- Health Education England asked to roll out more flexible working to all medical specialties
- Trusts given £10m to spend on improving working conditions
- Health secretary also reveals pension scheme changes and consultant contract ambitions
The government will consider a “modest additional investment” in the junior doctors’ contract two years after a bitter dispute with medics which led to the first strike action in 40 years.
In a wide ranging letter to the British Medical Association, health and social care secretary Matt Hancock attempted to distance himself from the stance of his predecessor Jeremy Hunt saying he wanted to “put the past behind us and move forward” with a review of the contract.
NHS Employers and the BMA junior doctors’ committee have agreed terms of reference to review the 2016 contract with a particular focus on safe working hours, weekend payments and protecting education and training.
In the letter to the BMA Council chair Chaand Nagpaul, Mr Hancock said he was “determined to ensure” the junior doctor contract “enshrines safe working, supports high quality training, pays fairly and is clear and simple.”
He said the contract review would “iron out some glitches and agree how we can make it safer, fairer and simpler.”
“I look forward to reaching an agreement that allows us to put the past behind us and move forward. To support this, we are prepared to consider modest additional investment (in addition to recycled resources) if that would support improved patient care. It is too early to say what level of investment would be appropriate but I will consider this as the review progresses.”
The letter also revealed the secretary of state had asked Health Education England to accelerate efforts to improve training and to roll out a pilot on flexible working in emergency medicine to other specialties.
He also said trusts will be required in future to publish an annual report on rota gaps and a plan to improve those signed off by the chief executive.
The secretary of state also said he wanted to see every trust “implementing e-rostering for juniors” with NHS Improvement asked to make sure this happening.
“Recognising the importance of simple things to improve the work environment for junior doctors, I am making available to trusts £10m to be spent by the Guardian of Safe Working in each trust in agreement with junior doctors locally to improve working conditions.”
Addressing this year’s pay deal, which was not backdated, Mr Hancock said he recognised “the frustration and disappointment” expressed by doctors.
“I have heard that very clearly and it wasn’t a decision I took lightly. In a tight financial year for our health service, the priority had to be ensuring that we could afford the staff we need to provide the care we need to provide to patients, but I would be deeply concerned if doctors took this as a signal that we do not value the extraordinary dedication and expertise which they continue to show day in day out,” he said.
Mr Hancock said he had asked DHSC officials to look into the concerns expressed by the BMA about the independence of the pay review process and the Doctors’ and Dentist’s Review Body which has had its ability to set pay rises capped by the government under austerity.
On the consultant contract, Mr Hancock said he wanted a “long term pay deal including contract reform” to be agreed through a “frank open discussion about how we can work together to do a deal that pays fairly, improves morale, values doctors – and in doing so meets our shared aim of improving patient care.”
He added: “I have asked my officials for advice on what resource envelope could potentially be available for the right long term agreement, to inform [contract] discussions in October and subsequent discussions with employers.”
He revealed the DHSC had asked the NHS Business Services Authority to implement a new “scheme pays” approach for doctors who have breached their annual pension allowance and are hit with tax charges. Under a scheme pays approach, the pension scheme pays the charge and reduces the pension benefit for the individual so they do not have to pay the charge directly themselves.
- Acute care
- Board Talk/governance/assurance
- British Medical Association (BMA)
- Business Services Authority
- Department of Health and Social Care (DHSC)
- Government/DH policy
- Health Education England
- Matt Hancock
- NHS Employers
- NHS Improvement
- Staff wellbeing
- Trade unions