In the NHS the current contract is not as many suppose based upon 11
sessions but is for a minimum of 10 sessions. There is no maximum number
of sessions for full time or maximum part time consultants.
The 11 sessions is an assumption based upon the fact that those who want
to do unlimited private practice are fined one eleventh of their salary
for the "privilege".
As Adrian says the concept of fixed sessions is harder to define for A&E
but custom and practice is that shopfloor sessions are fixed sessions
and admin sessions are flexible.
A consultant should normally have between 5 and 7 fixed sessions. Five
with heavy other commitments such as on call and seven with light other
commitments.
A session is technically called a notional half day and consists of a
period of 3.5 hours worked flexibly.
So Adrian's 8 hour day could reasonably be two NHDs of fixed commitments
if he takes a lunch break or does some admin amongst his shopfloor work.
Other departments strictly count a time of 7 hours scheduled to cover
the shopfloor as two NHDs.
In terms of out of hours I would strongly advise against anyone counting
sessions as Adrian does! Most department I know of do not allow for any
of the antisocial time to be discounted - every 3.5 hours = 1 session.
In his 4pm to Midnight shift he is on duty for 8 hours of which 7 hours
is antisocial (in generally accepted terms). Regardless of whether the
antisocial time counts as extra value this is more than two sessions
worth.
The second and perhaps more important thing is the averaging of
weekends. If you do 1 in 4 weekends but have to cover for colleagues
leave or to swap to allow your own leave then this equates to more than
1 in 4. The way to allow for this is to average the hours eg 16/4 = 4,
but then to multiply by the number of weeks in the year (52) and divide
by the number of weeks NOT on any sort of leave (42). The 42 arises by
deduction 6 weeks for Annual Leave, 2 weeks (10 days) for Bank Holidays
or lieu days and 2 weeks for Study Leave. SO 16/4 x 52/42 = 4.95
This is 1.4 NHDs
So by my reckoning Adrian is doing 3.7 sessions fixed of antisocial
hours plus his 3 sessions of normal working hours fixed sessions. This
makes nearly 7 fixed sessions with compensation.
Around the country compensation is variously given as -
1. Nothing
2. Shorter period of time out of hours counts as a session eg 2.5 hours
= 1 session
3. Reduced number of fixed sessions eg 5 fixed sessions in total
4. Sessions counting out of hours as 1.5 or even 2 sessions (This is the
same as 2 but some managers are more comfortable with one form of words
than another)
5. More money - This is very rare!
The biggest difficulty with anything other than 5 is that whilst the
clinical commitment may be capped so called time off can be very
difficult to take. Meetings with managers and other clinicians are
usually scheduled during the day and often take up more time than that
nominally allocated to flexible sessions.
I agree with Adrian however that a National agreement on the added value
of these sessions is the best way forwards for those of us who choose to
work them.
Andrew Hobart
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Adrian Fogarty
Sent: 18 June 2003 05:43
To: [log in to unmask]
Subject: Re: Fixed sessions out of hours
As the strict definition of "fixed session" does not really apply to
A&E,
James, we have tended to interpret our "fixed" sessions as those where
we
must be on the shop floor (or thereabouts!). This essentially boils down
to
our resident evenings and weekends together with one or two of our
standard
days each week.
As an example, I do every Monday evening from 4pm to 12mn, and this
counts
as (roughly) 2 sessions. I don't get any specific recompense for the
lateness of the shift (but see later).
I do three other standard day shifts, (Wed, Thur and Fri) each around 8
hours per day which equates (roughly) to 2 sessions per day. [So that's
8
sessions so far.]
I also do one weekend a month, which is nominally 8 hours Sat and 8
hours
Sun, although it's usually hard to restrict it to only 8 hours at the
moment, but will be easier as new middle-grades come on board. This
therefore equates to (roughly) 4 sessions per weekend, and, averaged
over a
month, this equates to 1 session per week. [So that's 9 sessions so
far.]
Then we add on 1 session for on-call from home, partly to cover after
our
"resident shifts" (when we are rarely called back), and partly to cover
our
registrars (which doesn't often happen now, and will decrease further
when
our 4th consultant starts next month, and rarely called anyway!).
Finally we add on 1 session to compensate for antisocial hours, i.e.
late
shifts and weekends. [So that's 11 sessions in total.]
We count the evening as 2 fixed, and the weekend as 1 fixed. We also
count
one-and-a-half of my standard 3 days as fixed, so that's 3 fixed
sessions
(the non-fixed sessions tend to be admin etc). So the total comes out at
6
fixed sessions out of a possible 11 sessions.
I hope this makes sense. I'm sure some of you might suggest that we
could
get more time off in-lieu for our evenings and weekends, but I'm eagerly
awaiting BMA negotiations on that point! And perhaps we don't claim
enough
sessions for our on-call from home, but we work a system where we are
extremely rarely called from home, as there's generally someone "senior"
actually in the department for the vast majority of the time.
Adrian Fogarty
A&E Consultant
Royal Free Hospital
----- Original Message -----
From: "BINCHY Dr J, A&E Consultant"
Subject: Fixed sessions out of hours
Any consultants out there doing fixed clinical sessions in the evenings
or
at weekends?
If yes what arrangements have you made with your trusts regarding extra
payments or compensatory time off?
I've been tasked by my local LNC to see what arrangements are operating
around the country. If you'd like to discuss this off site I'm at
mailto:[log in to unmask]
James Binchy
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