[Closed] doctors on strike

De-fund, Demononise, Privatise.

It's worked every-time before

I've just seen the best idea for a counter-measure against (K)Hunt on Facebook:

Coordinated. Mass. Pregnancy.
It's the only way.
It's like a strike, but with pay.
43% of staff will still have to work though, just like yesterday.

Do Australia and the like have vacancies for tens of thousands of doctors?

And as was heard on the radio the other day - doctors are prepared to leave the NHS to work in a private health care system on the other side of the world.

If you want to work in a private health system for better pay - why not push for making the NHS private and reap the rewards that way.

It is going to be very interesting to see what the BMA and junior doctors do now.

Fact is, junior doctors who want to progress need to stay in the NHS ... so I really don`t see what they can do, aside from threaten to leave the UK. But as mentioned, Australia and Canada options are not really all that great.

The smoke and mirrors on both sides is as amazing as it is frustrating for onlookers and consumers of health services - remember them?

Pretty obvious from this morning that gov was in a position where contracts were going to be imposed. That's the problem with playing chicken - someone ultimately loses. And the industry is in effect a monopoly.

Rather large elephant in the room - at some point we are going to have to pay towards health care. so the denial, anger and bargaining phases are running concurrently, we can all feel depressed by the process, and then finally move on to acceptance.

The elephant isn't going to budge not matter how hard anyone blows

Do Australia and the like have vacancies for tens of thousands of doctors?

And as was heard on the radio the other day - doctors are prepared to leave the NHS to work in a private health care system on the other side of the world.

[url= http://www.thedailymash.co.uk/news/business/all-junior-doctors-to-retrain-as-brand-managers-20160211106138 ]They could always go and do something more rewarding[/url]

If you want to work in a private health system for better pay - why not push for making the NHS private and reap the rewards that way.

Come on this is a wind up, yeah?

Why would a consultant want that?

The current system maximises their benefit. Roll on the status quo...

Come on this is a wind up, yeah?

Yes - in a way.

But if the offer is so great abroad they'll all go anyway no matter what Mr Hunt does. A few grand of weekend overtime pay isn't going to be the deciding factor for those thinking of leaving.

1 Jr doc I work with is not going back to the NHS after his PhD is finished, he's been snapped up by Australia

1 has applied for positions in NZ

the 3 other, have a few years to decide b4 they go back full time

They all agree if they do go back there no way they'll be doing A & E!

But if the offer is so great abroad they'll all go anyway no matter what Mr Hunt does. A few grand of weekend overtime pay isn't going to be the deciding factor for those thinking of leaving.

at some point we are going to have to pay towards health care.

What would a private NHS look like anyway?

We all continue to pay NI which is used to subsidise private healthcare providers? Do we then pay anything at point of delivery?

Or does health insurance become mandatory? How does that affect those with family histories of cancer and diabetes? (if not worse).

The Canadian model seemed to work well (i.e. you payed a monthly subscription and received free at point of use healthcare from a range of private medical practices) but I don't know how they funded the hospitals, which didn't appear to be private.

Being pragmatic (and playing Devil's advocate to some extent..) what is the solution to a growing and aging population with increasingly high expectations of the health service? Either we pay more in tax to hire more doctors (which I'm fine with) or we let the service go private and pay more that way through increased health insurance. The only other way is to prioritise healthcare over other government expenditure i.e. make cuts elsewhere, but where would that be?

My point being, would we pay more either way?

Well if nothing else it shows you that even the brightest, well resourced, solidaritaceous*, brother and sister workers are powerless in the face of our neo-liberal overlords. Whoop.

*Have cc'd this to Susie Dent

at some point we are going to have to pay towards health care.

And here I was thinking the NHS was funded out of taxation rather than thin air. I agree that the long term funding issue is not going away, but if the tories are so interested in tackling this, how does that square with private companies making profits off the back of it? Private sector 'efficiencies' no doubt. 🙂

DrP - given your observations on the previous page, why is competition for med schools still so intense?

And the rush to Aus? A system that openly combined public and private health provision and with identified contributions through Medicare. Imagine if that idea was proposed in the UK!

