PAs are 'Programmed Activities' - in older contracts they were called 'sessions' or 'notional half days'.
A PA is 4 hours of work if done within the normal working week (7am to 7pm Monday to Friday). A PA done outwith this normal working week is 3 hours of work. Work done does not have to equal a 'whole' PA, as some activities don't need 4 hours of work per week. It is possible to schedule work as 0.5 PAs, average it more sensibly over a period of some weeks, or group a number of activities together added up to equal 1 PA.
All of the activities in your job must be detailed in a job plan. You should not take up a post unless this has been precisely agreed with you. Any advertised post should include a proposed job plan in the information pack. If one is not included in that pack, you should ask to see one.
How many PAs should my contract be for?
The standard full-time contract is for 10 PAs. Posts that are less than full time will be for fewer than 10 PAs. Your prospective employer can advertise a post for more than 10 PAs, generally 11 or 12 (as greater than 12 would usually necessitate the consultant opting out of the European Working Time Directive, which an employer cannot require of them).
What are DCC and SPA PAs, and how many should I have?
DCC (direct clinical care) PAs form the largest time commitment in the contract. The standard 10 PA contract will have 7.5 DCC PAs. Examples of DCC activity include ward rounds, clinics, operating lists, clinical administration (dictation, phone calls about clinical matters etc), multidisciplinary meetings and so on.
Supporting professional activity programmed activities are usually abbreviated as SPAs. The standard 10 PA contract should contain 2.5 SPAs. PAs are those activities which the vast majority of consultants undertake in addition to their clinical work which are essential to their department's work and their own professional development.
The standard 10 PA contract should have 2.5 SPA PAs. Examples of SPA activity include teaching, training, research, audit, departmental management meetings, dealing with non-clinical emails, personal continuing professional development (CPD), appraisal and so on.
Can my employer demand that I work more than 10 PAs?
No, they cannot. In reality many consultants may wish to work an 11th or 12th PA. The contract works both ways: your employer cannot demand more than 10 PAs of you in a full-time post, and you cannot demand greater than 10 either. (However, if you are contracted for 10 but believe in reality you are working more, please see the more detailed job planning advice listed at the end of this guide).
One of the aims of the 2003 contract is to give consultants a mechanism for limiting their hours of work, and this is one of the most powerful tools for that. However a consultant undertaking private practice who has declined an extra PA where one is offered may risk their pay progression. This does not apply if he or she is already working the equivalent of 11 or more PAs. Many established consultants work more than 10PAs; when replacing them an employer might try to put all their clinical work into a 10PA job plan and cut the SPAs.
The importance of SPAs
Consultants should always have enough time in their job plans for non-clinical work (SPA time). It is during SPA time that consultants have the opportunity to improve and hone their skills, research, innovate, develop new techniques and build new services. Consultants have a responsibility to ensure that the work they carry out in this time contributes to their job. Employers have a responsibility to support this and understand the link between quality and efficiency.
Some employers contend that 'new' consultants need fewer SPAs and advertise jobs with fewer than 2.5 SPAs. We do not agree with that position, as we strongly believe that consultants at the start of their career have just as much to offer in teaching, training and managerial roles and have just as much, if not more, need for professional development. For these reasons, offering new consultants fewer SPAs is not justified, in our view. Consultants with 2 or fewer SPAs would find it extremely difficult to take any active role in teaching, training or management. Over time, the absence of such duties would also potentially prejudice that consultant if they were applying for CEAs.
What should I do if I am applying for a job advertised with fewer than 2.5 SPAs?
The wording in the model contract is that job plans 'will typically include an average of [71/2]
Programmed Activities for Direct Clinical Care duties and [21/2] Programmed Activities for Supporting Professional Activities.'
Firstly, a deviation from this should be questioned and the consequences understood. However, we recognise that for some applying for their first consultant post, particularly if there is competition for posts, acceptance of fewer SPAs may make some candidates feel they are more likely to get the job. If you do accept a job with fewer than 2.5 SPAs you should make sure that your job plan specifies what you do in your SPA time and what objectives are associated with this work.
Secondly, you must keep a diary of all your work once you take up post. The BMA believes that SPAs are an essential component of a consultant's job plan and we will fully support any consultant who is experiencing problems in agreeing an appropriate number of SPAs in their job plan. You can request an interim review of your job plan if at this time you feel you are doing hours and duties beyond or different from what you are contracted to do. Your employer is obliged to undertake a job plan review if you request it, and there is a process of mediation and appeal if it does not result in a mutually agreed resolution. If you are not paid for 2.5 SPAs per week, you should make it clear to your employer that you cannot carry out the work that you would otherwise have been able to do.
Using a diary and a record of what has previously been achieved in SPA time will underline the importance of the work you do and your employer will be more likely to understand what it is the trust will lose out on as a result of not agreeing adequate SPA time. On the other hand, you may be reluctant to scale back necessary SPA work. Your case for proper payment for this work will be greatly strengthened by being able to produce an account of time worked and things achieved.