet, don t worry!! To assist you with ensuring safe working and compliance, templates have been produced in conjunction with COGPED and the BMA which are suited to the requirements of GP Practices. These will provide information about the pay derived from those work schedules. Any timetable / work schedule following this guidance will be compliant and affordable. Personalised ( tweaked ) work schedule is agreed by the Educational Supervisor with trainee on commencement - based on learning needs and the opportunities within the placement.
Work schedules The generic work schedule brings together activities to achieve learning and service objectives within contracted hours for the duration of the training placement. The generic work schedule should be provided to a doctor prior to starting a placement to ensure that the doctor is informed of the work and range of duties that are expected to be undertaken and will identify: the intended learning outcomes (mapped to the educational curriculum this has been done for you) the scheduled duties of the doctor periods of formal study the timetable which the doctor will be working (ensuring compliance with the safety constraints above) the number and distribution of hours for which the doctor is contracted (40 hours per week in this case) the pay the doctor can expect to receive for the hours set out in the work schedule
Work schedules The 2016 TCS puts a considerable emphasis on safe working for the benefit of both junior doctors and their patients. The ones you need to focus on are: . A weekly average of 40 hours per week No more than 13 hours consecutive in a single day (including breaks) At least 11 hours off between shifts (so no split shifts ) Paid meal breaks (1 per day, 2 if the day exceeds 9 hours) No more than eight days in a row without a break (two days off after eight consecutive days) The remaining rules (with one exception) more generally apply to hospital based trainees
Constraints on out of hours When 6 hours Out of Hours is worked time off in lieu (TOIL) will need to be provided from Standard 40 hour week in the work schedule. This should be allocated by agreement between the GP Practice and the trainee and need not always necessarily be in the same week. However dependent on when the out of hours is worked, it may be necessary to structure the TOIL to ensure compliance with the contract s maximum working day and minimum break requirements In these cases it could be that the TOIL has to be taken from working hours on the same day that the out of hours is worked or from the day preceding or following day.
New pay provisions It is absolutely key that, as with any other contract, you get the basic salary right. If you get it wrong, this could cause an over or underpayment worth many thousands of pounds. However setting aside transitional protections, new pay is much simpler to assess. Basic pay is linked to stage of training there are no more annual increments to assess. Grade ST1 / ST2 ST3 / ST4 Pay nodal point 3 4 Basic salary 36,461 46,208 Where a doctor transfers from another training programme other than a Foundation programme or from a nationally recognised career grade in the NHS into GP training, then pay protection may apply in the form of a top up where required. We can assist you with this.
New pay provisions Pay is calculated on an average of 40 hours work per week. GP trainees should not be expected to work beyond this if you ask them to do so, HEE will not reimburse that additional cost. Pay is enhanced by 37% where any hours worked between 21.00 and 07.00. The template work schedule indicates that this should only happen when the trainee is doing out of hours provision; an average of 30 minutes per week is set aside in the template to cover this. Therefore at 2017/18 pay rates 168.84pa at ST1/ST2 and 213.72 should be entered on the work schedule and paid to the trainee while in GP practice. General Practice also attracts a flexible pay premium . This rep[laces the old GP supplement (45%) and needs to be included in the work schedule and entered in the pay file. Full time GP trainees in a GP practice placement will currently be paid 8,282 pa.
Less than full time Less than full time trainees will receive their pay and allowances on a pro rata basis. In addition, less than full time trainees who were already LTFT on 3rd August 2016 (or who were on maternity leave at that time and returned to LTFT working immediately thereafter) will receive a transitional annual pay premium of 1,500 They will continue to receive this for so long as they continue to train on a less than full time basis, until transitional protections end.
