When I looked back at my last update on the work of the Scottish staff, associate specialist and specialty doctors committee, it made me realise how much has changed over the last 12 weeks and yet how much has remained the same. 2022 has already thrown up some pretty big challenges globally as well as for the NHS. We started off this year with a surge in COVID-19 case from the Omicron variant and already we are facing another surge in Scotland from a sub-variant. The NHS has been incredible in continuing to deal with the challenges of COVID-19, I know many of you are tired and patients are frustrated. While we are used to working in challenging circumstances, what many of us are facing daily at the moment is unprecedented. The BMA has been working hard behind the scenes highlighting the difficulties clinicians are facing and that the risk of burnout is all too real.
Firstly, I want to update you on contract negotiations. When I last wrote to you about this I explained that we had agreed to extend our negotiation meetings into 2022. I had thought at that time we would be nearing the end of that by now, however there have been some further delays. We continue to engage in intensive and constructive negotiations which we are hopeful we will now conclude over the summer. We recognise that this is later than we had originally envisaged – this has been due to the complexity of the discussions, and the necessity to delay work to respond to the Omicron variant. We will work at pace and if we can successfully conclude the negotiations over the summer, then we would be able to present a deal more widely to SAS doctors and employers early in the autumn. If the deal is then accepted, these new contracts would be introduced later in the year.
I appreciate the further delays will be frustrating for you especially as we are now coming up to a year since new contracts were introduced in the rest of UK. Please be reassured that we have used this time as an opportunity to reflect on the deal in the rest of the UK and to try to negotiate something even better for Scotland. The importance of making sure that we have the right contract was highlighted to me earlier this month when BMA Scotland published results of a recent Freedom of Information (FOI) request that was sent to boards late last year on vacancy rate data. In previous years we have requested data on consultant vacancies, however when we repeated it this time for 2021 data we took the opportunity to ask as about SAS vacancies as well. Figures on SAS vacancies aren’t included in ISD (Information Services Division of NHS Scotland) data and therefore we can’t compare figures from previous years, however the data speaks for itself and unfortunately it is stark. From the responses we received it shows that there is a 25% vacancy rate of SAS doctors in Scotland, and just over 10% of SAS posts are filled by locums. And while the Scottish Government rings out its rhetoric that there are more doctors or nurses than ever before, we know that the demand has never been greater and patients are now presenting with more complicated needs because treatment has been delayed for so long, creating a perfect storm.
Earlier this month the Scottish Government finally published the long awaited ‘National Workforce Strategy for Health and Social Care’. The document is a mixed bag with some positive moves – but also some worrying gaps. It does importantly include promising steps to invest and develop the medical workforce for the future and we welcome the increased investment and ongoing commitment to expand medical training places. The key missing section is on retention – it takes a long time to train doctors, yet at the moment we face the pressing risk of losing more and more of those we currently have. While the section on nurturing the workforce is welcome, we urgently need more co-ordinated action now to guard against the possibility of losing many doctors before any new recruitment has a chance of making an impact. This strategy needed a much greater focus on how we prevent that through fairer reward, finally sorting pensions tax charges, better work-life balance, not to mention just making NHS Scotland a more attractive place to work, with an improved culture and less of a focus on targets and blame. There is an important focus on improved data – yet there is still a failure from the Government to acknowledge the fact the data they have doesn’t truly reflect the scale of the problems we face. As out recent FOI showed consultant and specialty doctor vacancies are still substantially underestimated in official figures and there is a lack of good data on the GP workforce – big gaps which will need to be plugged going forward.
All this goes to show the absolute urgency for finalising a new contract for SAS doctors and the importance in learning the lessons from the rest of the UK and making sure we get it right. We SAS doctors are an integral part of the NHS and at the conclusion of these negotiations we need to have an attractive contract that not only looks to the future to increase recruitment to NHS Scotland but also, and most importantly right now, encourages the retention of the wonderful and loyal staff that we have.
I don’t want to end this update without acknowledging the horrific scenes that we have seen coming out of Ukraine, first and foremost I want to extend my thoughts to the people of Ukraine at this time, and to our healthcare colleagues who have family and friends over there – we stand with you and you are in our thoughts. It’s difficult to comprehend what our medical counterparts in Ukraine must be feeling, and yet they continue to deal with everything that is thrown at them heroically – they have our upmost respect. The SAS medical workforce is incredibly diverse, and we have doctors working across the Scottish NHS from eastern Europe who may have close ties to people caught up in the conflict. If you are struggling and need support, the BMA offers free and confidential 24/7 counselling and peer support services open to all doctors and medical students. Equally if you have a colleague who has been affected, please share details of our Wellbeing Support Services. You don’t need to be a BMA member to access our helpline and it is also open to family members too. As always, as your trade union, we can also help if you need support in the workplace.
Finally a reminder that at the end of negotiations, if you are a BMA member, you will be able to have your say on whether we should accept what has been agreed. For us to get in touch with you to do that you’ll need to make sure the contact details you have with this are up to date – so please don’t hesitate to check that. If you aren’t yet a member it’s never too late to join, find out more here.
Dr Bernie Scott is Chair of BMA Scotland’s Staff, Associate Specialist and Specialty doctors’ committee