Consultant Contract FAQs
The FAQs have been produced in partnership with the BMA, SEHD, Pan Scotland Employers Reference Group and the Pay Modernisation Team.
A Microsoft Word version of all the FAQs detailed is also available for downloading and viewing.
Last updated December 2004.
Select a topic from the list below:
- Management Roles
- Job Planning
- Dual Registration and Seniority
- Backpay
- Superannuation
- Indemnity
- Eligibility to access the Consultant Contract
- Work in excess of 48 hours
- Management Roles
- We are setting up a new Director post in our organisation. The role is a management one but we expect that a consultant will fill it. Are we allowed to use the new contract for such a role if the doctor wishes to remain on medical terms & conditions?
- If the post is a management role and does not contain a clinical element then the doctor should transfer to the managerial terms and conditions rather than remain on the consultant contract unless by local negotiation they remain on the medical one for a short period of time e.g. to cover a secondment.
Medical directors have the option to opt for the new consultant contract salary scale and to qualify for arrears of pay for 2003/4, subject to satisfying the provisions outlined in Section 14 of the terms and conditions of service for the new contract. Given that there is to be a review of executive manager terms and conditions, the arrangements put in place should be regarded as holding arrangements, pending the outcome of that review. For further guidance refer to the letter of 30th March on Medical Directors as part of PMT3.
- Job Planning
- Who should undertake the job plan for the Medical Director / Director of Public Health?
The Chief Executive would agree the job plan for the Medical Director / DPH but clinical advice could be sought externally as necessary.
- Can non doctors carry out the job planning interview with consultants?
- The primary role for carrying out the job planning interview and signing off the job plan is the consultant’s clinical director/nominated deputy. Job plans can also be signed off by the Medical Director or other lead clinician nominated by the Medical Director.
This is normally a one-to one-meeting. Non medics e.g. general managers can be involved in the actual job planning meeting by agreement of the consultant but they should not lead the meeting. Managers have a central role in supporting Clinical Directors prepare for job planning interviews and ensuring the process is completed satisfactorily.
All job plans should be approved by the Chief Executive.
- Dual Registration and Seniority
- Are consultants who have been in post for several years entitled to additional seniority arising from the extra years taken in training to achieve their dual qualification (e.g. max-facial)?
- Yes, paragraph 5.4.1 specifies how this additional seniority should be calculated.
- Are consultants who worked abroad outside the NHS as consultants for several years entitled to any additional seniority?
- Yes, although the consultant would be expected to provide valid evidence of this experience as directed in paragraph 5 of Appendix 7.
- A consultant who joined us several years ago is claiming seniority for experience in the army. Is this appropriate?
- Yes, provided it was at consultant level, that they can provide evidence of their appointment, and that you are satisfied that credit was not already given for this on appointment.
- Our Medical Director is requesting recognition for his GP Principal experience and lengthened training as a result – should this be taken into account?
- Yes as per the SEHD letter of 30 March setting out the position for Medical Directors and the new contract.
- We are appointing an NHS consultant who has been a clinical academic. We understand that clinical academics all have a seniority date of 1 October regardless of when they were appointed as a consultant. Should we use the date they were first appointed a consultant or the 1 October date for their seniority date?
- The date of appointment to the consultant grade should be taken into consideration regardless of where that was plus any accelerated pay points awarded.
- For a consultant who, after being first appointed, worked and then took 2 separate periods of breaks amounting to at least a year, is the starting salary based on the date of first appointment or the date from when they returned to work after the year’s break?
- Paragraph 5.1.3 refers to service that counts in determining starting salary/seniority. Existing consultants are covered by the transitional arrangements in section 14. The nature of the break will determine whether the break is included in determining the seniority but this would be at the discretion of the employer if the absence is unauthorised. Assuming the leave was authorised and that previous service was given when they returned the salary on transfer is then governed by paragraph 14.4.
- Does a flexible training scheme include aspects such as maternity leave where the leave extends training by 3 years? If maternity leave is incorporated in a flexible training scheme does this count towards seniority calculations?
- Yes, maternity leave should be included in seniority calculations.
- How should we calculate the incremental date of a new consultant joining us on 1st August 04 as their first consultant appointment?
- Increments and incremental dates do not exist under the new contract and are replaced by seniority dates. Unless you are recognising prior experience (see question 4.13) then you should take the seniority date as 1st August 2005.
- We have a consultant who has joined us in November 2003 from overseas where he had several years experience as a consultant. Should we recognise the overseas experience?
- If the consultant can provide suitable evidence then the overseas experience can be recognised for the purpose of additional seniority.
