Junior doctor Medical student England Contract

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Junior doctor contract review 2018

Sheffield children’s hospital 20 Oct 2016

In August 2018, the BMA, working in equal partnership with NHS Employers and the Department of Health and Social Care (DHSC) have begun the review of the 2016 junior doctor contract in England. 

The first meeting of the newly reformed Joint Negotiation Committee (Juniors) met on 31 August 2018 to formally commission and start the review process.

Read the joint statement

 

Background

Since the imposition of the 2016 contract, the BMA has remained in dispute with the government and therefore hasn’t been able to agree any changes to the contract. However, we have been meeting regularly with NHSE on an informal basis and have focused on resolving issues raised by members, including tackling fatigue, improving rostering, and securing improvements for less than full time trainees. Further details on key achievements between 2017-18 are outlined below. 

There remains a number of areas where substantive change is still required, and we plan to address these in the review now that we have secured a commitment to negotiations as equal partners. We have been clear that the review must result in enhancements that will improve junior doctors’ working lives and address the issues that have previously stopped the contract from being collectively agreed.  

 

Junior doctor contract review survey

As part of the review process, we're collating as much evidence to support our negotiations with NHS Employers. Our survey of your experiences working on the 2016 contract has now closed – thank you to everyone who took part.

 

What will be reviewed

We have secured commitments from the Secretary of State for Health and Social Care as part of the 2018 review process on the following: 

  • The pay linked to evening and weekend working will be re-considered and the potential for additional, new, outside of the envelope funding will be part of that conversation, particularly for those working the most weekends.

  • There will be a strong focus on safety and training, and on ensuring that exception reporting works so that juniors don’t miss out on training, or work excessive hours, because of service pressures. 

  • HEE will look at how the Enhancing junior doctors working lives programme of improvements related to training (for example rota notice periods) can be accelerated.

  • Extension of the less than full time emergency medicine pilot to other specialties. 

  • In future, as part of the Quality Accounts, every trust must publish a consolidated annual report on rota gaps (which reflects rota notice periods) and the plan for improvement to reduce these gaps. This would need to be signed off by the chief executive of every trust and would be publicly available. 

  • All trusts will implement e-rostering for juniors to improve work-life balance and flexibility.
  • £10m will be made available to trusts via the guardians of safe working and local junior doctors forums; and will be specifically allocated to improving working conditions for junior doctors via facilities and resources.

 

The 2018 review process

The first step in the review process has been to establish five working groups that will gather data and evidence on how the contract is working. Our focus will be on jointly agreed themes, which reflect the outstanding issues and areas of concern as identified by your JDC.

The five key themes are:

  • Less than full-time, flexible working and equalities
  • Pay structure and transitional arrangements
  • Safety and wellbeing
  • Workforce 
  • Training and education

The role of the working groups is to commission research, evaluate data and prepare possible options and recommendations to improve the contract. The issues arising from the thematic research will inform how the review proceeds, with BMA members kept informed and engaged throughout the process. 

The groups will be supported by an overarching data group comprised of BMA, NHSE and DHSC analysts, that will draw together a shared source of data to enable discussions to be underpinned by agreed facts and evidence. 

The research outcomes from the working groups will be used to support the development of evidence-based objectives for improving the contract. These will form the basis for formal negotiations in 2019 to agree amendments to the 2016 contract. 

The final package of amendments will be presented to members and a referendum undertaken on whether to accept the new contract.