And if everyone up sticks and moves to Aus (ok, lets ignore the commodity cycle for now) what happens to wages?

We do already - what you mean is that the wealthy will continue to pay for private healthcare, the poor will have limited access to healthcare and the middle (recently known as the squeezed) will have to sacrifice more of their disposable income for healthcare.

Quite possibly. Now we have got past that point, sensible conversations can begin. Until then its the same old merry-go-round and can-kicking.

13th floor - the public and private sector can work together perfectly well and beyond a lot of the "privitisation BS" do in many areas of our lives. Its not one versus the other. There is a favourite case study by all accounts - Aus. How "generous" is the Aussie gov versus other countries? How much is funded by the patient?

and if everyone up sticks and moves to Aus (ok, lets ignore the commodity cycle for now) what happens to wages?

much more importantly, what happens to the quality of healthcare?

Both suffer most likely. Lose/lose game.

Not very pretty.

Next?

DrP - given your observations on the previous page, why is competition for med schools still so intense?

As I understand it, application numbers have declined.
But furthermore - a medical degree is a cracking degree to have, frankly.
Many of my uni friends got the 'Dr' qualification (PhD lot, hush now..!) then went into industry, pharmacy, teaching (!) etc.

People often aim for the qualification then use it for other means.

Another case in point.. our local GP training programme had 12 candidates on it. Only 3 went into UK GP practice.

DrP

13th floor - the public and private sector can work together perfectly well and beyond a lot of the "privitisation BS" do in many areas of our lives. Its not one versus the other.

Granted, I wasn't actually trying to pitch it as one vs. the other, I was genuinely trying to picture what it might look like, I have no real conception of how 'more privatisation' would actually work as I have no conception of how it all works now! 😳

Are there areas where private firms could actually make a profit by delivering the same service more efficiently whilst charging the government less than they currently 'pay' the NHS?

It's probably a question for another topic, perhaps one posted on the 1st of August... 🙄

Thx DRP - my younger son's contemporaries had very high levels of competition to get into med school this (current) year, hence the question. And some v.v. bright candidates (all A/A*s etc) couldn't find places. I find that odd in the context of the current debate. Although son's best mate was toying with the idea of abandoning med school and going to Oxford instead.

So where do all these students go? Do they all emigrate? Why were 90% of the staff looking after my Mother recently non-Uk born? What IS going on?

13th - true. Time and place... 😉

I was amused by this comment in the FT coverage - not an FT comment BTW

I am no great fan of the BMA. Between them, the BMA and the DoH are supposed to jointly run the NHS. Frankly they have never done a very good job of this historically for many reasons. But there is more to this than just a power struggle.

This is all really a proxy war between the Treasury and the Trusts. Most of the actors, Hunt, the BMA etc are just caught in the middle. The NHS/DoH is staffed by institutionalised academic health economists. They are about as worldly wise as Central Bankers. They are really not of this world, and also completely disconnected from the practical professional world of medicine. Oddly they often have rather strange views about healthcare. Keogh's view of the NHS as "PC World" is an example.

What we really have here is a procession of many actors with partial views, and limited perspectives. There is no point in singling one lot out for criticism. The point is that governance of the NHS is dysfunctional. Actually Mr Hunt's job - if he has one - is to sort that out. But he doesn't seem to have grasped what's going on either.

?

The Canadian model seemed to work well (i.e. you payed a monthly subscription and received free at point of use healthcare from a range of private medical practices) but I don't know how they funded the hospitals, which didn't appear to be private.

By charging $500 for the privilege of walking through the hospital doors if my experience of Canadian hospitals is anything to go by.

N.B. the doctor's fee was on top of that.

[quote=teamhurtmore spake unto the masses, saying]DrP - given your observations on the previous page, why is competition for med schools still so intense?
And the rush to Aus? A system that openly combined public and private health provision and with identified contributions through Medicare. Imagine if that idea was proposed in the UK!
And if everyone up sticks and moves to Aus (ok, lets ignore the commodity cycle for now) what happens to wages?