- We appointed a consultant who started with us on their first appointment as a consultant in September 2003. When should we calculate their date of seniority from?
- This consultant is a current consultant as per the provisions of paragraph 14.2.4 of the TCS and the seniority date is therefore September 2003.
- Backpay
- We have a locum who is CCST registered and on the GMC Specialist Register. They have been working as a locum for 2 years. Is she entitled to backpay?
- No.
- We have a consultant who worked part-time during 2003 but who has been working full-time from April 2004 and who will get an 11 PA contract. Do we have to pay the backpay based on the full time basis?
- The backpay is based on the first agreed job plan. As such, backpay will reflect the increase in hours.
- Would a consultant who took Voluntary Early Retirement with Employers Consent last year be eligible for backpay?
- No as this was the consultant’s choice to take early retirement. This does not fall within the circumstances covered in paragraph 14.6.1 of the TCS.
- Superannuation
- What element of the consultant’s pay is superannuable? All of our consultants are on 11.5 PAs – presumably this is all superannuable?
- The general rule is that any payment relating to activity outwith the full-time working week of 10 PAs is not superannuable. Therefore basic pay, availability supplements and out of hours premia (relating to out of hours work included within the 40-hour week) are superannuable, but Extra Programmed Activities are not. The exception to this rule is that Domiciliary fees not undertaken during programmed activities are superannuable and EPA undertaken by part-time consultants are superannuable up to a maximum of 10 PAs in total. See section 15 of the terms and conditions of service for more detail.
- The contract refers to elements that can be ‘expressly agreed’ to be superannuable (paragraph 15.1.2). Who makes the agreement and what other pay allowances might be included?
- Individual employers cannot determine the superannuable status of pay elements. This determination must be made by the Scottish Public Pensions Agency (SPPA).
Domiciliary Fees are an example of a pay element that would not technically meet the principle, but agreement has been reached to allow pensionable status.
- Indemnity
- Our LNC is arguing that any consultant who treats a patient outside their agreed Programmed Activities is not going to be covered by the Health Board’s indemnity cover and they say they will refuse to treat patients in such circumstances. What should we do?
- Consultants work on behalf of the NHS would be covered even if they had worked beyond their contracted programmed activities. Working Time Directive and Health & Safety risk issues should be addressed by the organisation however. Consultants should not be expected to work beyond their programmed activities other than in exceptional circumstances. If a consultant considers that his/her workload is regularly exceeding their contracted programmed activities they are entitled to request a job plan review (section 4.6).
- Eligibility to access the Consultant Contract
- We have some long term locums who have been filling a consultant role for several years as a locum. They have told us that they want to be put on the new consultant contract. We know that they do not hold CCST and would not be eligible to apply for the job on a substantive basis but the service would collapse if we lost them. What should we do?
- A locum consultant without CCST would not be eligible to move to a substantive post on the new contract. However paragraph 11.8.1 allows such locums to transfer to a locum contract covered by the new consultant contract TCS provided they were in post for a period straddling 1st April 2004. Your organisation should ensure that it adopts best practice in recruiting locum consultants with CCST.
- We have some GPs who undertake some clinics and do some other clinical work in the hospital. They have requested to be put on the consultant contract. Are they eligible? I know that they do not have CCST.
- No, they are not eligible.
- Work in excess of 48 hours
- Our consultants have been working well in excess of 48 hours. They are happy to continue to do this provided they get properly paid for it. The service will be badly harmed if we don’t let them continue working these hours and we can’t afford the service to be reduced. How can we handle this and why is there a limit at 48 hours anyway?
- The European Working Time Directive limit of 48 hours is a legal Health & Safety obligation (unless waived by the individual) rather than a ‘limit’ in the contract.
Consultants can waive their rights to the 48-hour weekly limit and Boards may agree a short-term breach of 48 hours provided there is a realistic and deliverable management plan to reduce this and the consultant signs a waiver. There should also be an assessment of the risk of damage to the service through forcing a reduction in hours against the risk of exposure to clinical incidents arising from tired doctors etc. Ultimately this is a Chief Executive decision as the Accountable Officer.
Local managers should review jointly with the consultant what work the consultant currently does which other members of the clinical team can undertake to help reduce their hours and consider service redesign opportunities. If consultants agree to work in excess of 48 hours, they should be paid for doing so by EPAs, but an agreed and realistic management plan must be in place to reduce the hours to 48 hours or less within a specified timescale to cover this temporary position.
- On-call
- How do we determine the availability supplement for individuals who are on more than one rota e.g. a specialty rota of 1:4 and regional rota of 1:10?
