NHS Employers has accepted its proposals for changes to junior doctor contracts ‘are not ideal’. It insists they are only a starting point for talks with the British Medical Association.

  • NHS Employers official says its proposals are only a starting point for talks with BMA
  • Paul Wallace says there is no intention to cut GP trainee pay
  • Junior doctors urged to reconsider talks and drop threat of strike action

Paul Wallace, director of employment relations and reward for NHS Employers, warned doctors of “misunderstandings” coming out of the BMA and said the threat of strike action by the UK’s 38,000 junior doctors was “unhelpful”.

The government has said it intends to impose a new contract on junior doctors from August 2016 after the BMA walked away from talks in October last year. Mr Wallace said NHS Employers would be speaking to around 3,000 trainee medics in coming months to ensure their views were heard.

He told HSJ the proposals from NHS Employers to the independent Review Body on Doctors’ and Dentists’ Remuneration earlier this year should not be seen as a final contract.

In July the review body said it supported the options called C and C+ “as the basis for further negotiation between the parties”. The proposal would mean a 15 per cent increase in basic pay with Monday to Saturday, between 7am and 10pm, classed as normal working hours. Unsocial hours rates would be up to 50 per cent extra for nightshifts and 33 per cent for Sundays.

Mr Wallace said: “Do we expect to be implementing the C+ proposal as the be all and end all of the new contract? The answer to that is no.

“We know that C+ is not ideal. The DDRB recommendations, while being broadly supportive of the things we put forward, identified – and we agreed – there is still much for the parties to discuss, which is why we wanted to get into negotiations with the BMA and, I hasten to add, still do.”

Asked why NHS Employers submitted an initial proposal that was less than ideal, he said: “You have to have a starting position in these situations. What we were trying to do is illustrate what a new system might look like and what some of the problems with the old system were. It was in the evidence that this was a starting position with much left to discuss.

“The principles of a new pay system have been identified but the details have not. Do I think we will end up with a pay system that will pay certain hours, nights or weekends at more than plain time? Absolutely. The questions are at what level and where those lines would be drawn?”

On Saturday the BMA’s junior doctors committee is due to hold a meeting where it is expected to vote on a motion to ballot members over industrial action in response to the threat of an imposed contract.

Mr Wallace said this was a “worry” for employers. He added: “I think it is unhelpful. In the current climate you will achieve more and proper reform by sitting down in a room and talking these things through. Even at this late hour, I would still encourage and urge the BMA to come back into the room and enter a negotiations process.”

He said some comments by doctors were “factually inaccurate” but that employers would tackle these “misunderstandings” with key facts over the coming months, including a pay calculator once the final contract had been designed.

Doctors have expressed concerns that ending automatic pay progression would discriminate against women and those who take career breaks. Mr Wallace insisted that employers would not discriminate against women taking maternity leave. For those taking career breaks, he said: “Should they come back onto the pay system as if they had never left it? That’s not what the law says; the law states you should come back onto the pay system at the point at which you left it.”

Other proposals include replacing the current supplement for GP trainees with a recruitment and retention payment. Despite claims the supplement would be completely removed, Mr Wallace said: “There is no intention to reduce GP trainee pay, none at all.”

On safeguards, Mr Wallace said the contract would include absolute limits which could be actionable if breached adding there would be advice and guidance alongside the contract for NHS trusts to follow.

HSJ has approached the BMA to interview members of the junior doctors committee.