At the start of the pandemic, clinical academics were being asked to or wanted to shift their focus away from academic activity and towards clinical activity.
As COVID-19 related workload is diminishing, members have been asking us about the arrangements for returning to academic practice. We have produced some initial guidance below.
Contractual agreements when working in the NHS
There is no standard national approach. As such, before agreeing to any change to your working arrangements, you should ask:
What contract you will be working under
We recommend that this should be through an honorary contract arrangement, including for academic trainees. However, academics returning to the NHS who do not hold any existing contract with NHS or HEI (higher education institutions) employers should be employed either on fixed term contracts, or locum arrangements, according to whether they can commit regularly or on a more ad-hoc basis.
What the indemnity, supervision and clinical governance arrangements will be
On indemnity, the Government has introduced additional indemnity cover for clinical negligence liabilities that arise as part of the coronavirus response to provide an additional safeguard to clinicians.
It is essential that your employer clearly sets out what support you will be given to perform your duties safely. You are also advised to consult your medical defence organisation. The indemnity arrangements under the Coronavirus Act do apply to work for local authorities.
What the arrangements for pay will be
Clinical academics will be paid according to their terms and conditions for core and additional hours, except where local agreements for additional pay have been reached.
How you record your clinical activity
It is important to ensure that you are paid appropriately for work done during the day and in unsocial hours. The model hours record sheet below will help you with this.
Whether previous service with the NHS or university will be recognised
The BMA’s view is that employers should factor in service in either the NHS or the university sector when calculating entitlement to sick leave, pay and other employment benefits.
Follet review principles
How do the contractual arrangements meet the shared commitment by the employers and the BMA to the Follett review principles of joint management and supervision?
Continuous service and pay
Where possible, you should continue working under existing substantive and honorary contracts, where these are in place, with an ‘exceptional’ change to your working pattern or job plan.
Funds can then be transferred between NHS Employers and HEIs at a later date, allowing for continuous service, with all of the benefits that accrue. Initial conversations show HEIs are agreeable to this temporary arrangement.
NHS Employers agree that the simplest model is for the NHS employer to keep a record of all the additional work being undertaken for the NHS, including work under your job plan/work schedule and any additional hours.
The HEI will process payment to each individual and charge the NHS employer for the work undertaken.
The NHS employer can ensure that all additional COVID-19 costs are being assigned to the newly established cost centres for the pandemic so that they can be accounted for and recovered centrally.
We recommend that you ask your university if they will regard this period as not being a break in service.
Whilst working under an honorary contract, it is important that it has the necessary protections as detailed above.
There are model honorary contracts for consultant clinical academics in each of the nations of the UK and the BMA and NHS Employers in England have agreed a checklist of minimum standards. If in any doubts, contact us.
Senior academic GPs
Implications for your academic training and funding
where academics agree to divert their time and attention to frontline health services, appropriate arrangements will be made to allow for extension to deadlines for submissions.
As above, you should first reach agreement with both your NHS and university employer about how any lost academic time will be reclaimed in the future.
Subject to local arrangements, you may also need to keep a record of your extra NHS activity to enable your university employer to claim back the cost of your time from the NHS.
The NIHR (National Institute for Health Research) and other funders have stated that no academic will be disadvantaged by returning to focus on frontline services. They are working on details of how awards and fellowships can be extended to accommodate this exceptional activity.
Please see the joint statement from the Royal College of Physicians on COVID-19 and clinical academics.