'Substantive' review of junior doctors' contract to go ahead

During the 2016 junior doctors’ dispute it was agreed via Acas, or the Advisory, Conciliation and Arbitration Service, before the contract was imposed in 2016 that the British Medical Association and NHS Employers would commission a review of the efficacy of the contract and to identify any areas for improvement to the contract terms.

When the BMA failed to accept any negotiated contract, the government pressed ahead with the contract and kept the committment for a review in 2018.

The contract dispute led to the first strike action by junior doctors in 40 years with four separate strikes with tens of thousands of outpatient appointments and elective operations cancelled.

According to documents published ahead of its conference this weekend, the Junior Doctors’ Committee said: “We continue to engage in informal talks with NHS Employers to resolve issues arising from the implementation of the contract and are preparing for the substantive review of the terms and conditions from August 2018.”

It said it also “continues to reaffirm rejection of the 2016 contract” and “remains in dispute with NHS Employers over its decision to press ahead with the imposition”.

It said two workshops have been already attended by NHS Employers, the Department of Health and Social Care, Health Education England and the BMA to discuss “the negotiating machinery for the review” and to agree a draft terms of reference.

It added it has “committed to hold a referendum on the final outcome of the review and/or to subsequently ballot eligible members for industrial action (should this be required)”.

The BMA told HSJ it was committed to the review and would set its objectives based on feedback from members.

Kaanthan Jawahar, BMA local negotiating committee representative for Nottingham Healthcare Foundation Trust, said he hoped the review would “fine tune” the issues that have arisen in the contract, so that “the work can continue to improve our terms and conditions”.

“It needs to be made clear what the purpose of exception reporting is and what the guardian of safe working’s role is and the importance of work scheduling,” Dr Jawahar said.

He added: “The biggest challenge is culture change, both within and outside of the medical profession.”

Sandeep Ranote, medical director at Northwest Boroughs Healthcare Foundation Trust, told HSJ that the guardian of safe working role had been “received positively” by junior doctors.

“There needs to be an emphasis on how can we look after the health and wellbeing of some doctors,” Dr Ranote said and he stressed the review was important.

“At the heart of this is listening to and supporting our junior doctors and a good work life balance and review of pay is part of that,” she said. “If it does raise issues, good, let it raise issues.”

Danny Mortimer, chief executive of NHS Employers told HSJ there had been an “agreement in principle” between the BMA, the DHSC and NHS Employers for the review.

Mr Mortimer said: “All the parties have agreed to enter a process as equal partners to jointly review the efficacy of the contract, and take forward negotiations to address the areas requiring improvement. Work is underway to identify the scope and timetable of the review.”