Have you missed the bit where it was explained that the doctors' dispute is not about the salary? (I know that it's hard for an economist to understand that not everything is driven by money.)

No Dr - I heard people saying that and then considered the situation for myself. Especially the final impasse? Thank goodness for critical reasoning eh? But granted tough to follow where we are amongst all the noise

I'd happily pay more NI to -

A) Give doctors what they want, which doesn't seem that unreasonable to me considering how hard they work.

B) Keep the NHS out of private hands.

I'd happily pay more NI so everyone can get healthcare free at the point of delivery no matter who they are.

^^^^
That too!

We have been doing that for years - so why all the angst?

The NHS is mainly funded from general taxation and National Insurance contributions. Small amounts each year come from patient charges for services like optical care, prescriptions and dental care. The decision about how much money parliament will give to the Department of Health to spend on the NHS in England is made as part of the Spending Round process.

[b]While the NHS has never been entirely publicly funded, the percentage of funding from National Insurance and general taxation is at an all-time high.[/b] An increase to National Insurance rates in 2001, designed mainly to give a boost to NHS funding, led to the balance between National Insurance and general taxation changing, although general taxation still accounts for around 80 per cent of all NHS funding.

One of the reasons Australia and Canada are attractive are that the fees of medical students are not subsidized to the same extent as here so they emerge from their training with much more debt. Salaries therefore are higher as they have to recognise the need to repay this. Obviously training here and working in one of those two countries is a nice arbitrage of the systems.

Obviously training here and working in one of those two countries is a nice arbitrage of the systems.

And yet no dismay and that type of arbitrage!! 😉

By charging $500 for the privilege of walking through the hospital doors if my experience of Canadian hospitals is anything to go by.

N.B. the doctor's fee was on top of that.

Are you Canadian / Canadian citizen?

So if jeremey hunt suddenly collapses with chest pains, from all those naughty drs, shoving needles into their action man dolls.

Who will his staff call, the Ambulance service, to be driven by those ambulance drivers (his descripotion of highly trained paramedics)to the nearest hospital, where he will be seen and treated by overpaid and underworked nursing and Doctoring staff,(his idea) who have probably been on a long shift, before he arrived, with some challenging decisions and patients to respond to.

and all for free. and not a virgin/serco/bupa, etc in sight/0r on site.

But then again he will most probably be treated privately as other patients would most probaly try and put him right about his pathetic, privatisational views.

TAXI FOR LODDICK

Ah i see plenty of folk falling for the great NI myth that it is somehow ring fenced and not simply just another tax.

And yet no dismay and that type of arbitrage!!

That is because they are only doing it for patient safety.

the-muffin-man - Member

If you want to work in a private health system for better pay - why not push for making the NHS private and reap the rewards that way

They don't want to work in a private system for better pay. They want to work in the NHS, for what they get paid now, under the terms they signed up for. But that's not an option on the table.

That is because they are only doing it for patient safety.

That's ok then.

I'm not sure if I pointed this out earlier, but I actually did the figures to compare my current salary to my potential new one under the new contract and I actually stand to personally gain from this debacle (as I'm a senior trainee at pretty much the top tier of the salary scale, I worked out that I'll be around £4k per annum better off).

However, I still think that the new contract is an utter pile of horseshit and am against it in its entirety. It's bad for my junior colleagues, it's bad for future recruitment, it's bad for women, it's bad for academics, and it's really bad for our fellow healthcare professionals, who are just about to get royally screwed over as well.

Are you Canadian / Canadian citizen?

No but then we don't charge non citizens for emergency care in the UK. Oh and don't for a minute think it was free for Canadian citizens either. They all had to pay too and different amounts depending on what province they were from.

After listening to hours of news reports and reading the papers over the last few months, I still don't understand what the dispute is all about.

To me what the government says it wants to do all makes sense, i.e. their aims. Apart from the bit that they want services 7 days a week but on the same budget. I guess spreading services over 7 days and not 5 is possible as the demand is the same but you treat patients over more days, however I am sure its si not as simple as that. In addition the doctors are only one tiny part of the NHS and actually you need all the nurses, X ray staff, lab tech, etc to be working 7 days and the costs associated with that.

