Hospital consultants could give up their veto on delivering non-urgent care at weekends but only if employers agree to safeguards, HSJ can reveal.
In an exclusive interview Dr Robert Harwood, lead negotiator for the British Medical Association, said consultants were willing to consider losing the veto on weekend working and were committed to seeking a deal through the current negotiations with NHS Employers.
Under their current contract, medical consultants have the ability to refuse non-emergency work before 7am or after 7pm on weekdays and on weekends.
NHS Employers claim this is a barrier to the delivery of seven day services as it allows individuals within teams to object to departmental changes.
Loss of the veto would be a siginificant win for the NHS organisation as it could begin requiring more consultants to be present in hospitals outside normal working hours.
Such a move would help employers develop seven day services in some acute specialties.
Dr Harwood, a consultant anaesthetist at Norfolk and Norwich University Hospitals Trust, told HSJ: “It would be fair to say we are talking about removing schedule three, paragraph six [of the consultant contract] – the veto – and replace it with a suite of safeguards to make sure patient safety and doctors’ working life are well balanced.”
He said no final decision had been taken and talks were ongoing but stressed the BMA would need specific protections to prevent consultants being unnecessarily overworked and to avoid the creation of recruitment crises as seen in areas such as emergency medicine.
He added: “Consultants are already prepared to work out of hours and they do it as part of their normal contractual arrangements.
“This is a process of negotiation so any settlement that is reached has to be fair to both sides.”
Dr Harwood was cautious about the progress of talks, which began in 2013 and are seeking changes to weekend working, pay progression and performance as well as significant reform to clinical excellence awards.
“I don’t think we know whether a deal will be delivered by the timescale which has been set.
“It depends on whether or not we can reach agreement easily,” said Dr Harwood adding: “We are there to get a deal, we are absolutely committed to reaching an agreement but it has to be a mutual benefit and that has been a challenge so far.”
Any potential deal will need to win support from wider BMA members, who yesterday voted on a series of motions on seven day services at the association’s annual representative conference in Harrogate.
Voting members called for investment in medical staff and for contract negotiations on seven day working to take account of “infrastructure and support services, compensation for antisocial hours, and family friendly working”.
The conference unanimously supported a motion that said seven day services “must not be conflated with with seven day access to routine services”.
It added that “delivery of both seven day routine and elective services is not feasible within the current NHS budget constraints leading to reduced clinical services Monday to Friday and/or closure of hospitals”.
Responding to the vote Dean Royles, chief executive of NHS Employers, said: “I know trade union conferences will try and up the ante on terms and conditions, but it is patient care that should drive decisions on the way services are delivered.
“From a patient’s perspective nothing about their care is ‘routine’ – it all matters equally and the right care needs to happen at the right time.
“Other staff groups like nurses, cleaners and physiotherapists have already agreed to change their terms and conditions. We should see doctors leading the charge to better, safer, more convenient care not holding back change.”