How do I count travelling time in my job plan?
Travelling time to and from the usual place of work is not included. However travel between sites and for
on-call duties is included within the PA for which the travel is necessary. Travelling time for emergencies is
How are lunch breaks counted?
A proper balance of work and rest is vital to maintaining a healthy workforce. BMA Scotland thus
recommends that consultants should ensure adequate breaks from clinical work during the day. However
the nature of many consultants’ work means that it is rarely possible for them to absent themselves from
clinical duties and have a total break. This necessarily professional attitude to patient care means that during
a day of clinical activity it is unlikely that many consultants will be able to free themselves from potential
interruption so as to allow an unpaid lunch break. The professional nature of consultants will allow breaks
to be taken where possible, but their continuous availability during this time is a benefit to patients.
Consultants normally exercise their judgment in taking breaks flexibly, at times chosen to minimise
disruption to patient care and to promote the safety of patients.
How do I calculate cover for colleagues (prospective cover)?
Your workload may be much higher when your colleagues are on leave. Remember this when you are
assessing the amount of time you spend on some activities. This is particularly important when you are
assessing your work done whilst on-call. The on call availability supplement is calculated on the frequency of
the rota commitment (as set out in paragraph 4.10.10 of the TCS). Also remember that your agreement is
required in advance through the job planning process regarding the circumstances in which you will provide
cover for colleagues on leave.
Do PAs have to be calculated in whole units?
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.
Attaching a timed value to PAs is intended to provide greater transparency. However, you and your clinical
manager can agree flexible arrangements. For example, you may average duties over a period of time to
allow for variable childcare commitments. Such agreements should be documented in the job plan. BMA
Scotland supports this approach which is in keeping with such initiatives as the PIN Policy on Supporting the Work-Life Balance.
Do I have to specify where the PAs will take place?
The contract will state your principal place of work. You will generally be expected to undertake your
programmed activities at the location agreed in the job plan. Arrangements to work off-site or at home at
specified times may be agreed in relation to specified duties and should be set out in the job plan, while
some supporting professional activity time can be scheduled flexibly and undertaken off-site. The nature of
public health medicine work means that it is unlikely to be feasible to define specific times and locations in
the job schedule. You may wish to discuss and agree flexible locations with your employer during job
A rigid approach may not be feasible where, for example, office space or resources are limited. BMA
Scotland recommends a flexible approach as beneficial to both consultants and employers.
To maximise the benefit to patients, consultants and employers, SPAs should be scheduled where
appropriate, but by their nature are often best delivered flexibly in time and location. Many consultants have
better IT, reading and other facilities at home than in their workplaces. Furthermore, SPAs undertaken at
home are less likely to suffer interruption and could therefore be much more productive. It is thus not
realistic to insist that all SPAs are undertaken on site. A flexible approach to SPAs reflects a better attitude to
work life balance and is being agreed by many employers.
It is, however, important that you abide by employer guidance on confidential or patient-identifiable data.
You will also need to be able to account for your SPA time at your next job plan review. Many Royal
Colleges and specialty associations give advice on necessary requirements in this area.
Can my employer demand that I work some of my PAs outside the normal working week?
Your employer cannot require you to undertake scheduled work outside 8.00am to 8.00pm, Monday to
Friday and 9.00am to 1.00pm on Saturdays, or on public holidays. Any programmed activity undertaken
outside of the hours 8am to 8pm, Monday to Friday, is regarded as taking place in ‘premium time’. This
means that a programmed activity at these times lasts only 3 hours instead of 4 hours. The contract states
that no more than 3 PAs per week should be out of hours other than in exceptional circumstances.
Remember that significant out of hours work will “use up” your DCC PA allocation more quickly.
The definition of premium time does not mean that , Monday to Friday, has been designated as the ‘normal
working week’. It simply sets a higher rate of pay for work outside of these hours. The normal working
week for a full time consultant is 10 PAs.
However, this is a matter for you and your employer to negotiate prior to taking up post. We recognise that
there are acute specialties where some “out of hours” work by consultants is necessary, so prospective
appointees do need to be realistic about this possibility. If you accept a post with scheduled work out of
hours included in the agreed job plan (for example, on-site working overnight for three nights each month),
then you need to be aware that you then cannot unilaterally withdraw from undertaking this work since
this would breach the contract.
You can, as an alternative, agree to be paid an enhanced rate of pay equivalent to time and a third for such
premium time work rather than reducing the length of the PA (see paragraphs 4.8 2 and 14.5.2 of the
terms and conditions).Where scheduled provision is made for out of hours work, recompense in the form of
premia, may be paid only by mutual agreement between you and your employer.
Non-emergency work for these purposes includes the regular, programmed work of consultants whose
specialty by its nature involves dealing routinely with emergency cases, e.g. A&E consultants.
How are On-call duties calculated?
Your on-call commitment should be clearly set out in the job plan.
The contract has the following provisions for on call and working outside the normal working week in the
Resident on call: Resident on call by consultants is an extremely wasteful way of providing
cover and the contract clearly states that consultants will not, save in exceptional
circumstances, undertake resident on call. However we recognise that in some rare
circumstances this may be necessary. In each Health Board area, LNCs (Local Negotiating
Committees – BMA supported committees in the area who negotiate with Health Boards on
matters not wholly covered in national contracts) will have reached a local agreement with the
employer on the arrangements that will apply to consultant resident on call, including
definitions, remuneration, accommodation and catering.
