2024 is going to be an important year for improving the workplace rights of doctors in Scotland. With the joint agreement reached last year, we will be entering into discussions for the renegotiation of the 2002 contract and to agree a new Pay Review mechanism, but first, the Scottish Junior Doctors Committee (SJDC) will be transitioning our talks into direct pay negotiations with the Scottish Government. We expect these to conclude with an above-inflation pay award that makes credible steps to achieving Full Pay Restoration.
In the meantime, though, work on our terms and conditions does not grind to a halt. After over two years of work, we have secured new commitments from the Scottish Government, health boards and NHS Education for Scotland (NES) to ensure that issuing of rotas will become a more reliable, predictable, and timely process.
We all know that we should receive our draft rotas no later than 6 weeks before we’re due to start, but we also all know that time after time this doesn’t happen for so many doctors. So before this blog gets to the improvements we’ve made, it’s important to highlight a step back that we have avoided.
Initial proposals were made to push the deadline for rota issuance back by 2 weeks permanently; this would have meant we were not entitled to receive our rotas until a minimum of 4 weeks in advance. Though the health boards and NES were amenable to this, it was not negotiable for SJDC and we would not budge on the 6-week timescale. Being unable to plan our lives until as little as 6 weeks in advance is bad enough, the BMA again stood up for doctors and stopped this proposal in its tracks.
Once this was settled, we worked through pinch points and data processing to work out where the hold ups could be minimised. We looked at onboarding for International Medical Graduates – an absolutely key and welcome part of the Scottish workforce – ensuring plans could be made to safely and comprehensively induct them into the rota process in a way that supports them – and their existing NHS colleagues – in feeling valued, settled and secure.
We’ve highlighted how rota arrangements that incorporate Less Than Full Time (LTFT) doctors are still letting down whole departments because including these trainees on the rota is still not a fully integrated option. Until training numbers are allocated on a Whole Time Equivalent basis, and departments staff their rotas accordingly, the delay in identifying LTFT trainees – and then subsequently making the rotas safe – can cause further delays in issuing final rotas to everyone.
We empathise with the teams who support our clinical workforce and the delivery of care; the current inefficient processes can make their jobs harder and can create friction between administrative and medical staffing groups. This is one of the reasons why changes have been recommended as a joint report. Achieving these recommendations will make things better for all of us.
The bottom line, though, is that the knock-on effect of the current uncertainty is always borne by the doctors, and it is always us who has to put our lives on hold as a result. Change is long overdue and the fact that these recommendations have been jointly agreed means that flaws in the system have been acknowledged by all, as has the impact they have had on our wellbeing; there shouldn’t now be any barriers to fixing those flaws by enacting what we’ve agreed.
What will make or break these agreements are the results that doctors can see and feel every few months as the rotational merry-go-round springs into action. The BMA are clear that every single doctor should have the contact details of their rotamaster in advance of starting their new role, so that life events can be accommodated and that any special circumstances can be taken into account without stress or detriment. The report concludes that this should be achievable; there is no reason why this bare minimum standard cannot be met. The BMA is also clear that not receiving your rotas 6 weeks prior to starting should be a vanishingly rare exception. We expect more than 95% of doctors to get their rotas more than 6 weeks in advance every single time, and we will be ensuring that stats are monitored so we can identify problem areas and hold boards – or departments – to account.
With this work we’ve collaborated with boards, NES and the Government to identify the issues and course correct how rotas and information are delivered. Now the work begins to regain the trust of doctors when it comes to our rotas. This will take time but we also need to see these actions and recommendations being rolled out across all boards; It’s now up for them to deliver, and to set the stage for a productive renegotiation of our contract until 2026.
Dr Chris Smith is Chair of the BMA’s Scottish Junior Doctors Committee.
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