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Clinical Staff - Contract Schedules and Appendices

The following Schedules are extracts from the April 2004 NHS Handbook, Section 13 and are contractual with the exception of the procedural aspects of the processes stated in Section 13.3 and 13.4



Schedule 1 - Job Planning

13.2 JOB PLANNING

13.2.1   There will be assessments of the academic and clinical workloads, which together constitute the integrated workload, implemented via an integrated job plan which will be jointly agreed with the clinical academic consultant by the University Employer and the NHS Employer prior to appointment and at the annual job plan review. Clinical academic consultants will be accountable to the University Employer (usually via the Dean) through their substantive contracts and via their honorary contracts to the NHS body in which they work (usually via the Clinical Director, Medical Director or Director of Public Health).

13.2.2   The core commitment of a full-time clinical academic consultant to clinical service will be set at 5 weekly programmed be varied outwith these parameters by agreement between the clinical academic consultant with the Dean and Medical Director/Director of Public Health (or their nominees). Unless otherwise agreed, the ratio of direct clinical care activities to supporting professional activities as outlined at Section 4.2.2 will be applied to the core clinical service commitment. In reaching an agreement on the ratio of direct clinical care activities to supporting professional activities within the job plan of a clinical academic consultant, account will be taken of the commitment of NHS consultants to formal undergraduate teaching within the relevant medical/dental school-NHS Board system. NHS direct clinical care activities will include consultant- led clinical teaching activities where patients are managed (or management is planned).

13.2.3   Unless otherwise agreed, emergency work undertaken during or as a consequence of the on-call period will count towards the total number of direct clinical care programmed activities at the level of 1 activity per week averaged over the year for a clinical academic consultant contracted for 5 weekly clinical programmed activities. This can be varied pro-rata for a clinical academic consultant working more or less than 5 clinical programmed activities by agreement as in paragraph 13.2.2 above.

13.2.4   A clinical academic consultant qualifying for an on-call availability supplement will receive the appropriate supplement determined by the frequency of the on-call commitment, in accordance with the provisions of paragraphs 4.10.9 to 4.10.15.

13.2.5   In scheduling on-call rotas, the NHS employer will take account of the full integrated workload of the clinical academic consultant, applying the principle that the clinical and academic components of the job are of equal importance (see paragraph 13.1.5).

13.3   JOB PLAN REVIEW

13.3.1   The integrated job plan will be reviewed annually. The integrated job plan review will be informed by the same information systems that also feed into appraisal, and by the outcome of the appraisal discussion.

13.3.2   An interim job plan review will be conducted where duties, responsibilities or objectives have changed or need to change significantly within the year.

13.3.3   The job plan review will be carried out by the clinical academic consultant and the Head of Division/Department (or other appropriate person nominated by the Dean - designated in the following paragraphs as the University manager) jointly with the Medical Director /Director of Public Health or the Clinical Director, or other lead clinician nominated by the Medical Director/ Director of Public Health (designated below as the NHS manager), and will review the job content and objectives as well as the delivery of commitments.

13.3.4   As part of the job plan review, progress against objectives and factors affecting delivery will be considered. The University and NHS managers and the clinical academic consultant should discuss whether targets had been set at the right level, resources provided by each organisation were adequate, and whether the timetable of time and service commitments should be amended.

13.3.5   The employer may decide to delay progression through seniority points in any year only where it can be demonstrated that, in that year, the clinical academic consultant has not: met the time and service commitments in his/her job plan; or met the personal objectives in his/her job plan or - where this is not achieved for reasons beyond the individual clinical academic consultant's control - has made every reasonable effort to do so; or participated satisfactorily in annual appraisal, job planning and objective setting; or worked towards any changes agreed as being necessary to support achievement of both organisation's service objectives in the last job plan review; or allowed, in preference to any other organisations, the NHS to utilise the first portion of any additional capacity (see paragraph 13.6.1) they have; or met the required standards of conduct governing the relationship between private practice and University or NHS commitments.

13.3.6   Following the annual job plan review, the Head of Division (or other Dean's nominee), jointly with the Medical Director/DPH, will make a report on whether the clinical academic consultant has met the criteria set out at paragraph 13.3.5, taking into account the provisions at paragraph 13.5.3. This report will be prepared by the Head of Division (or Dean's nominee) within 2 weeks of the job plan meeting and will be sent to the clinical academic consultant and the Dean and Chief Executive. Where the clinical academic consultant disagrees with the terms of the report he/she will be entitled to invoke the process set out in paragraph 13.4.1 (stage 1).

