We're committed to ensuring that temporary working arrangements are only in place during the fight against coronavirus.
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.
There was no specific contractual obligation for you to agree to defer your academic work. But, members were advised to consider their general obligations ‘to protect and promote the health of patients and the public’ and to ‘…offer help if emergencies arise in clinical settings or in the community, taking account of your own safety, your competence and the availability of other options for care’ (Good Medical Practice, paragraph 26).
As COVID-19 related workload diminishes, members have been asking us about the arrangements for returning to academic practice. We have written to academic trainees with some initial guidance which is summarised below.
Following engagement with NHS Employers, we now have a better understanding of the approaches that are being adopted on a local basis. However, 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.
Reassurance that there will be compensatory time will alleviate concerns that taking on additional work will be to the detriment of academic activities. These activities are what have enabled us to get so far in handling this disease, and will continue to do so as we progress towards effective treatment.BMA medical academic staff committee
Letter from employers
Following discussions locally, a joint letter has been issued to academic trainees in Exeter on the arrangements they should expect.
This has been shared with and by the university employers and the Medical Schools Council as an example of good practice. This is the sort of letter that academic trainees should expect to receive from their university.
Recording extra hours
Many of you have reduced your academic hours in order to help the NHS and have also taken on extra hours.
It is important to ensure that clinical academics are fairly rewarded for that work and your university employer knows how many hours need to be reimbursed by the NHS.
The BMA and NHS Employers agreed at the start that those working on time-sensitive projects, and particularly work directly related to COVID-19, should continue with their academic work.
For those who are not, and have volunteered to support frontline NHS work, there is a recognition that doing so will be at the expense of their academic work.
As such, there will need to be a future adjustment to the balance of their job plan to take account of this lost time. This should be jointly agreed between the individual doctor and their NHS and university employers. The BMA has produced an extra-hours record sheet to assist with this.
Senior academic GPs
The arrangements are likely to be similar to those outlined above, except that your honorary contract with the NHS may not cover any clinical work you would be expected to do during the outbreak.
You may need to come to a separate arrangement with your local NHS organisation about what is expected of you and how your university employer will be reimbursed for your additional NHS activity.
Academic GPs who usually undertake all or part of your clinical work as a locum are advised to ensure that your work as part of the COVID-19 response is covered by a substantive contract and that you clarify your entitlement to death in service benefits.
For senior academic GPs in England, we would recommend that you refer to HEE’s e-learning module for GPs returning to the NHS.
Returning to academic practice
Many of you are thinking about whether and when you can return to your research or educational activities.
However, with lockdown and extensive social distancing, many universities are effectively closed to staff and students.
If you have work that you can do from home and now have the time to do it, we would suggest you approach your university with a proposal for a phased return to academic practice.
We would suggest that academic trainees start arranging regular meetings with their academic supervisor(s), if you have not been able to do so already, and supervisors build in more time for such meetings.
- Remind your organisation of the commitments made by the funders at the start of the crisis.
- Read this useful guide to returning to academic practice.
- Read this guide to restarting NIHR-funded projects.
Implications for your academic activity and funding
We have been advised that 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.
We have heard that medical academics, especially trainees, are being regarded as a mobile asset in the fight against COVID-19.
We believe that, whilst academic trainees may have some flexibility about where they would want to work, this should be done on a purely voluntary basis.
The BMA and NHS Employers agree that robust training and induction is essential for all those moving or returning to primarily clinical roles. National guidance has been issued on the minimum requirements for staff returning to the NHS.
Public health academics - call for views
The BMA medical academic staff committee has been asked for views on a revised honorary contract for public health academics from Public Health England.
If you would like to be consulted on the draft, email us on [email protected].