If you continue without changing your settings, we’ll assume you’re happy to receive all cookies from the BMA website. Find out more about cookies
When you visit any web site, it may store or retrieve information on your browser, mostly in the form of cookies. This information might be about you, your preferences or your device and is mostly used to make the site work as you expect it to. The information does not usually directly identify you, but it can give you a more personalised web experience.
Because we respect your right to privacy, you can choose not to allow some types of cookies. Click on the different category headings to find out more and change our default settings. However, blocking some types of cookies may impact your experience of the site and the services we are able to offer.
These cookies are necessary for the website to function and cannot be switched off in our systems. They are usually only set in response to actions made by you which amount to a request for services, such as setting your privacy preferences, logging in or filling in forms.
You can set your browser to block or alert you about these cookies, but some parts of the site will not then work. These cookies do not store any personally identifiable information.
These cookies are required
These cookies allow us to know which pages are the most and least popular and see how visitors move around the site. All information we collect is anonymous unless you actively provide personal information to us.
If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance.
These cookies allow a website to remember choices you make (such as your user name, language or the region you're in) and tailor the website to provide enhanced features and content for you.
For example, they can be used to remember certain log-in details, changes you've made to text size, font and other parts of pages that you can customise. They may also be used to provide services you've asked for such as watching a video or commenting on a blog. These cookies may be used to ensure that all our services and communications are relevant to you. The information these cookies collect cannot track your browsing activity on other websites.
Without these cookies, a website cannot remember choices you've previously made or personalise your browsing experience meaning you would have to reset these for every visit. In addition, some functionality may not be available if this category is switched off.
Our websites sometimes integrate with other companies’ sites. For example, we integrate with social networking sites such as Twitter and Facebook, to make it easier for you to share what you have read. These sites place their own cookies on your browser as a result of us including their icons and ‘like’ or ‘share’ buttons on our sites.
Since the announcement of the forthcoming referendum on the amendments to the 2016 contract, there have been questions raised about when the Equality Impact Assessment would be released, and whether the changes negotiated would be an improvement for the many doctors with protected characteristics working across England. Back in 2016, the EIA for the imposed contract caused many of us concern when it identified that it would have an adverse effect on women.
The draft EIA for the new amendments has been released here and the BMA have commissioned an Independent Review of this from a QC and an independent equality expert which should be available shortly.
So, what is an EIA for, and why does it matter?
An Equality Impact Assessment (EIA) assesses the likely impact of policies or decisions on people with different protected characteristics (age, disability, gender reassignment, pregnancy or maternity, race, religion or belief, sex, sexual orientation). It’s a way for public bodies (in this case, the Department of Health and Social Care), to ensure that they are meeting their Public Sector Equality Duty in the Equality Act 2010, which requires them to have due regard to the need to avoid any unlawful discrimination, advance equality and foster good relations between different groups.
What does this EIA say?
The draft EIA from DHSC finds that the new contract ‘should further advance equality of opportunity for those working LTFT, the majority of whom are women or doctors with disabilities’; especially when coupled with other developments, such as the introduction of occupational pay for Shared Parental Leave (which the BMA JDC successfully campaigned for and secured this year), and the independent review of the gender pay gap for medicine which will make its recommendations in autumn 2019.
What are the changes that will advance equality?
The LTFT annual allowance of £1000, is aimed at compensating LTFT trainees for higher costs of professional registration, education and training as a proportion of their earnings, should advance equality of opportunity by gender and disability, given the significantly higher proportion of women and those with disabilities training LTFT, according to the draft EIA. The continuation of S2 transitional pay protection for those who have yet to complete their training is also likely to benefit women and disabled trainees as they are more likely to be the ones who have taken time out or are training LTFT.
The draft EIA recognises the importance of the proposed changes on work scheduling to LTFT trainees; sections from the good rostering guidance on LTFT working patterns and the Code of Practice on providing information to trainees at 8 weeks and 6 weeks before a training post starts will be contractualised. It also notes that proposals to ensure any time required for statutory and mandatory training outside of work schedule is either paid or given back as time off in lieu, are most likely to benefit LTFT doctors as they are more likely to have such training days fall on their non-working days.
Employers will be required to appoint a champion of flexible training. This aims to improve support available to LTFT trainees. It is therefore likely to be of most benefit to female staff, many with caring responsibilities, and to staff with disabilities. It should also advance equality of opportunity and help foster good relations as the champion will be able to promote flexible working and help change culture within employers.
What about the 5th Nodal Point?
The potential impact of a new higher nodal point on gender equality has been the subject of some debate. The draft EIA explains that the nodal point is considered justified as it is designed to reward senior trainees for their evolving skill, experience and high level service contribution when they are working at close to consultant level. The additional nodal point at ST6 will benefit those doctors who are training in specialties with longer training paths. The draft EIA shows that the majority of those working at ST6 and above are women (54%). This is slightly lower than for the whole trainee population (58%). It notes that others in shorter training programmes will complete training quicker and can apply for higher level roles such as consultant or GP. The issue of why there are fewer women in some of the specialties with longer training paths will be considered in the independent review of the gender pay gap for medicine which will make recommendations in autumn 2019.
The proposed pay-related changes to weekend allowances and unsocial hours arrangements are likely to benefit specialties where there are fewer women than in the whole trainee population, for example, emergency medicine has 49% women compared to 58% overall. The draft EIA concludes that these changes are justified though. They are aimed at providing equitable reward for doing the most onerous weekend patterns and compensating for the additional burden of unsocial hours shifts. Again, it notes that the gender pay gap review will look at what can be done to remove barriers for women to some of these specialties and there are some positive steps already underway such as the LTFT pilot in emergency medicine.
While this draft EIA is positive, the BMA have commissioned an independent review to check it We know too that the job isn’t done with the publication of the EIA. Organisations need to monitor the impact on equality in the real world when the policies are applied and continue to review them, mitigate any negative impacts and address any failures to advance equality of opportunity. We will continue to work to ensure this happens.