13.3.7   Where the Head of Department makes a recommendation to the Dean, based upon the Head of Division's report, that progression through seniority points should be withheld in any year, the clinical academic consultant will be entitled to invoke the process set out in paragraph 13.4.1 (stage 2).

13.3.8   Following receipt of any decision by the Dean to withhold progression through seniority points, the clinical academic consultant will be entitled to present a formal appeal to the University employer under the terms of paragraphs 13.4.2 - 13.4.13.

Please refer to the terms and conditions in Section 4 of the NHS Handbook.

The Working Week.

Travelling Time (to be included in each category)

Time spent travelling in the course of fulfilling duties and responsibilities agreed in the job plan is counted as part of agreed programmed activities. This will include travel to and from base to other sites, travel between other sites, travel when recalled from home during on-call periods (but not normal daily journeys between home and base) and 'excess travelling time'. 'Excess travelling time' is defined as time spent travelling between home and a working site away from base less the amount of time normally spent travelling between home and base.

Programmed Direct Clinical Care (D)

'Programmed Direct Clinical Care' includes: emergency duties (including emergency work carried out during or arising from on-call), operating sessions, pre and post operative care, ward rounds, outpatient clinics, clinical diagnostic work, other patient treatment, public health duties, multi-disciplinary meetings about direct patient care, administration directly related to patient care (e.g. referrals, notes, complaints, correspondence with other practitioners), on-site medical cover, any other work linked to the direct clinical care of NHS patients, and travelling time associated with any of these duties.

On-Call Worked (OCW)

All emergency work undertaken during or as a consequence of the on-call period.

Supporting Professional Activities (S)

'Supporting Professional Activities' includes: continuing professional development, teaching and training, management of doctors in training, audit, job planning, appraisal, revalidation, research, contribution to service management and planning, clinical governance activities, any other supporting professional activities, and travelling time associated with these duties.

Additional Responsibilities (A)

'Additional Responsibilities' are duties of a professional nature carried out for or on behalf of the employer or the Scottish Executive which are beyond the range of the supporting professional activities normally to be expected of a consultant. Additional responsibilities are Caldicott guardians, clinical audit leads, clinical governance leads, undergraduate and postgraduate deans, clinical tutors, regional education advisers, formal medical management responsibilities, other additional responsibilities agreed between a consultant and his/her employer which cannot reasonably be absorbed within the time available for supporting professional activities and travelling time associated with these duties.

Other External Duties (E)

'Other External Duties' comprises work not directly for the NHS employer, but relevant to and in the interests of the NHS. Examples include trade union and professional association duties, acting as an external member of an advisory appointments committee, undertaking assessments for NHS Education for Scotland, NHS Quality Improvement for Scotland or equivalent bodies, work for the Royal Colleges, work for the General Medical Council or other national bodies concerned with professional regulation, NHS disciplinary procedures, NHS appeals procedures and travelling time associated with these duties.

Availability Supplement

A consultant participating in an on-call rota is paid a supplement in addition to their basic salary in respect of their availability for on-call work. This supplement is separate from and additional to the arrangements for recognising actual work undertaken in the on-call period. The level of supplement reflects frequency of availability and, in addition, recognises two levels of on-call availability. Level 1 applies to a consultant who needs to attend a place of work immediately when called, or to undertake analogous interventions (e.g. telemedicine or complex telephone consultations). Level 2 applies to a consultant who can attend a place of work later or respond by non-complex telephone consultations later.

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SCHEDULE 2

13.4   MEDIATION AND APPEALS

Mediation

13.4.1   Job plans and variations to job plans should be agreed between the University Employer, NHS employer and the clinical academic consultant after full discussion and with all parties using their best endeavours to resolve any issues arising. This should include referral for mediation by more senior management in the event of continuing disagreement between the clinical academic consultant and his/her immediate University or NHS managers. In such circumstances the process set out below will be followed:

Stage 1

The clinical academic consultant and/or University manager or NHS manager will, within two weeks of the exhaustion of their initial discussions, refer the point of disagreement, in writing, to the Dean who will consult with the Divisional Medical Director/Director of Public Health. If the Dean or Divisional Medical Director /Director of Public Health was involved directly or indirectly in the job plan under disagreement, the referral will be to another appropriate person nominated by the Dean and agreed with the clinical academic consultant and Divisional Medical Director/Director of Public Health. The Dean, working with the Divisional Medical Director/Director of Public Health (or other agreed person), will convene a meeting with the clinical academic consultant and the University and NHS managers, normally within three weeks of the referral, to discuss the point of disagreement and to hear the parties' consideration of the issues. All parties will use their best endeavours to ensure that agreement is reached at this stage. The Dean, in consultation with the Divisional Medical Director/Director of Public Health (or other agreed person) will, normally within two weeks of the meeting, advise the clinical academic consultant and the University and NHS managers of his/her decision concerning the point of disagreement, giving full reasons to explain his/her decision.

