Flexible Training

1

• Flexible Training

2
Revised Remuneration Arrangements

• UK Flexible Working Group of COPMeD Roadshow
• 10 May 2005
• Gill Bellord Mike Beattie
• NHS Employers

3
Overview

• A vision
• Some history
• What needed to change
• Practical implications

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A Vision

• Vision is seeing what life
• could be like,
• while dealing with life as it is
• (anon)

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History - Early Schemes

• Not seen as a mainstream career pathway
• Flexible training schemes with defined rules
• For example
• PM79 (3) Senior Registrars
• EL (91) 5 Career Registrars
• Limited provision for PRHO and SHO

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History Hours Worked
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History - Progress
8
Current Problems

• Deans were asking DH for more funding
• The BMA was concerned about doctors remaining in
  training.
•  Trusts were refusing to take flexible trainees
  because they are too expensive

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The 2000 Contract
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Addressing the Issues

• Removing the pay obstacle to flexible training
• Working in partnership with BMA through JNC(J)
• Working with deaneries and medical staffing
  colleagues to arrive at practical solutions
• 7m recurrent funding from Department of Health
• Parallel work to look at access and monitoring

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New Arrangements for Flexible Pay

• The New Approach to Pay

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New Arrangements for Flexible Pay

• The new pay system addresses 4 key issues
• A lack of flexibility
• A lack of connection between pay and hours
  worked
• A lack of equity between full- and part-time pay
  rates
• A lack of transparency about who should fund
  what.
• It also simplifies arrangements for
  superannuation.

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New Arrangements for Flexible Pay

• Current working arrangements can be very
  different to pro-rata working.
• A pay system based on actual work done is a
  fairer solution.
• Nevertheless, legislation specifies a pro-rata
  approach to part-time medical training to ensure
  its effectiveness and equality.
• The new arrangements properly recognise and
  reward hours worked on a proportional basis,
  whilst still providing a basis for pro-rata pay.

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New Arrangements for Flexible Pay

• Where full-time trainees undertake out-of-hours
  duties, flexible trainees taking part in the same
  training arrangements should not be excluded from
  such work.
• Where full-time trainees normally undertake
  out-of-hours duties, flexible trainees should
  also undertake these duties.
• Flexible training cannot be different training
  it must have the same content as full-time
  training - spread over a longer timescale.
• Service delivery is an important part of the
  education - trusts must recognise this and
  utilise flexible trainees effectively.

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New Arrangements for Flexible Pay

• Pay has two components basic salary and
  supplement
• Basic salary is determined by the actual hours
  worked by the flexible trainee. This needs to be
  no more than the appropriate proportion of the
  actual hours worked by full-time trainees on the
  same rota.
• The supplement is determined on the basis of
  frequency and proportion of out-of-hours duties.
• The supplement is paid as a proportion of the
  basic salary determined by the actual hours
  worked.

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New Arrangements for Flexible Pay

• Basic salary is now related to hours worked the
  calculation of superannuation is simpler.
• The arrangements are intended to be applicable in
  the longer term EWTD will bring most trainees
  into Band 1 in the coming few years.
• The determination of intensity is based on a
  typical trainee doing 60 of full-time, using
  parameters derived from the Band 1 criteria.
• If in future the typical flexible trainee works
  other than 60, the parameters can be reviewed.

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The 2005 Contract
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The 2000 Contract
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The 2005 Contract
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New Arrangements for Flexible Pay

• Example 1
• Flexible contracted at 60
• Full-timer in Band 1, 1 in 8, working 47 hours a
  week
• Flexible hours 60 of 47 28.2
• On-call frequency 60 of 1 in 8 1 in 13.3
• Basic pay F7 70 of full basic pay
• Supplement FA 50 of F7

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New Arrangements for Flexible Pay Ex.1

• The total pay is worked out as follows
• (in the following, full-time basic pay is shown
  as FBP)
• Basic Pay 0.7 x FBP
• Supplement 0.5 x Basic Pay
• 0.5 x 0.7 x FBP 0.35 x FBP
• Total Pay Basic Pay Supplement
• (0.7 0.35) x FBP 1.05 x FBP

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New Arrangements for Flexible Pay Ex. 1
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New Arrangements for Flexible Pay

• Example 2
• Flexible contracted at 60
• Full-timer in Band 1, 1 in 8, working 45 hours a
  week
• Flexible hours 60 of 45 27
• On-call frequency 60 of 1 in 8 1 in 13.3
• Basic pay F6 60 of full basic pay
• Supplement FA 50 of F6

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New Arrangements for Flexible Pay - Ex.2

• The total pay is worked out as follows
• (in the following, full-time basic pay is shown
  as FBP)
• Basic Pay 0.6 x FBP
• Supplement 0.5 x Basic Pay
• 0.5 x 0.6 x FBP 0.3 x FBP
• Total Pay Basic Pay Supplement
• (0.6 0.3) x FBP 0.9 x FBP

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New Arrangements for Flexible Pay Ex.2
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New Arrangements for Flexible Pay

• Example 3
• Flexible contracted at 50
• Full-timer in Band 1, 1 in 8, working 47 hours a
  week
• Flexible hours 50 of 47 23.5
• On-call frequency 50 of 1 in 8 1 in 16
• Basic pay F5 50 of full basic pay
• Supplement FB 40 of F5

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New Arrangements for Flexible Pay - Ex.3

• The total pay is worked out as follows
• (in the following, full-time basic pay is shown
  as FBP)
• Basic Pay 0.5 x FBP
• Supplement 0.4 x Basic Pay
• 0.4 x 0.5 x FBP 0.2 x FBP
• Total Pay Basic Pay Supplement
• (0.5 0.2) x FBP 0.7 x FBP

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New Arrangements for Flexible Pay Ex.3
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New Arrangements for Flexible Pay

• Establishing Posts
• Agree eligibility and establish support
• Identify/agree suitable post(s)
• Agree work plan based on proportion of full-time
  duties
• Use the work plan to set basic pay and supplement
• Offer contract on this basis

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New Arrangements for Flexible Pay

• Establishing Posts
• Clarifies expectation on both sides
• If hours are longer than those agreed, pay will
  reflect it
• Trusts can manage duties to bring hours back to
  contracted levels and thus control costs
• Pay is protected at a minimum of the contracted
  level

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New Arrangements for Flexible Pay

• Pay Protection
• Flexible trainees in post or with posts already
  agreed at transition will have their pay
  protected until the end of those posts or
  placements currently contracted for, under the
  same arrangements as full-time trainees.
• Trainees entering new contracts after the
  transition date will have their pay protected at
  the level contracted under the new arrangements