Medical academic Contract England Northern Ireland Wales

Last updated:

The Follett Review Principles

All medically qualified academic staff working for both the NHS and a higher education institution should be employed subject to the principles recommended by Professor Sir Brian Follett in his Review of appraisal, disciplinary and reporting arrangements for senior NHS and university staff with academic and clinical duties published in September 2001.

The recommendations are broadly accepted by both sectors and are known as the Follett Review Principles. The key principle is for NHS and university organisations involved in medical education and research to work together jointly to integrate the separate responsibilities.

In practice, this should mean:

The purpose of this Memorandum of Understanding is to: -

  • there should be joint strategic planning bodies, with joint subsidiary bodies that are responsible for staff management
  • for staff with both clinical and academic duties there should be procedures that are articulated clearly, and which cover all aspects of their work
  • staff should be made fully aware to whom they are accountable for all aspects of their work
  • honorary and substantive contracts of employment should be cross referenced, consistent and issued in a single package
  • joint appraisal and performance review for clinical duties should be based upon the system that is used for NHS consultants
  • honorary and substantive contracts should be interdependent, with an obligation on both parties to inform the other about any issues relating to appraisal, job planning, discipline and dismissal.


The honorary component and the substantive component

Good practice for the employment of clinical academic staff recognises that both the honorary component and the substantive component are distinct contracts of employment, but that they may be perceived in holistic fashion, whereby performance of clinical duties under an honorary NHS contract may be necessary for performance of duties under a substantive academic contract.

Joint working of handling concerns about doctors with both an honorary and a substantive contract is expected in four areas:

The purpose of this Memorandum of Understanding is to: -

  • appraisals must be undertaken jointly
  • permission of the doctor must be obtained for the exchange of sensitive personal data, such as medical records, between the honorary and substantive employers
  • honorary contracts should contain an 'interdependency clause' stating that the honorary contract is based on a substantive contract of employment with a university being held and if the university post is terminated for any reason, the NHS organisation reserves the right to review the continuation of the honorary contract
  • the university and the NHS organisation develop co-partnership relations with each other and ensure jointly agreed procedures are in place for dealing concerns about doctors with honorary contracts.

The principles of joint working were further reinforced by the memorandum of understanding on post academic and clinical staff developed by employers and the unions in response to the University of Glasgow and HM Revenue and Customs VAT tribunal ruling in 2005.



The Follett Review Principles - Full report (PDF)