Most NHS senior human resources directors would support the imposition of national employment contracts on medical staff, a new poll has indicated.

Almost three quarters, 74 per cent, of 130 HR directors polled in HSJ’s survey, carried out in association with NHS Employers, said they would support the government recommending a national contract framework that trusts must apply.

The show of support comes after the British Medical Association pulled out of contract negotiations with NHS Employers earlier this month, claiming the government refused to offer safeguards and detailed information on the impact of proposed changes on doctors’ working lives.

The healthcare employers’ body had proposed ending the right of consultants to opt out of working at weekends on non-urgent cases, changing their pay structure, and reforming the clinical excellence awards regime. NHS Employers says safeguards had been discussed.

One HR manager said the imposition of a national contract was “long overdue”, but predicted “little appetite” for the measure when a general election was just months away.

Signing contract

The BMA said ‘national contracts are important in maintaining fairness in terms and conditions’

Another said it was “unacceptable that no progress has been made in national negotiations and that the burden of change has been borne by [Agenda for Change] staff”.

However, a significant minority – 26 per cent of managers – did not support the imposition of a national contract, arguing that local employers would struggle to implement it.

One said: “There is a shortage of doctors in key acute specialties, and our ability to hold the line on a national pay framework that has not been collectively agreed would be severely compromised in those shortage specialties.”

Another added: “To expect trusts locally to negotiate with the BMA on doctors’ terms and conditions would be wholly unrealistic.”

A majority of respondents said they were confident of being able to deliver an increased range of seven day services with 65 per cent rating their confidence as five or more out of 10, where one was “no confidence” and 10 was “total confidence”.

More than a quarter, 26 per cent, said out of hours enhancements was a key barrier to seven day services. One in five blamed consultants’ right to opt out of non-urgent weekend work.

Around 15 per cent pointed to the individual culture of their trust and a lack of available staff as a barrier, with 18 per cent pointing cost of extra staff as a hurdle.

Bill McMillan, assistant director of pay and negotiations at NHS Employers said: “For many years employers in the NHS have told us that there is a compelling case for reform of the doctor contracts to make them sustainable, affordable and effective. While in principle they favour nationally negotiated reforms to the contract they do not do so at any cost and over any length of time.

“The negotiations may have ended but the need for reformed contracts remain if they are to affordably and sustainably support the planning and delivery of the same quality of services seven days a week.  It is hardly surprising then that employers, when asked, say they would support a national framework for them to adopt and adapt.”

A spokesman for the BMA told HSJ: “National contracts are important in maintaining fairness in terms and conditions, and for junior doctors rotating between trusts it is vital in protecting training standards and a fair work life balance.

“We remain committed to reaching an agreement and urge the government to work with us to find solutions to the legitimate patient safety concerns doctors have raised and agree a contract that is good for patients, fair for doctors and good for the NHS.”

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