It works but is anyone else here!!

CEA without an agreed job plan?

Its that happy time of year again when thoughts turn to the mellow fruitfulness of autumn, golden leaves and golden awards. This years misinterpretation involves Trusts insisting that applicants need to have a job plan signed off by a clinical director to be eligible for a clinical excellence award. This is actually not the case. The DoH and ACCEA guidance says that the clinician...

...Should be engaged in the job planning and appraisal process

In other words there is no compunction for the clinician to have agreed a job plan but simply be negotiating one. This is because CEA's should not be used as a technique for Trusts to enforce job plans without agreement. Clearly there is a responsibility for clinicians to have a job plan whether or not they are applying for CEAs or not but it must be by mutual consent.

ACCEA guidance here

Has this happened in your Trust why not post a comment?

Two EWTD Myths Exploded

Sorry I've got to go home, it's 1 minute after 5 and if I stay then we'll both be in trouble from HR and I won't be indemnified.

First, the reference period for the EWTD is 26 weeks. The hours must balance during that period rather than on a day to day basis. Second, if one extra minute is worked today then compensatory rest is due. The worker can have a minute back as soon as is practical. Third trainees remain indemnified. The Junior Doctors Committee has discussed this matter with the NHS Litigation Authority and they have confirmed that indemnity cover is of course provided.

OK that was three myths so you got one extra for free.

Pensions Under Assualt from the Bean Counters

In our neck of the woods we all had a visit from Price Waterhouse Coopers. This was about 2 years ago. Some clever men and women with clipboards came and asked us what we do, how we might improve things. They wrote it down into a Word Macro and then charged the hospital a fortune. I went to a regional meeting and it turned out that PwC had been into every hospital in the region. Word on the street (no doubt wrong) was that some hospitals had paid up to £1 million to get someone else to talk to their own employees!

Now they have waded into the 'we're having a miserable time in the private sector so you can lose your pension too' debate, reported here by the BBC.

It may be worth noting that in 2006, Keiran Poynter, the previous Chairman of PwC took home £2.5 million (I can't find the figures for the current one strangely). The 793 partners earned an average of £716,000 each. Of course pay and conditions are vital tools in recruitment.

Oddly enough PwC has 16,000 employees in the UK so their partners represent 4.6% of the work force. The NHS has 1 million employees and 40,000 consultants or 4% of the workforce. If senior management are included too it comes to less than 4.6% of employees. Yet our pay and conditions are far too good. Even if our pension contributions are 35% above the private sector their salary is 716% greater than ours. I know which I'd settle for.

Bean counters. They simply can't see beyond the numbers.

Pensions Under Threat

The Great News! The recession is nearly over and it's only needed public borrowing and printing enough money to account for 21% of GDP.

The Bad News. We're broke and you've got to pay it back.

The Result. Pensions are even less affordable than ever and yours is going to be cut.

In a story in today's Times plans are announced to cut council workers pensions. One of the plans is to swap to career related average earnings (as tried a couple of years ago for the NHS). It seems likely that all further pensions accruals (not just new starters) will only continue to build benefits on this basis. For council workers at the upper end of the salary range (a bit like consultants) this will mean cuts in pensions of 10's of thousands per year.

A senior local government official who has been briefed on some of the proposals said that doctors, nurses and teachers were likely to face similar changes as the public sector burden becomes unaffordable.

Wave goodbye to that last minute Bronze award impacting your pension. On a career average basis it'll make not a jot of difference. The pension changes are likely to be brought in with the sweetener of a pay increase. This will of course be eroded over the course of a couple of years DDRB pay awards.

Gird up your loins for a battle!

EWTD and Consultants Filling the Gaps

In many trusts consultants are the glue holding rotas together. Across Trent different approaches have been taken. The summary position is that the hours need to be negotiated.

'...emergency work that takes place at regular and predictable times, often as a consequence of a period of on-call work (e.g. post take ward rounds). This should be programmed into the working week as scheduled PAs'

So if your on call means that you are in on a Saturday from 8am to 12 midnight then you have just worked 5.5 PA's of direct clinical care.  Have the rest of the week off or annualise it and have a couple of extra weeks off per year!

As a medical emergency is defined generally (but nowhere defined in the T&C's);

'An injury or illness that is acute and poses an immediate risk to a person's life or long term health'

A routine trauma list or similar is not really covered by this definition and it can be argued that it therefore lies outside of the compunction to cover emergency work. As this work also lies outside the 7am to 7pm Monday to Friday working week it should be negotiated with doctors as to whether they wish to cover this work or not. Employers cannot force doctors to cover these sessions.

Are Queens' Juniors to be forced to wear uniform?

Uniform is creeping in for doctors across the country. Juniors in many hospitals have been asked to dress like nurses (and we turned a blind eye) and in The West Middlesex Hospital in London consultants, yes that's right consultants have been told that they will be required to wear a uniform consisting of blue polyester trousers and green polyester polo shirt. Other than the fact that I would love to see some of my orthopaedic colleagues response to this demand it stikes me as rather un-professional.

Does nobody know that blue and green should never be seen?

Consultants, the New Senior Registrar

Now that most of our juniors are on EWTD compulsory rest most of the evening, consultants across Trent are happily picking up the ploughshears and putting their backs in to delivering front line care. Gaily staffing all night emergency lists and clerking in little old ladies with collapse query cause. The NHS rapidly seems to be moving away from a consultant lead to a consultant delivered service.

What models of on call have you used to try to make up for gaps in trainee rotas?

What's the BMA ever done for me???

This independent blog has been created  in an attempt to improve communication between consultants in Trent.

The views expressed are our own and not the BMA's (which has many people to keep on side - I think you know what I'm saying!).

Please remember this is a public place. It's entirely anonymous but please avoid defamation or slander.

Thanks.