Regional Representatives 10 th November 2010 Consultant Job Planning Regional Representatives 10 th November 2010 Graham Venn

Regional Representatives 10 th November Contract Introduced by Government - unclear how many hours consultants worked For many surgeons it identified and remunerated previously unpaid work Attractive – Clear WYSIWIG formula If activity is agreed – pay follows

Regional Representatives 10 th November contract If you are still on the old ‘pre 2003 contract’ ask yourself why? Less remuneration and less progression 2003 contract transparent and better remunerated WYSIWYG structure when agreed Don’t have to work more than 11 PAS (44 hours) Many work 12 – EWTD Only 10 PAs super-annuable (pensionable)

Regional Representatives 10 th November 2010 Job Plan Review Just that – a bilateral review Not – unilateral change in job composition Not – wholesale opportunity for reduction in remuneration – cost saving Not – a vehicle to deviate from the agreed 2003 contract structure

Regional Representatives 10 th November 2010 Job Plan Components Direct Clinical Care All direct patient care Theatre OPD Ward Rounds etc Include reasonable continuity of care factor ‘I-am-on-call-all-the-time-for-my-patients’ laudable but not remunerated Supporting Professional Activity Additional Responsibilities – Audit Lead Other Duties – Work for Royal Colleges

Regional Representatives 10 th November 2010 Use Consistent Template Much easier to argue when well documented A modified BMA template serves well

Regional Representatives 10 th November 2010 Daily Work Plan DayTimeLocationWorkCategory No. of DCC PAs No. of SPA PAs Wednesday0800 to 1200 City Hospital OPD (Inc review, clinic and letters) DCC1.00embedded teaching 1200 to 1400 County Hospital (alternate weeks + travel) Aortic Surgery MDM DCC to 1700 City Hospital Ward RoundDCC0.75embedded teaching Thursday0800 to 1800 City Hospital OperatingDCC2.5

Regional Representatives 10 th November 2010 Weekend Work DayTimeLocationWorkCategory No. of DCC PAs No. of SPA PAs Saturday0900 to 1200 City Hospital (1 in 4) On Call Ward Round (includes travel) DCC to 1500 City Hospital (alternate weeks) Waiting List Initiative DCC0.5 Sunday Predictable On Call Work (Saturday) 1200 to 1800 (1 in 4) City Hospital Post Take Surgery + WRs 0.5

Regional Representatives 10 th November 2010 Annualised activity Much of the week is less predictable – fitted in whenever possible – not time table friendly Best totalled and kept in separate section as annualised activity Can be used for non fixed operating lists Week part fixed and part flexible Most useful part of JD

Regional Representatives 10 th November 2010 Annualised Activity WorkLocationWeekly Hours CategoryWeekly DCC PAs Weekly SPA PAs Teaching Students City Hospital2SPA0.5 AuditCity Hospital2SPA0.5 Service LeadCity Hospital4SPA1.0 Post G SuperCity Hospital2SPA0.5 CPD and Research City Hospital2SPA0.5 Patient Admin Variable6DCC1.5 Total1.53.0

Regional Representatives 10 th November 2010 SPA Activity Training: CS, AES etc.S1 CPDS2 TeachingS3 Postgraduate Undergraduate External Audit and Clinical GovernanceS4 Job Planning / AppraisalS5 Research (negotiable with Trust)S6 Clinical Management - Service Lead etcS7

Regional Representatives 10 th November 2010 Training and Assessment All consultants have some mandatory role Assessment, ISCP, Trainer Meetings Your Trust gets paid from Deanery for this Formal role Clinical Supervisor, Assigned Educational Supervisor, Program Director Royal Colleges have suggested allocations Annualise and include

Regional Representatives 10 th November 2010 Continuing Professional Development Mandatory part of revalidation and needs annualised apportionment. Objective evidence to support Any meeting – including preparation Internal and external study Reasonable journal time etc

Regional Representatives 10 th November 2010 Teaching Postgraduate. Lectures Assessments as part of ISCP or other evaluation process. Timetable any formal teaching sessions. Lectures to GP etc Undergraduate Exam supervision and ad-hoc lectures. Bedside and OPD teaching sessions Annualise

Regional Representatives 10 th November 2010 Audit Timetabled audit sessions Personal audit, again mandatory for revalidation Data required for the SCTS and CCAD including data entry, local and national analysis Include any time involved in specific audit projects.

Regional Representatives 10 th November 2010 Job Planning, Appraisal etc This takes more time than you think - mandatory for revalidation Time for preparation and meeting 360 degree appraisals etc Discretionary Point and CEA application Do a diary card exercise and annualise

Regional Representatives 10 th November 2010 Clinical Management and Meetings Many have role for specific aspect of service TAVI, Mitral Valve Lead, Aortic Vascular Service, Less Invasive Surgery, Off pump If you are doing it, count it! Consultant Meetings formal and informal More senior roles such as CD or MD should be part of DCC contract

Regional Representatives 10 th November 2010 Research Needs agreement of Trust - Not obligatory However - easy to justify if bringing grant income into your Trust – supporting research nurses etc. Grant preparation, Consenting, trial admin Integral part of many central London CAG bids

Regional Representatives 10 th November 2010 Miscellaneous Mandatory Training Coding and activity meetings Protocol writing Personal Study College duties Formal Role AAC representative Interviewing for Consultant, Junior Doctor and allied HCP posts

Regional Representatives 10 th November 2010 On Call Frequency of RotaCategory A (Immediate Call Back) Category B (Delayed Call Back) 1 in 4 or more8%3% 1 in 5 to 1 in 85%2% 1 in 9 or less3%1% Average Hours Worked per week - example PA Allocation 1:6 rota - 3 hours1 PA

Regional Representatives 10 th November 2010 Clear Summary Programmed ActivitiesNumber Direct Care7.5 Optional and Funded2.0 Supporting Activities2.5 Total PAs12.0 ( )

Regional Representatives 10 th November 2010 Summary Not Rocket Science! Strengthened as a Specialty if we are consistent, transparent and objective Advice document SPAs will be under attack Justify all that are appropriate – diary card if required Make sure you annualise and identify ALL your DCC

Regional Representatives 10 th November 2010 Contract Health Warning Incentivised work ‘displaces SPA time’ Cross Cover Waiting List Initiatives Risk to integrity of SPA time Does your cross cover take your JD above 12PA? You need more colleagues not more paid cross-cover You will lose the SPA pay in the long term