For a Medical Director or Director of Public Health, mediation will take place via a suitable individual nominated by the Divisional Chief Executive (or successor equivalent) or NHS Board Chief Executive.

Stage 2

Following receipt of this decision, where exceptionally a clinical academic consultant remains dissatisfied with the proposed job plan, he/she may refer the point of disagreement to a University Vice-Principal (or other appropriate person nominated by the Vice-Principal) who will consult with the Divisional Chief Executive (or in the case of a clinical academic consultant in public health medicine, the Chief Executive of the NHS Board). This referral should be made, in writing, within two weeks of the receipt of the decision. The Vice-Principal (or nominee), in consultation with the Divisional Chief Executive (or Chief Executive of the NHS Board in the case of a clinical academic consultant in public health medicine) will convene a meeting with the clinical academic consultant and the University and NHS managers to discuss the point of disagreement and to hear the parties' consideration of the issues. All parties will use their best endeavours to ensure that agreement is reached at this stage. The Vice-Principal (or nominee), in consultation with the Divisional Chief Executive (or Chief Executive of the NHS Board in the case of a clinical academic consultant in public health medicine) will, normally within two weeks of the meeting, advise the clinical academic consultant and the University and NHS managers of his/her decision concerning the point of disagreement, giving full reasons to explain his/her decision.

Formal Appeal

13.4.2   There may be exceptional cases where agreement cannot be reached through mediation. In such circumstances the process set out below will be followed:

Following receipt of the decision from the Vice-Principal (or nominee), where a clinical academic consultant remains dissatisfied with the proposed job plan, he/she will be entitled to present a formal appeal to the University Employer. Such a request will be made in writing to the Principal within four weeks of the receipt of the decision. The Principal will, on receipt of a written request for appeal, convene an appeals panel which should meet normally within 6 weeks of the request. Membership of the panel will be:

One member nominated by the Principal on behalf of the University Employer, with the agreement of the Chief Executive of the NHS Board, who would act as the chair;

One member nominated by the clinical academic consultant;

One member appointed from an agreed clinical academic consultants' appeals panel list.

13.4.3   Where either the clinical academic consultant or the University or NHS employer requires it, the appeals panel will hear expert advice on matters specific to a specialty.

The List

13.4.4   A list of members (the clinical academic consultants' appeals panel list) suitable for acting as the third appeals panel member will be agreed between the University Employer, the NHS Board, the BMA Medical Academic Staff representative and, where appropriate, the representative of the BDA. If a local list is unavailable, the third member should be drawn from a 'national' list, which will be the combined list of all those which have been agreed.

13.4.5   The member from the list will be nominated by the Principal after discussion with the NHS Employer and the clinical academic consultant or their representative. Where there is a recognised incompatibility with the first member nominated, the Principal will select an alternative from the list. The Principal should endeavour to ensure that individuals on the list are normally used in rotation.

13.4.6   The list should be regularly reviewed.

Membership of the Appeals Panel

13.4.7   No one will be a member of the appeals panel if they have been involved directly or indirectly in the job plan under disagreement.

13.4.8   The clinical academic consultant has the right to be represented at each stage of the appeals process by a representative of the BMA or BDA, or other trade union / professional association, or colleague.

13.4.9   The appeals panel will not include legal representatives acting in a professional capacity.

13.4.10   Appeals panel members do not act in an advocacy role but are expected to judge each case on its merits.

13.4.11   The Employer and clinical academic consultant nominees will be University employees or NHS employees/NHS Board members.

Administration

13.4.12   The Appeals panel will make a final decision (on a majority basis) on the proposed job plan which will be binding on both parties; no further right of appeal exists.

13.4.13   No point of disagreement of the job plan will be implemented until confirmed by the outcome of the formal appeal except that any decision of the panel which has implications for the salary of the clinical academic consultant will have effect from the date at which the clinical academic consultant gave notice of their intention to appeal formally.

