The last BMA medical academic staff committee meeting of the 2021-22 session was held on Friday 15 July. Most members of the committee joined the meeting at some point during what was already a rather hot day.
There was an unfortunate clash of meetings on Friday morning, with the BMA consultants committee negotiating team meeting with NHS Employers to discuss local clinical excellence awards, to which I was invited to represent MASC. Our deputy chair, Raj Gupta, therefore, chaired the morning session, although I was able to dip in and out of the meeting.
I fed back on the meetings of the HENSE (Health Education National Strategic Exchange) that I attend on behalf of the BMA. A couple of issues came up at those meetings. First the decision by the UK Government to give the GMC the power to set the prospectus and syllabus of each medical school.
This apparently arose from the need for the GMC to be able to set the syllabus for PA courses. The GMC assures us they don’t have any intention of using the power. The second was the drive to make clinical academic careers more attractive which was being taken forward by a HENSE working party which I also attend.
I highlighted the importance of pay parity and of tackling the gender gap in academic medicine, especially the loss of women academic post-PhD. A task force has been established to look into this.
I also reported on the meeting of BMA council that week. There was a long debate on possible industrial action to take forward the annual representative policy on pay restoration, which touched on whether clinical academics would be able to take such action.
We will need legal advice on this point. Raj reported on the meeting of the CC that he had attended which was similarly focused on pay and clinical excellence awards and possible industrial action.
MASC members felt it was important the BMA highlighted its successes in the last decade as well as the areas on which it could do better, such as pay, not least to ensure we retained the members that we had.
The co-chair of JATS (Joint Academic Trainees Subcommittee) Yanushi Wijeyeratne reported on the recent meeting of the subcommittee. She noted there was an issue of employment rights for trainees moving between the NHS and the university sector. Often local negotiations were required using the Principles and Obligations document issued by NIHR (National Institute for Health and Care Research) and other funders.
Advice and guidance on this transition period has been highlighted on the BMA website and in the enewsletter: medical academic contract. Other issues of concern were the Welsh junior doctor contract negotiations; consultant starting salary for academic trainees; and the impact of the new curriculum in the medical specialties on academic training.
JATS was not convinced that the letter from InterAct and NIHR on the last issue would resolve concerns of academic trainees. If you have any concerns please email us on [email protected]
JATS deputy chair Jonathan Gibb raised his concern that higher degrees obtained as part of intercalation while undertaking the medical degree would no longer be among the requirements or assessments for applications to some specialty training.
This followed on from the decision not to take such degrees into account in applications to foundation training. The ostensible reason was to facilitate widening participation but he, and other members of the committee, argued that a better approach would be to assist all medical students that wished to intercalate to do so.
Many members of the committee argued that research opportunities while a student were an important route into academic medicine, which this decision risked closing off. The committee agreed to seek a common approach with the BMA medical students committee.
MASC deputy chair and women in academic medicine co-chair Marcia Schofield updated on the work of the WAM Group. Unfortunately, having obtained a new job, her co-chair Sarah Allsop has had to step back from the Group and MASC.
Marcia said that would welcome volunteers to take on some of the responsibilities. In particular, help was required in preparing a policy document for publication.
On equalities issues more generally, Mary McCarthy asked if MASC could follow-up on the recommendations of the Romney report and Anil Jain suggested having a presentation at a future meeting on the BMA’s recent report on racism in medicine.
David Katz encouraged us to look at the things we can do, such as focusing on the new medical schools and their need for a diversity of staff and trainees. Jeeves Wijesuriya urged us to focus on the need for change on MASC and the importance of attracting and retaining members from minority groups and the measures needed to achieve that.
Raj noted that getting new people in and hearing their voices was a struggle generally, and that he would welcome any suggestions. One option is to stand for election to the committee and we have places available from Scotland and Wales.
Appraisal and revalidation
David Katz and Bob McKinley reported on their efforts to reflect the position of clinical academics and the Follett Review principles fully in the appraisal and revalidation guidance being prepared by the Academy of Medical Royal Colleges.
Frustratingly, while some progress had been made, it had not be possible to include all that they had wanted in the guidance. This they felt risked undervaluing teaching and research generally and the roles of clinical academics specifically.
