Authors: Emma Runswick and Pete Campbell
On the 30th March, BMA Junior Doctors Committee and NHS Employers published a joint statement which stated that:
“the BMA agree that when not possible to implement, the working hours restrictions and rest requirements in the TCS will be suspended and that the Working Time Regulations 1998 (WTR) will be the fallback position for the duration of the pandemic.”
“Trusts should discuss proposed new patterns of work with affected trainees prior to implementation”(emphasis ours)
Some supporters of the Broad Left, ordinary members of the BMA and the Junior Doctors Committee representatives strongly objected to this and the joint statement was rewritten reflecting some of our concerns. The up-to-date statement is available here.
We were, and continue to be, in favour of sensible flexibility during the pandemic, with the aims of providing appropriate medical cover particularly during staff sickness. However, we argued that giving employers permission to ignore our contractual rights for an undefined reason without agreement from the affected junior doctors, with no clear endpoint for that position, was dangerous.
We argued for changes, including highlighting the importance of safe working, ensuring consultation of affected trainees, and that trusts would have to prove that breaching our terms and conditions was truly a last resort.
End of “Emergency Covid-19 Measures”
On the 29th April NHS England wrote to all trusts requesting the restart of all urgent non-COVID 19 service and the gradual reintroduction of elective work. This has led to a slow withdrawal of the redeployment of junior doctors, and led us to reconsider the joint statement. The end of redeployment or restarting elective work is evidence that workload is normalising and normal TCS should be met. However, in lots of trusts, this is not happening.
“Step down” rotas are being implemented in some trusts which are designed to ‘catch up’ with delayed NHS services, some of these rotas continue to breach contractual protections with the backing of the joint NHS Employers and BMA statement. These rotas can be nothing like pre-covid rotas, with increased intensity, additional weekend working and additional hours.
Pay and Leave Arrangements
Many representatives working locally are yet to see fulfilment of the promise made by NHS Employers:
“NHS Employers is grateful for the commitment made by junior doctors and the BMA at this time and will take this into account when preparing for future negotiations once the COVID19 pandemic is resolved.”
Local trusts and Programmes are returning rapidly to old tricks, attempting to “charge” a 1.5 days of annual or bereavement leave for the new 12 hour standard day, denying leave requests and creating limits on what leave can be carried over into future rotations. Legislation aimed at allowing key workers to carry over untaken leave during the pandemic specifically excludes junior doctors.
There is notably no national agreement on payment for untaken leave, and the new version of the contract has been withdrawn from the NHS Employers website – perhaps due to the new section on the value of a day of annual leave.
16.9 On termination of your employment, you will be entitled to pay in lieu of any outstanding entitlement accrued in the leave year in which your employment terminates or be required to repay to the Trust salary received in respect of annual leave taken in excess of entitlement. The amount of the payment or repayment shall be based on accrued salary for the leave year paid at a rate of 1/260th of your salary for each day accrued.Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016 Version 9 (withdrawn)
There also doesn’t appear to be a pay deal for >1 in 2 weekend frequency, though some local BMA reps have won excellent deals (eg at Liverpool University Teaching Hospitals).
In nursing, the government has withdrawn the deal offering payment to “aspirant nurses” (final year nursing students) leaving many in the lurch, despite thunderously clapping for carers.
We cannot trust the government, or NHS Employers, to treat us fairly or recognise our work with mealy mouthed promises. If there is a second wave, we must not be put in this position again – we need better protections and agreements on pay and training arrangements in advance.
We are shattered
Many of us have had an extremely rough few months. Some of us have lost friends, family, and colleagues to the virus. Some of us have been sick. Some have not been able to see our families – abroad, or living away for protection, or shielded. Most of us have cancelled leave, given up training plans, worked harder rotas and stepped into unfamiliar medicine to play our part in pandemic response.
Now more than ever we need contractual protections for rest and working hours, alongside other positive trade union endeavours like the Fatigue and Facilities Charter. Many of the positive aspects of the response to the pandemic are already being stripped away. If we don’t act now to allow recuperation, there won’t be anything left to give in a second wave.
The BMA must now withdraw from the joint statement and work with local representatives to ensure safe rest and hours limits are implemented across the UK.