Doctors to refuse overtime in major dispute with hospital trust
Doctors at a major teaching trust are to refuse overtime and extra shifts from next week, HSJ has learned, amid escalating tensions with executives over a decision to stop paying premium rates for locum shifts.
Resident doctors and consultants will cease taking up overtime, extra sessions and waiting list work at University Hospitals Birmingham unless they are paid at rates agreed by the British Medical Association.
The BMA confirmed this morning that doctors were in official dispute from today, with the union officially recommending members not work outside their contracted hours for less than rates the BMA advises, laid out in local dispute cards.
Last week, UHB was accused of imposing a “badly disguised pay cut” on doctors by the BMA, after telling employees that agency staff cover and premium enhanced bank rates “will cease” from Monday 11 November.
Resident doctors have been asked about a vote of no confidence in executives over the changes, while consultants are keen for external management to be brought in and both groups unhappy with how executives have handled the situation, HSJ has been told.
Collective concerns are understood to include a lack of notice and opportunity to discuss arrangements with executives before they were imposed, while consultants fear the impact staff shortages will have on patient safety.
Rinesh Parmar, BMA West Midlands regional consultants committee chair, said: ”We have been successful in negotiating with other trusts to prevent them making unilateral changes to rates for extra-contractual work and it is disappointing that managers at UHB do not see fit to follow national guidance for the benefit of their patients and staff.
“Without offering appropriate rates for work, the trust runs the risk that doctors will simply not pick up these extra shifts. This will inevitably lead to burnt out doctors, understaffed wards and patients who will have to suffer with poor and delayed care.”
Local BMA leaders added that within 48 hours of launching a survey of members, more than 96 per cent of respondents said they were prepared to take action – including not picking up extra-contractual locum work – on a 62 per cent vote turnout.
‘A bankrupt trust can’t function’
In minutes of Wednesday’s resident doctor meeting with UHB’s group chief medical officer Kiran Patel, seen by HSJ, the trust said the process for changing locum rates began “two years ago”, with clinical delivery groups tasked with reducing bank staff provision and increasing substantive contracts over the past few months in preparation.
The trust had also said in earlier communications the measures are agreed by the Birmingham and Solihull Integrated Care System, and would be implemented across other BSol providers.
Questioned over whether he felt reducing locum rates by £23 was acceptable in the resident doctors’ meeting, the minutes quote Dr Patel as saying: “No, but a bankrupt trust can’t function. There is a bigger picture in terms of changes needed to solve the problem. We recognise that we are not in a great place and we are looking for long-term solutions.”
Separately, an email sent by CEO Jonathan Brotherton and the CMO to consultants and registrars, seen by HSJ, appeared to show a backtracking on UHB’s official position.
It said: “Our hospital and clinical support service executives will review the requirements for non-contractual work, daily, and will be able to authorise rates above and beyond established rates, as we have been doing.
“This will inevitably result in some areas of not only enhanced, but escalated rates, to ensure that patient safety and staff wellbeing are at the forefront of our consideration, as we seek to reduce the requirements for non-contractual work over the longer term.
“If there are areas of individual or collective concern, please ensure you continue to escalate those concerns through the relevant CDG senior medical leadership in order to support resolution of specific issues.”
UHB was asked to comment further.