They, therefore, proposed that MASC seek to update and re-issue the guidance that had been prepared jointly with the university employers. Please send in any comments or concerns you have about the appraisal process.
The morning session closed with a discussion on the importance of increasing the number of foundation and specialist training places in response to the increase in medical student numbers to avoid future medical unemployment.
Concern was also expressed about the ongoing medical apprenticeship scheme, with support for greater opportunities to undertake existing medical degrees part time as a more effective means of widening participation.
The committee also noted the proposals from grass-roots medical students for additions to medical school curricula. Members agreed on the importance of working with colleagues in the other branches of practice, especially MSC, on these issues, and of ensuring that the full diversity of the committee was represented in future discussions.
Pay and CEAs
Following the morning meeting with the CC’s negotiating team and representatives of NHS Employers, I was able to lead the afternoon’s discussions on pay and CEAs. The Review Body on Doctors' and Dentists' Remuneration report was due out in less than a week after the meeting and the BMA’s next steps on pay would be very much determined by the report and the response of the governments to it.
Meanwhile, the CC had issued a rate card for extra-contractual work which has also been brought to the attention of clinical academics via the BMA e-newsletter: consultant non-contractual rate card.
On local CEAs it was clear there was difference of view between the BMA and NHS Employers and Department of Health and Social Care on the next steps. We had understood that a proposed memorandum of understanding was a temporary stop-gap measure pending the conclusion of negotiations on the contract.
NHS Employers, meanwhile, seem to see it as the vehicle for reaching agreement on the contract. It was agreed that I should contact the DHSC to see if we could reset the discussions.
The committee also agreed it would be helpful to tease out the DHSC’s motivation for its position given that it risked undermining UK life sciences and economic benefit derived from them.
I also took the opportunity to highlight to employers and the DHSC the need for a fall-back position for those losing their national awards, especially for senior academic GPs, who did not have access to a local CEA scheme.
Joe Rosenthal of the Society for Academic Primary Care and Bob McKinley reported that discussions were ongoing regarding the career structure and pay for academic GPs and, in particular, the need for access to a local CEA scheme.
Members noted that it was often difficult for universities to know the correct pay scale for academic GPs. If you have encountered such problems please contact us for advice.
The meeting then moved on to pensions noting a report on the recent meeting of the BMA pensions committee by MASC representative Mark Gabbay. Discussion focused on the draft response to the DHSC’s proposals on continuing access to the NHS Pension Scheme for doctors employed by universities.
Members agreed that while having an honorary NHS contract should guarantee access it should not be an absolute requirement as many doctors took time out of clinical practice to undertake teaching or research fellowships.
With the reduction in benefits from the Universities Superannuation Scheme, preventing ongoing access to the NHS schemes could deter doctors from taking on these roles and from developing an academic career. The committee agreed to the draft response and members also asked if the paper would apply to the devolved nations.
Role and constitution of MASC
The committee discussed the report of the survey of conference representatives’ views on the role and constitution of MASC (many thanks to those who completed it).
Members noted and agreed the committee represented a wide range of doctors engaged in academic activities, while acknowledging that its particular role was to represent those that had no other committee to represent them.
Members broadly supported the proposals in the paper for a move to national elections but did ask for further information on the numbers of members in each group of academics and for further consideration to be given to how best to ensure fair representation of women medical academics and those from minority groups and whether any members should be elected by the ARM. Advice will be sought from the elections team and from the BMA organisation committee.
In addition to the above, members of the committee were urged to read the blog by Angharad Davies reporting the outcome of the recent survey on the impact of the Research Excellence Framework: Careers and representation at risk in higher education. The committee also agreed to produce and publicise a similar blog on its survey of medical schools on their equalities monitoring of PhD applicants and awardees.
Finally, as the meeting was the final one of the 2021-22 session we bid farewell to those leaving the committee this year: Sarah Allsop, Sharif Ismail, Shumone Ray and Jeeves Wijesuriya. Many thanks for all their hard work and for challenging us to be better.
Have a great summer all. I look forward to a productive albeit challenging 2022-23 session.
David Strain is chair of BMA medical academic staff committee