Terms and conditions of service and remuneration
An occupational physician’s job description and contract of employment must define the duties of the appointment considering the guidance and relevant employment legislation.
Guidance for occupational physicians wishing to offer their professional services to organisations is given in chapter 12 of our guidance.
Definitions and remuneration
The BMA regards occupational physicians as being in one of the following: trainee occupational physician, specialist occupational physician and part-time occupational physician. Individual organisations may use their own titles.
If occupational medicine is to attract and retain a able and experienced doctors, the BMA believes that rewards and prospects must be competitive with those available to the profession in other fields.
Trainee occupational physicians are doctors undergoing specialist training in a post approved by the FPO (Faculty of Occupational Medicine) which normally lasts for a minimum of four years.
Specialist occupational physicians have a CCT (certificate of completion of training). It is suggested that occupational physicians receive at least the minimum salary set out in the supplement depending on experience.
Part-time occupational physicians should be paid at sessional rates not lower than those set out in the salary supplement. Relevant experience and qualifications should be considered when deciding rate of pay.
It is recommended that contracts or letters of appointment should include provision for regular reviews of salary scales in light of changes in the BMA’s recommended scales.
Item of service remuneration and ad hoc fees for a specific occupational health problem or problems are a matter of private negotiation between the occupational physician and the customer.
It is recommended that contracts or letters of appointment should include provision for regular reviews of salary scales in light of changes in the BMA’s recommended scales.
Item of service remuneration and ad hoc fees for a specific occupational health problem or problems are a matter of private negotiation between the occupational physician and the customer.
Salary supplement
The suggested salaries and sessional rates given in the supplement should be regarded as the minimum and should be increased where qualifications, skills and experience warrant. Employers should also take account of special circumstances such as regional variations in the cost of living.
Contracts of employment
The Employment Rights Act 1996 gives employees the right to a minimum period of notice of termination of their employment according to length of service, and the right to receive from their employer a written statement of their main terms and conditions
of employment.
It is the doctor’s responsibility to ensure their contract of employment covers the BMA’s recommendations regarding terms and conditions of service.
The following provides a brief description of the types of contract:
A contract of service is one under which the person paying for the services has general control over the performance of those services. This type of contract is covered by the benefits of the Employment Rights Act 1996 (as amended).
A contract for services is one under which the person providing the services is free from the element of control. If and when the contract is terminated by due notice there is no question of unfair dismissal compensation, nor do any of the other benefits associated with the Employment Rights Act 1996 (as amended) arise. An example contract is provided in appendix 7.
A letter of appointment is a formal offer of a post.
Advice on job descriptions and contracts of employment for occupational physicians is available to members of the BMA by contacting 0300 123 1233.
The contract of employment should contain:
- title of post
- hours of duty
- remuneration
- overtime arrangements
- occupational pension arrangements
- notice periods
- annual leave entitlement
- sick leave and pay arrangements
- grievance procedures
- duties and responsibilities
- arrangements for health records
- supervision/liaison with colleagues
- advisory nature of the role to the other divisions of the organisation which are also responsible for the health, safety and welfare of employees, eg safety committees.
Pay protection of higher-grade salary for those considering an occupational physician training post in the NHS
Doctors can only commence training in occupational medicine after spending a minimum of two-years in higher medical training, preferably having acquired a postgraduate qualification. This means many occupational medicine trainees have worked in general practice or general medical specialties at a senior level.
Principal GPs are offered protection of their pensionable income in their last complete year of practice.
Trainees (including GP registrars) moving from a higher training grade to a lower training grade post should receive pay protection.
Salaried career doctors (including consultants) on a national contract are offered protection of their current incremental pay point or threshold, provided they have worked 13 months or more in such a post immediately prior to re-entering training. This is also available for salaried GPs although can be more complex.
Unfortunately the contractual clause is not explicit in covering salaried GPs. Most stakeholders (including NHS Employers) interpret pay protection as being applicable to salaried GPs if they have been employed under the model terms and conditions.
You can read more about this on the NHS Employers website. However members are encouraged to contact the BMA for advice on their particular circumstances.
Occupational pensions
Arrangements for occupational pensions vary from employer to employer. Occupational physicians should consider the provisions of the occupational pension scheme before entering into a contract of employment.
Doctors who are well established in their career and who change employer should consult a pensions adviser. BMA members may obtain advice from the BMA pensions department [email protected]
Restrictive clauses
Attempts to include a clause in contracts to restrict the practice of an independent occupational physician should be resisted.
BMA members should contact us for advice where a proposed contract lays down such restrictions.
Medical indemnity
Good medical practice provides that a doctor must have adequate insurance or indemnity cover, so patients are not disadvantaged if they make a claim about their clinical care.
If cover is provided by employers, the BMA advises doctors to decide if they need additional personal cover with a medical defence organisation.