What I don't really get is the the BMA side. They say its is all about patient safety but if that is the case why is not every other person in the NHS striking as well. Would it not also effect the consultants the nurses, etc, etc. If it really is all about safety then wouldn't it be the duty of any and every professional person in the NHS to strike as well.

To me on the outside it really does just look like doctors not wanting or liking to be told what to do and wrapping it up in the patient safety argument. If not why are all the other NHS staff not supporting them as well and as equally alarmed about patient safety.

Ah i see plenty of folk falling for the great NI myth that it is somehow ring fenced and not simply just another

Who would that be then? I can't say where anyone has said such a thing. Apart yourself of course with normal inane ramblings.

P.S. Could I have a completely unbiased view of the reasons for the dispute.

+1

What I don't really get is the the BMA side. They say its is all about patient safety but if that is the case why is not every other person in the NHS striking as well. Would it not also effect the consultants the nurses, etc, etc. If it really is all about safety then wouldn't it be the duty of any and every professional person in the NHS to strike as well.

To strike legally it has to go to a union ballot. As it does not effect all NHS workers directly they can't ballot on it only the unions that it effects can, the BMA, in this case. As it that is for Dr's only then only they can vote and take action, it was opened to Jnr Dr's as it effects them. It's possible that the BMA may call for an all out members of the BMA to fight it which means all members get a vote whether to take action.

As for what it's all about. Well it's explained many times over in this thread.

Apart from the bit that they want services 7 days a week but on the same budget. I guess spreading services over 7 days and not 5 is possible as the demand is the same but you treat patients over more days, however I am sure its si not as simple as that. In addition the doctors are only one tiny part of the NHS and actually you need all the nurses, X ray staff, lab tech, etc to be working 7 days and the costs associated with that.

This is exactly what the dispute is about. Why are we pushing for a "7 day NHS" when no-one can tell us what that means? We already have emergency and urgent care 7/7, and there isn't a need for 7 day elective care currently. Even if there was, we don't have the numbers of doctors to provide this. And even if we did, we'd need all the other healthcare professionals to buy into it as well to make it work.

What I don't really get is the the BMA side. They say its is all about patient safety but if that is the case why is not every other person in the NHS striking as well. Would it not also effect the consultants the nurses, etc, etc. If it really is all about safety then wouldn't it be the duty of any and every professional person in the NHS to strike as well.

The BMA only represents doctors, not nurses or other allied healthcare professionals. Therefore the latter group cannot strike unless their union (Unison, for the most part) ballot them on industrial action. I'm not sure, but I think consultants have various no-striking clauses written into their current contract.

To me on the outside it really does just look like doctors not wanting or liking to be told what to do and wrapping it up in the patient safety argument. If not why are all the other NHS staff not supporting them as well and as equally alarmed about patient safety.

Nurses, midwives, porters, consultants etc etc are all supportive of this action. They are all aware that they are in the firing line of Mr Hunt next. The exodus of junior doctors following this contract imposition will be nothing compared to the exodus of other healthcare professionals if they are treated in the same way.

Drs now , other parts of the nhs to follow sooner rather than later, or be tuped accross to private employers.

The consultants are most definitely up in arms about this since they believe they will be targeted next.

The brass tacks of the Drs position is that they can be made to work longer hours for potentially less pay. Extra hours means more tiredness which affects their (life and death) decision making. Having your wages cut for continuing to do the same job is gonna p*ss anyone off surely?!

The government can't afford the increasing costs of the NHS so are trying to save money on their wage bill by getting more service provision without spending any more money they don't have

Simples

Apart from the bit that they want services 7 days a week but on the same budget. I guess spreading services over 7 days and not 5 is possible as the demand is the same but you treat patients over more days, however I am sure its si not as simple as that. In addition the doctors are only one tiny part of the NHS and actually you need all the nurses, X ray staff, lab tech, etc to be working 7 days and the costs associated with that.

