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February 28, 2016 / politicsbitesize

Junior Doctors and a Seven-day NHS: A Timeline

JunDocsImgThe current Tory rhetoric and media narrative advocating a seven-day NHS has a long history, which truly begins in the mid-80s in the Thatcher/Reagan years. For the sake of brevity, below is a (non-exhaustive) timeline of meetings, events and policy papers from 2012 advocating a seven-day elective NHS by various bodies including the government, think tanks, NHS Employers and NHS England. Most importantly, however, the timeline also charts the impact of this process on the junior doctors and their stand, with the BMA, against the unsafe and unfair contract that has been generated by these documents and consultations.

Timeline

January 2012Equality for All: delivering safe care seven days a week published by NHS Improvement http://www.nhsiq.nhs.uk/resource-search/publications/nhs-imp-seven-days.aspx

– Professor Sir Bruce Keogh, the NHS Medical Director, invited key clinical leaders to a meeting on 20th January to consider how seven-day working in specific services and clinical areas could be introduced successfully across the NHS http://careers.bmj.com/careers/advice/view-article.html?id=2966 | https://www.england.nhs.uk/7ds0112event/

29 March 2012 – Andrew Lansley’s Health and Social Care Act 2012 passed by parliament. Part of Choice in health and social care and NHS efficiency https://www.gov.uk/government/publications/health-and-social-care-act-2012-fact-sheets

https://www.gov.uk/government/policies/choice-in-health-and-social-care

June 2012 – 13 NHS Trusts set up the South West Pay, Terms and Conditions Consortium (SWPTCC) with the aim of setting up a regional system of pay, terms and conditions, which would operate separately of the NHS nationally. The consortium met with opposition by the Trade Unions and in Parliament http://www.unisonsouthwest.org.uk/_assets/images/campaigns/documents/regional%20pay%20consortium%20-%20pid%20final%20draft%20-%20may%202012.pdf

November 2012 – The think tank Reform publishes a report, drawing heavily on SWPTCC, tabling recommendations to Government on how to improve productivity and efficiency in the NHS. The document stipulated that the apparent “surplus of doctors” in the UK “creates an opportunity to drive down pay and review medical ranks” http://www.reform.co.uk/wp-content/uploads/2014/10/121107_Doctors_and_Nurses_WEB.pdf

– Scoping study on contract for doctors in training by NHS Employers published https://www.gov.uk/government/publications/supplementary-evidence-for-the-review-body-on-doctors-and-dentists-remuneration-review-for-2013

February 2013 – The NHS Services, Seven Days a Week Forum, chaired by the National Medical Director, was established

March 2013 – Policy Paper 2010 to 2015 government policy: Choice in health and social care was first published

– SWPTCC reports its finding into pay for all doctors, and all other NHS staff (most of whom were covered by the previously negotiated ‘Agenda for Change’ terms) http://royalnursing.3cdn.net/007ba0a5d5c29691dd_y9m6b86hc.pdf

April 2013 – SWPTCC disbands and no Trust proceeds with its plans https://www.opendemocracy.net/ournhs/steve-topple/of-smoke-mirrors-cartels-and-7-day-nhs

June 2013 – Heads of Terms agreed with the BMA for possible negotiations http://www.nhsemployers.org/~/media/Employers/Documents/Pay%20and%20reward/Juniors%20Heads%20of%20Terms.pdf

July 2013 – NHS England along with our national partners launched A Call to Action which set out the challenges and opportunities faced by the health and care systems across the country over the next five to ten years https://www.england.nhs.uk/ourwork/qual-clin-lead/calltoaction/

– UK junior doctors’ committee agreed to enter formal negotiations with the government

September 2013 – Consultants Committee agreed to enter formal negotiations with the government for England and Northern Ireland

October 2013 – Department of Health grants NHS Employers a mandate to negotiate with the BMA, formal negotiations commence

16 November 2013 – NHS Improving Quality report Every day counts published http://www.nhsiq.nhs.uk/resource-search/publications/every-day-counts-seven-day-services.aspx

20 Dec 2013Everyone Counts: Planning for Patients 2014/15 – 2018/19 published by NHS England. Document purpose: Guidance. Seven-day NHS proposals

