On the ground: money matters

A doctor stood to lose thousands of pounds owing to the interpretation of a few words in her terms and conditions

Location: UK
Last reviewed: 12 February 2021
Busy hospital with blurred figures moving through a reception area

A single word or phrase can sometimes be at the centre of a legal or contractual dispute. For one doctor, a £10,000 pay cut was at stake.

The doctor was switching from her previous specialty to general practice, and because the latter is officially ‘hard to fill’, she qualified for pay protection, but there was an important condition.

The 2016 junior doctor contract states: ‘Where a doctor opts to switch into a hard-to-fill specialty having achieved an Outcome 1, Outcome 2, or Outcome 6, in their most recent ARCP, and would have otherwise progressed to the next grade had they not switched specialty, their pay-protected amount will be based on the basic salary for the grade they would otherwise be at had they not switched.’

To explain to anyone who isn’t or hasn’t recently been a junior doctor, the ARCP is the annual review of competence progression undertaken by trainees. At the time of applying for GP training, the doctor’s most recent ARCP, for the specialty trainee 2 year in her previous specialty, was an outcome 1, which signifies satisfactory progress, with the development of competences at the expected rate.

But then a problem arose. Having accepted a GP training post, she handed in her notice, and it was during this period that she received another ARCP outcome, for her ST3, and this time it was a 3 – defined as ‘inadequate progress by the trainee – additional training time required’.

Her new employer said this meant she did not qualify for pay protection. This would have been a severe blow – a pay cut of more than £10,000, down to ST1 level, and a huge disincentive to fill a specialty that needs all the doctors it can get.

However, let’s go back to that wording. It refers to ‘where a doctor opts to switch…’. At the time of ‘opting to switch’ – making her application, it being accepted, her giving in her notice – the most recent outcome had been 1. It was surely that ARCP, rather than the more recent one, which applied.

The doctor was not succeeding with her arguments, so she asked the BMA for help. An employment adviser had a number of emails and phone calls with the trust. The trust was turning to NHS Employers for advice, but the employment adviser could refer back to the BMA’s policy directorate, which has detailed knowledge of NHS contracts.

The adviser says: ‘In the end, they accepted our position on this and offered the pay protection. It was a case of being persistent with our position and trying to persuade the employer that our interpretation of the provision was correct.’

The member said she was relieved, and the BMA employment adviser was supportive, helpful, and professional.

On the ground is a regular article highlighting practical help given to BMA members in difficulty