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In August, the BMA junior doctors committee entered into the 2018 review of the imposed contract, in equal partnership with NHS Employers while maintaining our dispute. It heralds new opportunities for junior doctors, with a chance to move forward and work for meaningful improvements.
Any review of the contract has to be robust and evidence based, to ensure that we correctly identify what is and isn’t working. Under ACAS facilitation, we agreed a framework for the review which enables all parties to objectively assess the impact and difficulties caused by so many brand untested mechanisms of working. But what is most important is that we address the issues identified as being unacceptable to the junior doctor workforce, when they rejected the contract in 2016.
Rejection of the contract came in many forms, but some of the biggest concerns centred on the disproportionate impact it had on women and less than full time trainees. In their own equalities impact assessment, the Department of Health and Social Care admitted this to be the case, a fact that was and remains, wholly unacceptable. With other pieces of work taking place around the gender pay gap and improving the flexibility of training, it was appropriate that we dedicated sufficient resources to address these difficulties through contractual review.
The review process has established five groups, of which less than full time, flexible working & equalities is one. The other groups include: pay & transitional arrangements; safety & wellbeing; workforce; and training & education. Each group will concentrate on different aspects of junior doctors’ working lives and will be supported by an overarching data group comprised of BMA, NHSE and DHSC analysts, drawing on a shared source of data to enable discussions to be underpinned by agreed facts and evidence. This allows for data to be validated and agreed by all parties, before it can be brought into negotiations, to avoid disagreement and ensure the difficulties such as those encountered over ‘7 day working’ do not reoccur. The review will conclude at the end of December, and the groups will make formal recommendations to inform negotiations in January.
The ‘less than fulltime, flexible working & equalities’ group will focus specifically on topics to improve contractual mechanisms for these groups, ensuring a contract that is fair for all regardless of specialty, working pattern or gender. There will be a new impact assessment to determine how working lives have changed compared to the previous contract. It will look at non-contractual elements including the extension of the LTFT emergency medicine pilot to other specialties, the associated costs of training and how improvements to work-life balance can be strengthened for all junior doctors.
We will be communicating with you regularly, asking for your views and expertise in informing this vital work. In return we will continue to keep you fully informed about the progress and challenges we encounter along the way.
Now is our chance to make a better contract, one that is fairer and improves the working and training lives of all.
Mairi Reid is deputy chair for terms and conditions of service and negotiations on the junior doctors committee.
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