- Refer to paragraphs 4.8 and 4.10. The frequency of the rotas should be aggregated over the reference period taking both rotas into account. You should not pay two separate supplements.
- Some of our consultants’ on-call rotas lie between the Medium and High bands, e.g. 1:4.8. Should this be rounded up to 1:5 and be a Medium band or down to a High band?
- You should use an arithmetic approach and round up or down as appropriate i.e. it should be rounded up or down to the band which is nearer in numerical terms.
- Travel
- Should consultants be paid for travel between their home and place of work? Do we pay via an additional programmed activity or are they paid for the actual time it takes to travel each day?
- Refer to paragraph 4.7.1. Consultants are not paid a mileage allowance for normal home to work travel and there is no time allowance for such travel within PAs. However, they are paid a mileage allowance as per paragraph 8.2.4 where they travel on official journeys between home and other than the principal place of work plus the travelling time for such journeys is included in the PA calculation. The provisions of paragraphs 8.2.5-8.2.8 are also relevant.
- Could you help with an interpretation or confirmation of our understanding of travel expenses for locums? Para 11.5.1 reads as though those in a locum consultant capacity would be entitled to claim daily mileage from home to base, subject to a deduction of 10 miles each way, if the journey is greater than 10, except in circumstances where the provisions of para 8.2.4 - 8.2.8 would provided a more favourable allowance on any given day. This seems to be an anomaly between locum and substantive consultants who do not get daily home to base mileage except in the circumstances of 8.2.4 -8.2.8. Is our interpretation correct, locums get and substantive consultants don't get daily journeys reimbursed from home to principal base with the exceptions identified?
- The new contract did not change the previous provisions for travelling expenses for locums contained in para 289 of the merged medical dental TCS PCS 2003 (DD) 02 Locums are entitled to get daily journeys from home to principal base reimbursed.
- Assessment of Hours
- Some of our specialties operate on-call arrangements where the consultant concerned will be the physician/trauma surgeon of the week. This requires them to cease all other clinical commitments like clinics and routine ward rounds and concentrate solely on the emergency work. How should we assess the number of programmed activities associated with this type of cover?
- A diary assessment over an agreed reference period that includes at least one week of such emergency work will give the average assessment.
- Programmed Activities
- We have a consultant who is on a part-time 9 session contract. The clinical director wants to change this consultant’s job and give him/her a 10 PA contract Is there any sense in offering this consultant a 9 PA +1 EPA contract so that they remain part-time and so the EPA can be withdrawn if necessary?
- 9 PAs +1 EPA will be treated the same as 10 PAs from a superannuation point of view. However you should bear in mind that a consultant on a 9PA +1EPA plan will be able to withdraw their 1EPA and work 9 weekly PAs. Offering 10PAs would enable the Health Board to ask the consultant to undertake an EPA as an 11th PA if they so wished. This however would affect the consultant’s position and their potential pay progression if they only wished to work a total of 10 PAs and not undertake an 11th. The options available under paragraph 14.3.5 for part-time consultants should also be considered.
- Where consultants do some out-of-hours work when not on-call that amounts to one PA every 6 weeks, can you confirm that the consultant should receive payment for 1/6 of an EPA per week plus one-third of this amount for the out of hours element?
- An agreement should be reached by all parties in job planning on whether to round up the job plan to 0.5 EPA and agree additional duties to reflect this in the job plan or to adjust other duties in the job plan down and not pay the 0.5 EPA. Alternatively it could be sensible to agree time in lieu.
The recognition of out of hours work must be agreed with the consultant under paragraph 4.8.3 of the TCS. The recognition of work done when on call is covered in paragraph 4.10.7 of the TCS.
- Offsetting
- What items are being offset for backpay? Are TANHDs included?
- TANHDs are netted off if they were for extra work that will be included in EPAs or other additional remuneration under the new contract. Refer also to guidance in PMT3 (30th March 2004) and PMT13 (26th July 2004).
- Annual Leave
- Are consultants entitled to any additional annual leave with the new contract?
- Yes, paragraph 7.1 outlines the approach which is based on the number of days worked during a week.
- Should the annual leave year be calculated from the date of appointment or from 1 April to tie in with the new contract?
- The annual leave year is calculated from the date of appointment – see paragraph 7.1.2 of the TCS.
- Study Leave
- Is a 0.5 WTE consultant entitled to half the study leave entitlement of a full time consultant? The part-time consultant in question is indicating that for CPD he/she requires to obtain 50 points (the same as a full time consultant) and is unable to do this on his/her pro rata study leave entitlement.
- The number of days study leave is the same for part-time consultants as for full timers i.e. 30 days in any 3 years.
