BMA :: BMA response to NAO report on consultant contract

Hospital consultants are working long and intensive hours for the NHS and are striving to lead improvements in patient care, says the BMA in its response to the National Audit Office (NAO) report on the new consultant contract for England published yesterday.

Although the NAO reported that consultants? working hours have decreased by 1.4 hours a week, consultants? workload remains high. Dr Jonathan Fielden, Chairman of the BMA?s Consultants Committee said: ?It has never been easy calculating exactly how many hours consultants work for the NHS.

It is clear that their workload remains high, is intensely demanding and exceedingly complex. NHS trusts have deliberately cut back on activity in recent months to save money despite consultants? willingness and ability to do more. NHS consultants have led on delivering reductions in waiting times and strive to introduce new treatments and efficiencies for patients. If trusts are failing to realise the benefits of the contract it is because they have been distracted by the pressure to balance their books and meet political targets.

?The Government accepted that the old contract failed to recognise how hard consultants worked and believed consultants should be better rewarded. The new contract is designed to more accurately reflect consultants? working patterns and aims to pay consultants for the work they agree to do. However many consultants continue to work many unpaid hours in excess of their contract through their professional dedication to patient care.?

Evidence on the impact of the contract on patients was gathered almost a year ago, and there are now signs that improvements in care are becoming more apparent. Dr Fielden said:

?This is the most significant change to consultants? contracts since 1948 and it will take time for the NHS to use the tools in the contract to their full potential. Hospitals and consultants can now more clearly match activity to the needs of patients and when the contract is implemented properly we are seeing the benefits. Consultants have told us how the contract has facilitated better team working to improve continuity of care, changed working patterns to improve efficiency, allowed a greater presence of consultants on wards at key times and optimised the best use of theatre time.”

The NAO is critical of the government for how much the contract was overspent. Dr Mark Porter, lead negotiator for the BMA?s consultants? committee said: ?The Government miscalculated the cost of the contract because it underestimated how hard consultants work for the NHS. The contract was fully costed during negotiations and the Department of Health made extra funding available to NHS trusts when it became apparent that there would be an overspend.

?The recommendations are helpful in highlighting to trusts the importance and value of the job planning process that allows resources to be matched to consultant workload. The BMA looks forward to discussing with NHS Employers how best consultants can use their contracts to maintain and increase standards of patient care.?

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