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SCHEDULE 3

13.5   STARTING SALARY AND PROGRESSION THROUGH SENIORITY POINTS

13.5.1   There are both clinical and academic factors to be considered and applied in determining the starting point for a clinical academic consultant's substantive contract. These will be governed, in the case of the NHS elements of the individual's commitments, by Sections 5.1 and 5.4. The University Employer may also apply academic criteria (over and above the NHS terms and conditions) in determining the overall starting salary for the clinical academic consultant's integrated contract and this will not be less than the minimum point on the consultant pay scale.

13.5.2   Decisions on a clinical academic consultant's progression through seniority and pay points will be led by the University Employer (usually the Dean) but undertaken jointly with the NHS Employer (usually the Medical Director or Director of Public Health). These decisions will be informed by the annual job plan review. The appeals procedure relating to pay progression will be the same as set out for job planning in Section 13.4 above.

13.5.3   The clinical academic consultant will normally progress each year through the seniority points set out in Appendix 3. Progression through seniority points can only be withheld or delayed as detailed in paragraph 13.3.5.

13.5.4   Progression through seniority points will not be deferred in circumstances where the inability to meet the requirements set out in paragraph 13.3.5 above is occasioned by factors outwith the control of the clinical academic consultant, for example, absence on study leave.

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3.5.5   Progression through seniority points must not be related to or affected by the outcome of the appraisal process.

13.5.6   Where a manager believes that a clinical academic consultant is unlikely to meet the criteria set out in paragraph 13.3.5, an interim job plan review should be arranged to address this at the earliest opportunity.

13.6 ADDITIONAL CAPACITY

13.6.1   Additional capacity, in relation to private practice, will be deemed to exist where a full time clinical academic consultant is contracted for 5 clinical service weekly programmed activities (or less) within a total equivalent to less than 12 weekly programmed activities in the integrated job plan. The utilisation of extra programmed activities for direct clinical care, as detailed in paragraphs 4.4.6 - 4.4.12, should be subject to agreement between the clinical academic consultant, the University Employer and the NHS Employer. Where a clinical academic consultant does not personally profit (e.g. the profits are retained by the university/charity) from undertaking private practice as defined in paragraph 4.4.7, there will be no expectation that he/she should then offer an extra programmed activity in order to qualify for pay progression.

13.7   PRIVATE PRACTICE AND FEE PAYING WORK

13.7.1   The rules and conditions regarding private practice, outlined in Section 6 and Appendix 8, apply equally to clinical academic consultants as to NHS consultants. Where a clinical academic consultant wishes to undertake private practice, and this is allowed for under the terms of Section 6 and is permitted under the terms of the University Employer's regulations, the impact on the university and NHS components of the clinical academic consultant's working week should be a matter for local determination by the University Employer (usually the Dean), with the full participation of the relevant NHS Medical Director/Director of Public Health, bearing in mind the need to achieve a fair balance between the individual's NHS and university commitments.

13.7.2   Any separate remunerated work undertaken by a clinical academic consultant explicitly on behalf of the University Employer will be exempt from the rule that he/she must first offer an extra programmed activity in order to qualify for pay progression. For all other remunerated work the same rules as apply to NHS consultants will apply.

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SCHEDULE 4

13.8   DISCIPLINARY AND GRIEVANCE PROCEDURES

13.8.1   The University Employer and NHS Employer will prepare agreed procedures for investigating and managing matters related to poor performance, discipline and grievance.

13.8.2   The University Employer and NHS Employer will agree on whether a matter related to poor performance, discipline or grievance will be dealt with under the procedures of the University Employer or those of the NHS Employer and, will work together at all stages of the jointly agreed procedures, irrespective of whether the issue has arisen in relation to the substantive or honorary contract.

13.8.3   Disciplinary or other proceedings undertaken by either the University Employer or NHS Employer resulting in the termination of the substantive or honorary contract may have implications for the continuation of the other contract, which may only be terminated after due process of the other employer.

13.8.4   For clinical academic consultants, the university procedures for disciplinary and grievance matters are laid down by statute. Therefore, any matter leading to disciplinary action which arises under the clinical academic consultant's honorary contract, even if it is the result of a jointly agreed and jointly administered procedure, may be the subject of a further procedure undertaken by the University Employer in accordance with statute. However, disciplinary and grievance matters arising under the substantive contract, and investigated and managed under university statute as part of a joint procedure, will not be subject to any such further university procedure.

* If you require Guidance Associated with Section 13 Annex C to the NHS Handbook, please contact your HR Officer.

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