Working out of hours: In distinction from resident on-call, we recognise that in some
specialties (e.g. anaesthetics, surgery, obstetrics), scheduled out of hours PAs, where a
consultant is mostly “hands on” working, may be necessary, and some rotas are now based
on this working pattern. The terms and conditions of the contract permit employers to seek to
job plan these duties by out of hours scheduled DCC PAs, where each PA has a duration of 3
hours rather than 4 (or, by mutual agreement, a premium rate of pay of time and a third can
be applied). The job plan must be structured to ensure adequate rest is provided before and
after the out of hours period. Remember that the number of PAs undertaken during the out
of hours period should not exceed 3 per week other than in exceptional circumstances.
On call rota: Participating in an on call rota is recognised through the payment of an
availability supplement representing a percentage of basic salary which reflects the frequency
and level of availability. This supplement is separate from the actual work undertaken when
you are on call, which is recognised and paid through the PA allocation.
Under the 2004 contract on-call duties are recognised in three ways:
i) Availability supplement
You will receive a supplement to recognise the inconvenience of being on-call. The
supplement will depend on the rota frequency and the category of your on-call as follows:
Level 1 will apply to a consultant who needs to attend a place of work immediately when
called, or to undertake analogous interventions (e.g. telemedicine or complex telephone
Level 2 will apply to a consultant who can attend a place of work later or respond by noncomplex
telephone consultations later.
| Frequency of Commitment
|Value of supplement as a percentage of full time basic salary
|| Level 1
| High Frequency:
| 1 in 1 to 1 in 4
| Medium Frequency:
| 1 in 5 to 1 in 8
| Low Frequency:
|1 in 9 or less frequent
In calculating the frequency of the rota, it is important to take into account prospective cover
rather than taking the frequency to be equivalent to the number of people taking part in the
rota. Prospective cover will result in a change in the frequency of your rota commitment and
therefore of the frequency band. For example a 1 in 10 or 1 in 9 rota with prospective cover
will be pushed into the medium frequency band, becoming at least a 1in 8 rota, and a 1 in 5
rota will be in the high frequency band, becoming a 1 in 4 rota. This is based on the formula:
rota after including prospective cover is 1 in (number on rota x 42/52).
This is an area where a collective agreement for all consultants in a department might apply or
where the local negotiating committee may have reached an agreement with the employer.
(ii) PA allocation for predictable work: taking place at a regular and predictable time, often
as a consequence of a period of on-call work. An obvious example is post-take ward rounds.
This should be programmed into the week as scheduled direct clinical care PAs. This predictable
work should be relatively easy to assess as by its nature, it will happen fairly regularly. There is
no limit to the amount of this type of work you can put in your job plan. However, no
more than 3 PAs per week should be undertaken during the out of hours period other than in
exceptional circumstances (para 4.8.5 of the 2004 Scottish consultant contract).
(iii) PA allocation for unpredictable emergency work: work done on-call which is directly
associated with on-call duties, e.g. recall to the hospital for an emergency operation, public
health management of a case of meningococcal disease. This work will be much harder to
assess and you will simply need to keep a record of what you do over an on-call period and
then average that out as a weekly amount. For example, if you have a 1 in 4 rota, do a full
week of on-call at a time and during that week, there are 4 PAs worth of unpredictable
emergency work, then that would be 1 PA allocated in your weekly job plan. There is a limit
of 2 PAs per week for unpredictable work. If you are working more than 2, then you
can still get recognition for this work by pay or time off. If this work is sufficiently regular,
it should be programmed as predictable work.
If you cover your colleagues’ on-call duties when they are away on study leave, annual leave
and public holidays, make sure you bear this prospective cover in mind when assessing your
workload for both types of emergency work. With 6 weeks’ annual leave, on average 2 weeks’
study leave and public holidays, you are likely to be covering 10 weeks of each colleague’s
duties. This may mean your average out of hours workload is greater than that measured
when nobody is on leave. This is another issue on which the local negotiating committee may
have reached an agreement with the employer.
Remember there is no obligation for a consultant to be resident on-call at night. Where you
agree to be resident at night, the rate payable is for local agreement between the employer
and the local negotiating committee. BMA Scotland believes that this should be substantially
higher than standard or premium time rates.
My job plan has more than 2.5 SPAs and I have additional responsibilities. The total of PAs is therefore more than 10 – how will this be paid?
For full-time consultants, the contract says that your job plan will include 7.5 PAs of direct clinical care and
2.5 PAs of supporting professional activities (SPAs) per week, unless otherwise agreed. However, if your job
requires more supporting professional activities or includes additional responsibilities or other external
duties, this must be reflected in your job plan by reducing your direct clinical care, paying extra PAs (if you
agree) or both.
All consultants should keep detailed diaries of their SPA activities, including evidence of
output, eg audit results, CPD activities, feedback from teaching and training etc. You have an
obligation to fill the time agreed with appropriate activity within the definitions of SPA