• Luton and Dunstable University Hospital FT had major increase in consultants indicating they would cancel extra appointments
  • Trust offered senior doctors time off in lieu in a bid to avoid high number of cancellations 
  • Trust bosses now tasked with finding alternative cover

Consultants at a major teaching trust were offered time off in lieu to stop them refusing extra work because of the ongoing NHS pensions crisis, HSJ has learned.

In May this year, Luton and Dunstable University Hospital Foundation Trust had an “exponential increase” in consultants indicating they would stop carrying out additional sessions.

According to a report to the trust’s board, this was a “direct result” of the confusion around how they would be affected by the annual allowance taper, which restricts the amount higher earners can save into their pension before incurring tax charges.

To encourage staff to carry out their planned extra work in May and June, trust bosses offered consultants time off in lieu later this year. They hoped this would give staff enough time to get financial advice and work out if it was necessary for them to scale back their hours to avoid being hit by a large tax bill. 

Luton and Dunstable’s deputy chief executive Cathy Jones told HSJ it was becoming clear the trust would have to increase its workforce to deal with people taking the extra time off in the fourth quarter of the financial year.

She added: “We will need more workforce when that comes around. We are hoping that those who continued with their sessions will find when they have got their advice they will fall short of the threshold.

“But actually, given that teams are also looking to reduce their programmed activities substantively we are clearly going to have to look to increase our workforce to compensate the loss that this is bringing.

“And that is hard because there aren’t the people out there.”

The report to the trust’s board, which was sent to the trust ahead of its July board meeting, read: “The trust has acted to offer consultants flexibility in continuing to deliver extras in the short term, with the offer of time off in lieu later in the financial year if subsequent independent financial advice is for them to stop carrying out additional work.

“Our non-consultant staff have also been supportive in offering additional sessions where possible for example in endoscopy, although these staff do not offer the same level of flexibility as consultants.

“This has mitigated the original risk of cancellations of large numbers of patients who already had appointments booked in May and June.”

The report added the trust predicted it would struggle to meet its performance targets, including 62-day waits for cancer and maintaining no 52-week waits, because of the issues caused by the pension tax rule changes. 

Since April 2016, the annual allowance taper has restricted the amount of tax relief available on pension contributions to those with a threshold income over £110,000, gradually reducing it from £40,000 to £10,000.

Concerns have been raised that the changes are discouraging doctors from taking on extra work, or encouraging them to leave the health service altogether.

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