Published: 20/06/2002, Volume II2, No.5810 Page 6 7
NHS managers are optimistic that the new consultants' contract will expand the capacity of the health service and allow it to work 'around the clock' and bring down waiting times.
The contract, which will cost£310m to implement and will increase starting salaries by 20 per cent, will for the first time mean that all consultant work done between 8am -10pm Monday to Friday and 9am - 1pm Saturday and Sunday can now be part of standard contracts, paid at normal rates.
The contract, which will have to be approved by a ballot of consultants later this year, will not be introduced until next April. It will give consultants a core working week of 10 four-hour sessions, and according to health secretary Alan Milburn it will do away with the 'old NHS working week of 9-5'.
During their first seven years in post, a consultant can be offered up to two extra four-hour sessions of NHS work on top of their 40-hour week. If they refuse this and undertake private work, they would then not be progressed up the pay scale. For all other consultants the same rules apply, but only up to one four-hour session can be offered.
Job plans, specifying the sessions to be worked, will now have to be agreed annually between consultants and trusts. If there is a disagreement over the sessions being asked for, there can be an appeal to the medical director, and then a local appeals panel in line with national guidance.
Although the deal backtracks from the headline seven-year ban on private work originally proposed by the government, appraisals could be used as a more subtle way of dissuading consultants to take on private work.
NHS Confederation human resources policy manger Alistair Henderson said job appraisals could look at how long consultants are working and examine whether their hours were excessive: 'One of the things that appraisal would do is look at clinical governance issues, if you as an employer had concerns about this and safety issues.'
But he said the real significance of the contract was 'the ability to do evening clinics, more evening work, Saturday and Sunday morning work, coupled with the requirement for consultants to offer their work before private work.'
He said changes in contracts would develop: 'You may begin to see contracts offered that do say, 'as part of this we expect you to work Saturday and Sunday morning'. It is the facility to schedule work in those areas, and we will be paying a plain time rate.'
Portsmouth Hospitals trust chief executive Alan Bedford said extension of the working week was a crucial part of the contract.
He said: 'It is very important. It is the only way we can achieve targets, by sweating the assets we have got.'
Stoke Mandeville Hospital trust interim chief executive Fiona Wise also said the most important aspect was the ability to extend the working day, to get more use out of expensive operating theatres. She said: 'Most trusts would like to look to three-session days.'
The British Medical Association junior doctors annual conference last week called for the contract to be renegotiated because of concerns about the extension of the working day to include evenings and weekends.