1. Junior doctors’ contract The new 2016 contract Junior doctors’ 2016 contract

2. Junior doctors’ contract The new 2016 contract May 2016 Under the auspices of ACAS, the government, NHS Employers and the British Medical Association reached agreement on new terms and conditions of service for doctors and dentists in training in England.

3. Junior doctors’ contract The new 2016 contract June 2016 The BMA leadership positively endorsed the new terms and held roadshows across the country explaining the contract to members. BMA members balloted on the new terms.

4. Junior doctors’ contract The new 2016 contract 5 July 2016 BMA members voted against accepting the new terms, 58% to 42%, on a turnout of 68%. Dr Johann Malawana resigned as chair of JDC.

5. Junior doctors’ contract The new 2016 contract 6 July 2016 The Secretary of State announced in the House that all attempts to reach a negotiated settlement had failed, and that further talks were no longer a viable option. As a result of this announcement, details of the final 2016 terms and conditions of service were published on the NHS Employers website.

6. Junior doctors’ contract The new 2016 contract What will be implemented now? It is expected that the 2016 contract will now come into force on 3 August 2016, and the first doctors will take up employment on those terms on 5 October this year. These terms and conditions of service are the same as those previously published on the NHS Employers website on 16 June.

7. Junior doctors’ contract The new 2016 contract What changed between the March TCS and the current TCS? March positionNew position N/A Accelerated Training support including access to mentorship, study leave funding and specially developed training inputs, additionally funded from outside the contract pay bill. N/A HEE mandated by SofS to review transfer between regions for married couples and civil partners, caring responsibilities, travel times to be completed by end of March 2017. N/A A joint review of good rostering practice, including the proper use of technology, which support greater flexibility for junior doctors and employers, completed by January 2017. Where trainees have to change training path due to disability, then their previous nodal point pay will be protected. Extended to cover those with caring responsibilities also. Guardian role did not cover these issues previously. Guardian oversight of diversity and equality issues, including liaison with the Director of Medical Education to ensure that a member of the educational faculty in the Trust is designated as a champion for flexible training. Statutory equalities monitoring. Employers, HEE and the BMA will put in place comprehensive equalities monitoring mechanisms for all protected characteristics to be signed off via the JNCJ for implementation from April 2017.

8. Junior doctors’ contract The new 2016 contract Staff handbook references included but no specific guidance. Joint guidance referenced in the contract to ensure the effective delivery of elements of the NHS-wide staff handbook covering Caring for children and Adults, Flexible working and balancing work and personal life. Agreed 5 point nodal point structure Agreed improved 4 point nodal point structure to distribute pay more fairly Guardian report to the board at least once a year. Guardian report to the board at least once a quarter, including data on rota gaps. A consolidated annual report on rota gaps and improvement plan included in Trust's Quality Account. N/A Junior doctors forum established to advise Guardian and play role in scrutiny of the distribution of income from fines. System of financial penalties. Financial penalties extended to cover where breaks are not achieved on 25% or more of occasions. Where the Guardian is appealed local grievance processes will apply. Any appeal against the decision of the guardian will involve a representative from the BMA or other relevant trade union nominated from outside the Trust, and provided by the trade union within one calendar month. March positionNew position

9. Junior doctors’ contract The new 2016 contract Performance management of the Guardian via appraisal and 360 degree feedback. Processes improved so that Junior Doctors Forum or any individual doctor in training should raise those concerns with the Trust Medical Director. These concerns can be escalated to the senior independent director on the Board of Directors where they are not properly addressed or resolved. FPP for Emergency Medicine at £1,500 Value increased to £20,000 over the length of the training programme. FPP for Psychiatry at £1,500 Value increased to £20,000 over the length of the training programme. FPP for OMFS at £1,500 Value increased to £20,000 over the length of the training programme. FPP payments pensionable FPP payments non-pensionable FPP for leadership roles Leadership FPP removed to improve pay system as a whole Streamlining processes optional. Employers mandated to establish regional streamlining processes by April 2017. Period of Grace facilitated should funding be available. HEE commitment to fund the Period of Grace. March positionNew position

10. Junior doctors’ contract The new 2016 contract 13 month qualifying service needed for pay protection and requirement to move immediately to new training programme. Where changing training path due to disability the eligibility time period before qualifying for pay protection is reduced to zero. In all other circumstances (change due to caring responsibilities, change to a shortage speciality) then the qualifying period is reduced to six months service. Where in this circumstance a trainee has missed the relevant application round, then they must gain a place within twelve months of leaving the original programme. N/A Secretary of State asked GMC to lead a review by Royal Colleges to support appropriate recognition of competence where junior doctors change training paths, which should enable quicker progress through training programmes and the salary structure in some circumstances. Work completed by 31 March 2017. Breaks provisions as per 31 March TCS. Improvement to TCS wording around flexibility and spacing of breaks. Pay for additional hours of work as per 31 March TCS. Improvement to TCS wording around authorisation and guardian oversight, and on-call. TOIL as per 31 March TCS. Improvements to TCS wording around time limits. March positionNew position

