Working arrangements for consultant anaesthetists

Working Arrangements
Sean Tighe
AAGBI Council Member
[email protected]
Topical Topics!
Study/Professional Leave
Acting down
Resident on call/ shift working
Extra duty payments
2003 Consultant contract; “Typically” 2.5
PA in a 10 PA contract
Now down to 1 SPA and 9 DCC in some
Most SAS have < 1 “session” for personal
How did this happen?
We were not doing it?
We let it?
We had no choice?
We wanted it?
How to maximise
Robust LNC?
Robust Colleges?
Robust individuals?
Robust job planning
SPA Action Plan
Use the new contract!
Do not be intimidated
Be robust at job planning
Have reliable diary evidence
Do not work for nothing
Drop commitments if not paid for
Mediation, Appeal
Ensure new applicants know the SPA offer
– Get REA/RCA support
– Discourage applicants if not adequate SPA?
Study and Professional leave
“Paid” study leave is a contractual
entitlement defined in 2003 contract
– Max of 30 days in 3 years
– With pay and expenses
– The amount of expenses paid is not defined
– Increasingly restricted budgets
Professional leave is discretionary
– No obligation to allow any!
Study Leave Action Plan
Define CEPD requirements at appraisal and in PDP for revalidation
– “with expenses” if possible
Get CD and MD signed approval of PDP
Apply for expenses in advance
If expenses refused either;
– Refuse to go on S/L and then make formal complaint to CD, MD Clinical
Tutor and LNC re revalidation failure
– Include complaints in annual appraisal
– Encourage colleagues to similar action
– Write to RCA President re training and CPD implications
– Involve BMA
– Obtain trade sponsorship and warn of consequences
– Fund it yourself and claim tax relief if doing PP
– Formal grievance procedure
– County court
Professional Leave
LNC agreement on allowance
– Importance of wider contributions to NHS
– Get sponsor to write to CE
– Statements from National authorities
– Stress individual negotiation with MD
Expenses rarely required
Professional Leave Action Plan
Plan ahead
– Include in appraisal/PDP objectives
– Give annual estimate to MD in advance
– Negotiate with MD in advance
If exceed allowance;
Discuss with CD/MD
Annualise/ Flex SPA
Annualise DCC
Use AL or take unpaid leave
Arrange external funding to Trust
Acting down
Increasing requirement
– Usually illness/accident/overslept/Rota confusion!
Different to resident on call or 1st on call
– Irregular, unpredictable, short notice
Must be an LNC agreement in place
Base on BMA guidance
Exhaust alternative arrangements, eg locums
Executive approval
Need another consultant to take over O/C—paid 1 PA
3 x PA or 2 x PA plus time off in lieu, or 2 x time off in
– EWTD; 11 hours rest next day, in addition
Shift working
Must be mutual agreement if appointed to
another job plan
– Mediate/Appeal if pressurised
Base remuneration on 2003 contract
May suit some
Resident on call
Not recommended by CCSC for consultants
Outside 2003 contract
Not cost effective
Very few PA’s left for elective DCC
May suit some!
All the time is working time
– 4 PA for one night O/C
EWTD implications
– Must have 11 hours rest, ideally consecutive
– Can be delayed and taken “as soon as
Extra Duty Payments
Definition; irregular, temporary activity
Eg, WLI’s
Insist on parity with surgeons and all other
If in paid SPA time
– Declare when and where the SPA will be
done and demand payment, or
– Agree to “flex” SPA, without payment, or
– Get DCC time back in lieu (Annualisation?)

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