But you would gain in the utilisation of resources - higher utilisation rates of operating theatres, machinery, cat scanners etc. with the same level of demand spread over seven days (or indeed catering for expected increased demand using existing facilities) expensive assets not sitting unused. if you combine with greater centralisation of certain types of surgery (which seems to lead to better clinical outcomes). Then look at the wider picture with (potentially) less cancelled or missed appointments if they fit in better with peoples lifestyles.

massively complex calculations of what might or might not hold benefits in the longer terms.

Unlimited demand, limited resources to satisfy them...the old conundrum.

The brass tacks of the Drs position is that they can be made to work longer hours for potentially less pay.

Do the working time regs not apply to Doctors? 48hr max per week (averaged)? No less than 11 hrs between shifts. Minimum number of rest days etc.

http://www.bma.org.uk/support-at-work/ewtd/ewtd-juniors

Let's make that clearer shall we.

working hours have been reduced from an average of 56 per week to 48, calculated over a period of 26 weeks.

Doctors are entitled to choose to work additional hours if they wish.

a period of 11 hours continuous rest a day (or compensatory rest to be taken at another time if this is not achieved).

a day off each week , or two days off in every fortnight (or compensatory rest)

a 20 minute rest break every 6 hours (or compensatory rest)

I'd happily pay more NI so everyone can get healthcare free at the point of delivery no matter who they are.

That implies that NI and healthcare are somehow linked, which they aren't. Why not just say I'd happily pay more tax, why single out NI?

Did someone just fart?

Well those are the regs but I think you will find its not quite so clear cut if you talk to the doctors themselves.

"Dr's can choose to work additional hours" however, staff shortages often mean that the choice is work extra or let Pts suffer because there are not enough staff to cover the whole (existing 5 day service) rota.

"20 minute rest break every 6 hours" - stopping people dying isn't the sort of thing you can stop doing to take your statutory break. Many departments are so flat out, Drs feel obliged to not stop working so Pts are looked after.

Fundamentally this is about the Drs working conditions or wages being changed for the worse (as they see it) without anything to compensate it.

But broken record but...

...work in one of biggest teaching hospitals in Europe. We don't have enough junior docs to staff rota without locums IN OFFICE HOURS MONDAY TO FRIDAY. So mor docs at weekend means we need more locums.

Applications for GP training, surgical training, medical training are all at record low this year.

We cancel elective surgery mon-fri due to lack of beds. Trying to operate electively on a weekend will just mean more cancellations.

We don't have enough staff to safely staff Monday to Friday. The only way to have more weekend staff is to reduce weekday staff. That is not progress!

Told you ... the demand will increase.

Does that mean if NHS is poorly there will be less "health tourists"? 😮

We do already - what you mean is that the [i]sick[/i] will continue to pay for private healthcare [i]as the NHS won't pay for my lifelong medication despite having an exemption card[/i]

FTFY

I have paid out over £2K, plus train fares, for two visits to a private doctor in London.

Did someone just fart?

Somewhere in the world probably, why?

Now if the CH 4 fast facts is to be believed

Without being a fly on the wall in the negotiations, it’s hard to know what the real sticking points are. The BMA has made no secret today that it sees status of Saturdays as the main obstacle. At the same time, the doctors’ union is not conceding that all the other areas of disagreement in these complicated negotiations have now been completely settled. If it is the case – as the government claims – that earlier fears over unsafe working hours have now been allayed, this message has not trickled down to striking doctors on picket lines.

They are still telling the public, perhaps wrongly, that this industrial action is still at least partly about unsafe hours.

Then the only winners hers are the communications/PR/spin doctors employed by the BMA, since this thread shows this is the narrative that we apparently have to accept.

You have to take you hat off to the BMA, they are a bloody good Union and of course they have plenty of history here even going back to the origins of what they now (apparently) hold most dear.

That's not "if CH4 is to be believed"- that's "if the government is to be believed"

Sorry must have misread it. Are CH4 as bad as Auntie then?

But broken record but...

...work in one of biggest teaching hospitals in Europe. We don't have enough junior docs to staff rota without locums IN OFFICE HOURS MONDAY TO FRIDAY. So mor docs at weekend means we need more locums.