Description: ‘This guidance sets out the need for bold and ambitious five year strategic plans from NHS commissioners. It describes an approach to deliver transformational change with the first critical steps over the next two years, to achieve the continued ambition to secure sustainable high quality care for all, now and for future generations’

December 2013NHS Services, Seven Days a Week Forum Summary of Initial Findings https://www.england.nhs.uk/wp-content/uploads/2013/12/forum-summary-report.pdf

July 2014 – Danny Alexander writes to the Review Body Members (including the Review Body on Doctors’ and Dentists’ Remuneration (DDRB)) about pay rises in the NHS and (in point 6) raises the positive uptake of the offer of a ‘proactive and systematic approach to considering contractual issues’ with consultant and doctors in training. He asks the DDRB to ‘make recommendations on new contractual arrangements for doctors and dentists in training’ (See NHSPRB & DDRB 2015/16 Special Remit Report)

24 Oct 2014NHS’s Five Year Forward View Report published

December 2014 – The BMA submitted evidence to DDRB

October 2014 – The BMA stalled talks due to the Government’s failure to agree to safeguarding measures for doctors’ welfare and patient safety

Jan 2015NHSPRB & DDRB 2015/16 Special Remit Report: ‘In recognition of the strong case for delivering seven-day healthcare services on the grounds of patient safety and quality of care, the Parliamentary under Secretary of State for Health has asked the NHS Pay Review Body (NHSPRB) to consider the barriers and enablers within the Agenda for Change pay system for delivering health care services every day of the week in a financially sustainable way

Both the NHSPRB and DDRB have been asked to submit observations, for England only, by July 2015 which will then be reported to Ministers’

March 2015 – DDRB invited stakeholders to give evidence

8 May 2015 – Policy paper: 2010 to 2015 government policy: choice in health and social care             From: Department of Health and The Rt Hon Norman Lamb (First published: 25 March 2013) https://www.gov.uk/government/publications/2010-to-2015-government-policy-choice-in-health-and-social-care

18th May 2015Seven-day a week NHS: Prime Minister’s visit and speech https://www.gov.uk/government/news/seven-day-a-week-nhs-prime-ministers-speech

July 2015 – DDRB submitted its final report to the Government

August 2015 – BMA’s Junior Doctors Committee decided not to re-enter contract negotiations

September 2015 – The BMA voted to ballot junior members in England for industrial action and made the decision to re-enter consultant contract negotiations

18 October 2016 – Junior doctors’ protest in London

19 October 2016 – Early day motion 539 JUNIOR DOCTORS primarily sponsored by Caroline Lucas is tabled

November 2015 – In a turnout of 76.2 per cent, junior doctors voted overwhelmingly for industrial action

December 2015 – Industrial action in England was suspended following conciliatory talks with NHS Employers and the Department of Health

21 Dec 2015 – Government’s NHS mandate 2016 to 2017 published: ‘The mandate helps set direction for the NHS and helps ensure the NHS is accountable to Parliament and the public. The mandate must be published each year, to ensure that NHS England’s objectives remain up to date. This mandate was produced following public consultation.

By setting a multi-year mandate with a multi-year budget the government is enabling the NHS to plan more effectively to deliver our long-term aim to achieve the transformation set out in the NHS’s Five Year Forward View and create a fully 7-day NHS’ https://www.england.nhs.uk/ourwork/qual-clin-lead/7-day-week/

January 2016 – Talks between the BMA and the government were restarted and based on early progress, the decision was made to suspend the 48-hour industrial action planned for 26-28 January. Talks concluded with no resolution. Industrial action went ahead for 24 hours from 12 January

February 2016 – Talks between the BMA and the government concluded with no resolution. BMA decide to go ahead with the second day of industrial action planned for 10 February

– Junior doctors protest outside Houses of Parliament

– Jeremy Hunt announces his plan to impose the junior doctors’ contract to parliament https://www.youtube.com/watch?v=4HsgZlxrcQw

9 March 2016 – 48hr strike action against the imposition of the contract by junior doctors planned

6 April 2016 – 48hr strike action against the imposition of the contract by junior doctors planned

26 April 2016 – 48hr strike action against the imposition of the contract by junior doctors planned

 

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