Transitional pay GP trainees who were a doctor in training on 2nd August 2016 in England will be eligible to receive protection under the terms of schedule 14 of the contract, although for many, as the new contract offers more pay earlier, it will not be needed. GP trainees will usually be covered by section one of schedule 14. This provides for a cash floor below which their salary will not drop. This is calculated using their old basic salary on the day before they transfer to the new contract, plus the banding for rota on which they were working, as it was on 31/10/2015. You may need to contact the doctor s previous hospital to find this out! It is a significant responsibility to ensure these cash floors are calculated, communicated to your payroll provider and communicated to the trainee prior to the first month s pay. NB An increasing number of doctors will bring their cash floor with them from their previous employment as an FY1/FY2/trainee. You are advised to contact the previous employer to ascertain whether a cash floor already exists prior to calculating your own as the trainee carries their cash floor with them. Transition arrangements last for a maximum of 4 years (unless LTFT) but in any case end on 3rd August 2022 for all affected trainees even if LTFT.
Exception reporting Trainees should Inform you when their work varies significantly and/or regularly from the agreed work schedule e.g. hours, education, support Report should be sent by trainee within 14 days (7 if a possible claim for additional pay) to the GP trainer (clinical supervisor) Reports about working hours should be copied to the Guardian of Safe Working Hours Reports about missed training opportunities should be copied to the head of school Each GP Practice will have its own exception report tool (e-mail will usually be sufficient, provided the subject header flags that this is an exception report) you need to communicate the detail to your trainees Where an immediate and substantive risk to safety arises this should be raised immediately (orally) Can lead to a work scheduling review National guidance on how to respond to these is available to support you
Exception reporting In unplanned circumstances where a doctor considers that there is a professional duty to work beyond the hours described in the work schedule in order to secure patient safety, compensation, in form of additional pay or TOIL, will be applied if the work is authorised by their manager. It is strongly recommended that other than in truly exceptional circumstances, GP practices should use TOIL to compensate for additional hours worked. HEE will not fund any pay for hours worked above 40, so if the practice chooses to pay a trainee for the additional hours, that pay should be deducted from the amount billed to HEE. In such circumstances, the payment made would be at at the prevailing rate (basic pay, or enhanced (night) pay). Frequent reports by trainees should result in the work schedulke being reviewed to ensure that trainees are able to work within their hours and to receive all training requirements. We can advise you onhow to do this if you need to do so.
Guardian of Safe Working Hours Ensures that issues of compliance with safe working hours are addressed by the doctor and/or employer/host organisation Responsibilities include: Acting as the champion of safe working hours for doctors Receiving copies of exception reports in respect of safe working hours Escalating issues in relation to working hours to the programme director Requiring intervention to mitigate any identified risk Requiring a work schedule review to be undertaken Intervening in any instance where the safety is compromised
Unsafe working penalties Where limits on safe working hours (48 hours average week; 72 absolute limit in seven calendar days; breach of more than three hours in the 11 hour minimum rest period) are breached, then the doctor will be paid at penalty rates In addition, a financial penalty will be levied on the Practice for each hour above these limits (total of the two will be four times the hourly rate (basic or enhanced) of which the doctor will receive 1.5 x the basic hourly locum rate or 1.5 x the enhanced locum rate as applicable). You could be requested to pay this additional sum by the Guardian. Other than in very rare circumstances, it is unlikely that a GP trainee would ever be required to work in a way that might risk a fine being generated but if you are fined by the guardian, you cannot reclaim this from HEE.
Support and advice available from the Royal Free
As LEAD EMPLOYER, RFL would normally Issue work schedule to Trainees Manage exception reporting Provide a Guardian of safe working Calculate the basic pay Calculate any pay protection Process pay
As support and advisor, RFL will Provide advice and support in the interpretation of the 2016 contract Provide advice and support on the production of work schedules including providing templates to use Provide advice and support on the calculation of basic pay, identifying whether pay protection is required and the calculation of this. Advise on how to engage a Guardian of Safe Working Hours Advice and support is available in the first instance by contacting rf.Wessex@nhs.net or rf.ThamesValley@nhs.net Further advice and guidance will be made available online shortly.
Conclusion The Royal Free is here to support and advise. Please contact us should you have any concerns on your responsibilities in respect of the 2016 junior doctors contract GP Practices engaging trainees on the new 2016 terms and conditions need to; Gain an awareness of the new 2016 Terms & Conditions, Use, understand and implement compliant work schedules Calculate GP trainee pay including protection Ensure your payroll provider is aware of and understands this calculation Set up processes for managing exception reporting