11. Junior doctors’ contract The new 2016 contract First refusal clause. First refusal clause removed. Fidelity to the NHS agreed, flexibility to work for any NHS staff bank. Requirement to offer such service is for work commensurate with the grade and competencies of the doctor, though the doctor may choose to accept work at a lower grade, if they wish. LNC to agree local processes. Locum rate as per the March pay circular Locum rate improved to provide a 22% uplift on the appropriate hourly rate N/A An additional payment for “senior decision makers” will be introduced. Statutory whistleblowing protections. This right is enshrined in the contract for junior doctors, and this includes the ability to raise concerns regarding the work of HEE without detriment, from either the employer or HEE. Pay system as per March TCS. Brand new pay system jointly agreed in order to value the work of junior doctors including at night and weekends. This includes extending the hours which night enhancements apply to, introducing a weekend allowance, and a new system to pay for on-call. 48 hour rest period after consecutive night shifts. 46 hour rest period after consecutive night shifts, amended to improve work life balance and continuity of care. Implementation timeline as per previously Published in March Implementation timeline amended and agreed with the first trainees moving on to the new TCS in October 2016. March positionNew position

12. Junior doctors’ contract The new 2016 contract Transition for a period of 3 years Transition extended by one year. Employer based variation clause in the contract. Commitment to vary the contract via collective agreement through the JNC(J), and an ongoing review of the contract. N/A The right for doctors with significant caring responsibilities to this as part of the personalised work schedule review N/A Addition of a pay premium of £1500 for doctors who are in less than full time training (LTFT) at the time of transition, or who are on maternity leave at the time of transition and subsequently return directly to an LTFT post March positionNew position

13. Junior doctors’ contract The new 2016 contract What happens next? The 2016 contract can only be introduced once existing contracts of employment expire. A new implementation timeline has been published which reflects this position.

14. Junior doctors’ contract The new 2016 contract New implementation timeline Date July 2016Appoint guardians 26 July 2016Guardian conference 3 August 20162016 contract is live October 2016 Transition to the 2016 TCS for: Obstetrics trainees taking up new appointments at ST3 and above November / December 2016 Transition to the 2016 TCS for: F1 doctors taking up next appointments F2 doctors taking up next appointments and sharing rotas with F1 doctors February / April 2017 Transition to the 2016 TCS for: Psychiatry trainees taking up next appointments (all grades) Pathology trainees (lab based) (all grades) Paediatrics trainees taking up next appointments (all grades) Surgical trainees (all disciplines) taking up next appointments (all grades) F2 doctors and GP trainees (ST1/2) taking up next appointments and sharing rotas with any of the above August / October 2017Transition to the 2016 TCS for: All remaining trainees taking up next appointments (all grades) All new starters (all grades) Notes: 1. The above does not include trainees employed on long-term contracts in lead employer arrangements (other than those who joined such arrangements on a single placement contract in August 2016, or those whose contracts have a clause allowing for them to be varied in this way); these trainees will remain on the 2003 TCS until they finish training current contracts expire. 2. There will be some parts of the country where rotation dates do not coincide precisely with the above timetable. In such cases, trainees will move to the 2016 contract at the next rotation date following their scheduled transition date, and by October 2017 at the latest.

15. Junior doctors’ contract The new 2016 contract Next steps for employers Appoint a guardian of safe working hours: 1.Ensure sufficient time allocation (PAs) in the job plan 2.Ensure appropriate admin support to manage flows of exception reports and other information 3.Agree reporting cycle, liaison with local negotiating committees (LNC) etc. 4.Establish junior doctor forum to advise the guardian.

16. Junior doctors’ contract The new 2016 contract Next steps for employers Take appropriate steps to meet local public sector equality duty (guidance is on the NHS Employers website). Agree local processes for managing exception reports and work schedule reviews. Ensure medical staffing / HR / payroll teams are trained and able to deliver rapid implementation of the 2016 contract. Agree amendments to working patterns to ensure safe rostering. Draw up work schedules for posts. Offer employment on 2016 TCS in accordance with transitional timeline.

17. Junior doctors’ contract The new 2016 contract Legal position The two judicial reviews were conjoined at an early stage. Both were stayed pending the ballot. A case conference is scheduled for the 21 July

18. Junior doctors’ contract The new 2016 contract Local engagement Employers will need to work with individual trainees locally to ensure that the 2016 contract can be introduced without negatively impacting patient care. The best way to do this is to engage with doctors locally, rota by rota, to work through the benefits of the 2016 contract from a safety perspective when agreeing new rotas.

19. Junior doctors’ contract The new 2016 contract Trust doctors The 2016 TCS are not suitable for trust doctors – employers must decide on which (local) TCS to use for this group (or to use the SAS contract, where appropriate). Employers seeking to ensure pay parity for this group must use the parallel pay codes that will be set up in ESR. It is vital that we are able to see, at a national level, who is on the 2016 TCS and who is not.

20. Junior doctors’ contract The new 2016 contract System support for employers Skills for Health / Allocate: rota and pay calculations (July) ESR : new pay elements (September) Skills for Health / Allocate: exception reporting systems (September)

21. Junior doctors’ contract The new 2016 contract Available now 2016 Terms and Conditions of Service Pay and Conditions Circular Model contracts Model offer letter Guardian of safe working hours JD / PS Work schedule template Public Sector Equality Duty guidance Implementation timeline Implementation guidance FAQs

22. Junior doctors’ contract The new 2016 contract Contact us: doctorsanddentists@nhsemployers.orgdoctorsanddentists@nhsemployers.org Website: www.nhsemployers.orgwww.nhsemployers.org @NHSemployers Facebook.com/NHSEmployers