Regional Representatives 10 th November 2010 Consultant Job Planning Regional Representatives 10 th...

Regional Representatives 10th November 2010

Consultant Job Planning

Regional Representatives

10th November 2010 Graham Venn


2003 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


2003 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)


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


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


Use Consistent Template

• Much easier to argue when well documented

• A modified BMA template serves well


Daily Work Plan

Day Time Location Work CategoryNo. of

DCC PAsNo. of

SPA PAs

Wednesday 0800 to 1200

City Hospital

OPD (Inc review, clinic and letters)

DCC 1.00 embedded teaching

1200 to 1400

County Hospital(alternate weeks + travel)

Aortic Surgery MDM

DCC 0.25

1400 to 1700

City Hospital

Ward Round DCC 0.75 embedded teaching

Thursday 0800 to 1800

City Hospital

Operating DCC 2.5


Weekend Work

Day Time Location Work CategoryNo. of DCC

PAsNo. of SPA

PAs

Saturday 0900 to 1200

City Hospital(1 in 4)

On Call Ward Round (includes travel)

DCC 0.25

1200 to 1500

City Hospital(alternate weeks)

Waiting List Initiative

DCC 0.5

Sunday

Predictable On Call Work(Saturday)

1200 to 1800(1 in 4)

City Hospital

Post Take Surgery + WRs

0.5


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


Annualised Activity

Work Location Weekly Hours

Category Weekly DCC PAs

Weekly SPA PAs

Teaching Students

City Hospital 2 SPA 0.5

Audit City Hospital 2 SPA 0.5

Service Lead City Hospital 4 SPA 1.0

Post G Super City Hospital 2 SPA 0.5

CPD and Research

City Hospital 2 SPA 0.5

Patient Admin

Variable 6 DCC 1.5

Total 1.5 3.0


SPA Activity

• Training: CS, AES etc. S1• CPD S2• Teaching S3

• Postgraduate• Undergraduate• External

• Audit and Clinical Governance S4• Job Planning / Appraisal S5• Research (negotiable with Trust) S6• Clinical Management - Service Lead etc S7


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


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


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


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.


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


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


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


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


On Call

Frequency of Rota Category A (Immediate Call Back)

Category B (Delayed Call Back)

1 in 4 or more 8% 3%

1 in 5 to 1 in 8 5% 2%

1 in 9 or less 3% 1%

Average Hours Worked per week - example

PA Allocation

1:6 rota - 3 hours 1 PA


Clear Summary

Programmed Activities Number

Direct Care 7.5

Optional and Funded 2.0

Supporting Activities 2.5

Total PAs 12.0(9.5 + 2.5)


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


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

Regional Representatives 10 th November 2010 Consultant Job Planning Regional Representatives 10 th...

Documents

Transcript of Regional Representatives 10 th November 2010 Consultant Job Planning Regional Representatives 10 th...