Junior doctor contracts in England

Published Tuesday, January 5, 2016

This Commons Library briefing provides background information on plans for the introduction of a new contract for doctors in training (junior doctors) in England, including a summary of the proposed changes, and an update on the current state of negotiations between NHS Employers and the BMA. The briefing also provides some brief information on the delivery of seven day services and proposed changes to the consultant contract.

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NHS Employers, on behalf of NHS organisations and the Government, are currently working on detailed proposals for reformed contracts for doctors in training (junior doctors). Separate negotiations are taking place on a new consultant contract.

The Department of Health sets the framework for NHS Employers’ work on NHS staff contracts, and has specified that revised contracts must be broadly cost neutral. The Health Secretary also asked the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) to report on contract reform, and how this can support the delivery of seven day services.

For junior doctors, the new contract would mean an extension of plain time working further into the evenings on weekdays, and to Saturdays. It would also make changes to pay progression and replace the banding system, where pay supplements are based on an assessment of the length and unsocial timing of contracted work.

NHS Employers state that their proposed contact changes will:

  • Enhance the quality and quantity of training opportunities.
  • Provide a higher basic rate of pay.
  • Provide proportionate payment for additional hours worked.

Negotiations between NHS Employers and the British Medical Association (BMA) junior doctors committee stalled in October 2014.  The BMA have expressed a number of concerns about the proposed contract changes, including concerns that doctors' welfare and patient safety are not being sufficiently considered by NHS Employers.

While the BMA has re-entered negotiations over the consultant contract it is calling on the Government to reverse the current proposals for change to the junior doctor contract.  In July 2015, the Health Secretary set a deadline of mid-September for the BMA to re-enter negotiations.  The BMA junior doctors committee refused to do so and the Government has said it will impose the new junior doctor contract in time for the new intake in August 2016. The new contract will apply to any doctor in training taking up a new employment contract.

On 26 September 2015 the BMA announced a ballot of junior doctors on industrial action. A detailed offer for a new contract was published by NHS Employers on 4 November 2015; this was rejected by the BMA. The results of the ballot were announced on 19 November 2015: 98% supported strike action (based on turnout of 76%).

The BMA had planned for junior doctors to provide emergency care only on 1 December 2015, and for a full walk-out from 8am to 5pm on 8 and 16 December. The BMA also called for the involvement of the Advisory, Conciliation and Arbitration Service (ACAS) and talks between the BMA, NHS Employers and the Department of Health began on 26 November. An agreement was reached on 30 November for the BMA to suspend its planned industrial action, and for the Department of Health to temporarily suspend implementation of a contract without agreement.

The negotiations broke down on 4 January 2016 and the BMA gave notice of industrial action on the following dates:

  • 8am Tuesday 12 January to 8am Wednesday 13 January (emergency care only)
  • 8am Tuesday 26 January to 8am Thursday 28 January (emergency care only)
  • 8am to 5pm Wednesday 10 February (full withdrawal of labour)

The BMA and NHS Employers have issued statements setting out their views on how the negotiations had progressed, and the issues on which they could not reach agreement; both sides have offered to return to ACAS to continue talks. See the further reading section of this note for coverage of the most recent developments.

The negotiations only relate to the junior doctor contract in England; the health departments in Wales and Scotland have said they will maintain the existing contractual arrangements and no decision has been reached in Northern Ireland.

Commons Briefing papers CBP-7314

Author: Tom Powell

Topics: Health services, Health staff and professions

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