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Andrew Cash is a man in a hurry. He has to be. As the newly appointed head of a 'millennium executive team' set up to ensure that the NHS runs smoothly this winter, he has one of the health service's few immovable deadlines.

If a flu epidemic fills hospital mortuaries to overflowing, nurses quit the NHS en masse to earn massive sums working new year's eve on agency rates, or the millennium bug strikes down information technology systems, his head will be on the block.

Seconded from Northern General Hospital trust in Sheffield, where he is chief executive, Mr Cash is a veteran of national hit squads, having served on both the Patient's Charter group and the Emergency Services Action Team.

In his new role, he and his team - which will include a doctor, a nurse, human resources and IT specialists, and staff from the ambulance and social services - will start a programme of visits to trusts in September. Its aims are to co-ordinate winter preparations and to 'target help and support when and where it is needed'.

Mr Cash's own trust was, appropriately, one of the first to agree millennium payments with staff back in May. Anyone outside the medical profession who works the daytime shift on 31 December will get three times their normal rate plus time off in lieu; staff on call will get 40 per cent of the value of the deal. From 8pm to 8am on new year's day they get five times their normal rate - as will on-call staff, even if they are not required to work.

Ron Little, public relations director at the Northern General Hospital trust, believes that a generous settlement was needed to ensure adequate cover. 'There are clearly going to be a lot of people looking for holiday breaks.'

He says it would be wrong to expect 'standard contract acts of employment to match the needs of patients on an occasion like this'.

'We believe we have reached a sensible balance - and that seems to have been the view taken by the staff side, the trust board and the NHS Executive.

'We agreed this in early May - we were probably the first to arrange our affairs - and it is interesting that quite a few hospitals in the area have followed suit.'

Since ministers declared that there would be no national settlement, and no central funding for local arrangements, trusts have been left to find a millennium pay formula which attracts staff without breaking the bank.

Trusts are divided into two camps: those which have decided to award several times the standard rate and those which have opted for a flat rate payment. The other great divide, of course, is how much trusts are paying.

Flat-rate payments of£100 or£150 are fairly standard. All Manchester trusts are offering£150 for millennium night and£75 for new year's day in a city-wide deal put together by the trusts themselves.

According to North Manchester Healthcare trust HR director Clive Warbrick, staff - including doctors - accepted the one and only offer on the table.

Dartford and Gravesham trust is offering£200 for new year's eve working.

Offers of double and treble time are also common, but many staff will do better, with offers of four times the normal rate plus time of in lieu on the table, especially for staff prepared to work on past midnight.

Time off in lieu is not a part of all deals: at Chesterfield and North Derbyshire Royal Hospital trust staff are doing without time off in return for four times the normal rates.

Unison is no longer holding out for a national settlement and has now authorised its officials to go for regional deals.

In Eastern region, trust staff are considering a flat payment of£100 for the early shift on 1 January, and£50 for later shifts and on-call.

If they accept, trusts will have got themselves a bargain.

Unison has already rejected an offer from London regional office of£150 for millennium night and£75 for new year's day.

A region-wide approach is also being taken in Northern Ireland, where staff are considering an initial offer of between£75 and£150 - depending on times worked - and 50 per cent additional payments on 1 January. Scotland and Wales are also expected to take a common approach.

The British Medical Association did not put forward a national claim on behalf of doctors, and local negotiations are taking longer to reach a resolution than for other groups.

Association of Healthcare Human Resource Management chair Ian Stone still hopes for a national deal for junior doctors. But whether consultants can be persuaded to work for the kind of sums on offer to others is less certain.

There is one piece of good news: the Southampton women's survey reveals that the number of babies expected over the new year is no higher than for any other year. There will, at least, be no millennium baby boom.