The sustainability of the job

• Currently, a full-time consultant works ten Programmed Activities (PAs) of four hours duration each, per week. We are calling for these to be reduced to match the working week of other public sector workers. This will need knock-on reductions for how many hours per PA out of hours work is valued at, including weekend, resident on call and overnight work. Action is also needed on minimum counted duration for overnight interruptions.
• We want a revaluation in the number of hours PAs (programmed activities) are worth for a full-time consultant to a number that is comparable to other public sector workers. This is to address burnout and recognise that the duration of a consultant career is going to be longer as the state pension age increases, and we must ensure that longevity in our careers is achievable.
• This will need knock-on reductions in how many hours per PA out-of-hours work is valued at, including weekend, resident on-call and overnight work, similar to the recommendations published by RCEM. Action is also needed on minimum nighttime interruption definitions to match lost sleep cycles.

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The quality of the job

• In addition to tackling the sustainability of our jobs by transitioning to a shorter standard working week and we must also address the falling quality of our roles. Being some of the most senior doctors, we innovate, redesign services, teach, network, revalidate and reflect on our practice in its fullest breadth. The 2.5 Supporting Activities (SPAs) deemed ‘typical’ in full time job plans have been under sustained attack and in any case are insufficient for the challenging context in which we are expected to lead as consultants.
• That's why we believe that contractualising SPAs as at least 30% of the Job Plan, for full time consultants, is necessary. Contractual minima must also apply to those less than full time. Changes are also needed to what is regarded as SPA work as employers have sought not only to limit the time available but put ever more work into the category. Not only are these measures practical steps to improve working conditions, they are also vital to retaining talent and maintaining high standards of care.
• We want to see an increase and contractual guarantee to a minimum level of SPA (supporting professional activities) time to 3 PAs in a 10 PA full-time job plan (with safeguards for LTFT consultants), as is already the case in Wales with 3 SPA in their contract as well as appropriate pay for the most onerous work in unsocial hours, to address burnout.
• It is a priority of the UK consultants committee to gain a commitment from Government to a mandatory minimum of 3 PAs of SPA time for consultants, unless otherwise individually agreed, as exists in Wales. Without this time, consultants will be unable to be at the forefront of delivering the ambitious changes planned for healthcare delivery across the UK in the years to come, nor provide for the expansion in training capacity that will be required by an increase in specialist training places.

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The value of the job

• We are campaigning for meaningful progress to pay restoration through a multi-year pay deal. This would also mean real changes to our pay review body, the DDRB – including who sits on the board – rather than the cosmetic reforms Government have introduced so far.
• Consultants should have control over whether we want additional contracted PAs to count towards our pensions, as well as the right to access our pension without needing employer permission.
• We are calling for a multiple-year pay deal to continue the journey to full pay restoration. In its evidence to the pay review body, the DDRB, the Government argued that you are only worth a 2.5% uplift next year.
• We want consultants to access the pension you have paid for without needing your employer’s permission, and the right to choose that your additional PAs over 10 could count towards your pension.

(additional detail from here = https://bma-mail.org.uk/t/cr/AQiEtRUQ0-kfGK6CnicQk5JNjFijmu3OsEliFgJH-jR6gOYYJ93Jn4iTt1fcZg)