You're going to need even more when 50% of trainees bail out on completion of the foundation programme or core training. Problem of course is that this doesn't just cause holes in the rota [b]now[/b] but also means in ten years or so there is going to be a consultant shortage.

Still, I seem Jeremy 'rhymes with' Hunt has set up a public enquiry into junior doctors' low morale, on the same day he has imposed the contract.

Are CH4 as bad as Auntie then?

Really don't know what you're getting at- the CH4 quote you gave makes no statements of fact, so it's not a question of believing them or not- they're reporting the government's claims but expressly state that they're not established facts.

I see. Must have misread it ^2?

Ch 4 really shouldn't put such stuff in a section called FactCheck and certainy not in "The verdict" section. Quite dishonest of them.

What do you think is dishonest about it?

d. If it is the case – as the government claims – that earlier fears over unsafe working hours have now been allayed,

I think that right there sites that the ch4 website is just filling pages with content it can't verify

Kind of amazed at some of the attitudes on here.
These guys n girls are Doctors FFS not Arthur Scargill.
If they say they are being pushed into an intolerable situation by a government who have never hidden the fact they are intent on de-constructing the NHS, why cant we just get behind them, with out obsessing out every tiny point.

Don't it always seem to go - That you don't know what you've got till its gone

The govt has shown the way for how easy it is to do this now- all you really need are a nicely compliant media, some 'all in it together' soundbites, and some petty jealousy among those who'd have us see the medics as having clay feet. Quite simple.

And then finally, when it wasn't quite going Hunt's way- he just pronounced that the negotiations were over. They can do that now, anywhere they like.

As doctors pretty much sat at the top of everything, they were the targets to knock out as a first pass, and that's been concluded- its really pretty much all over for any other public service now, as these tactics have been so effective.

I wonder who'll be next.

Teachers? Possibly. Though it might be that there's not a lot they can sell off and make money from in teaching.

.....Police?

I'm waiting to see the media campaign begin, and soon, to start gently chipping away at whoever is next in their sights.

It's done wonders for the morale of the nursing staff too. Those I inow are convinced they are next. Many, including my wife now looking to get out of primary care whilst the going is good. Two of her ENP colleagues quit this week, leaving another big hole in provision in the local ED/WIC. She's thinking hard about jumping ship too, especially as the local GP surgery are desperate for a practitioner.

I'm not too sure where this is going now.

Doc will be moving to Wales, Scotland and abroad, quality candidates won't be entering training, so your future doctor won't look after you as well, the number of specialty training posts has been reduced, there is not enough funding for the support diagnostic services for 7 day working, funding has been cut by 25% for social care services so people can't get out of hospital.

But to look at the positive, when it all goes tits up and they privatise it all at least Mrs FD will earn substantially more as a private hospital surgeon, and will only have to deal with nice middle class people, as more needy people in society won't be able to afford the private health costs 😀 🙁

And then finally, when it wasn't quite going Hunt's way- he just pronounced that the negotiations were over. They can do that now, anywhere they like.

It's done wonders for the morale of the nursing staff too. Those I inow are convinced they are next. Many, including my wife now looking to get out of primary care

Yes have also heard the nurses fear they will be targeted yet and looking for ways out

Most other NHS workers have that same fear.

[quote=FunkyDunc spake unto the masses, saying]
But to look at the positive, when it all goes tits up and they privatise it all at least Mrs FD will earn substantially more as a private hospital surgeon, and will only have to deal with nice middle class people, as more needy people in society won't be able to afford the private health costs

Well, who gives sh1t about poor people? They are just lazy and have only themselves to blame.

(Am I getting the hang of this Tory thing yet?)

[quote=thisisnotaspoon ]bruneep - Member
Work days/ nights/ weekdays/weekends do difference in pay
Working 0300 on a Sunday morning same pay as working 1000 Monday
[b]Yes, but you're likely paid more for all your hours than someone doing the equivalent job mon-fri 9-5[/b].
People on a different set of T&C's to me in my job get a ~5% bonus in return for not being paid overtime (but still expected to work it). I 'missed out' on that offer, get paid overtime, but get less money in my normal paycheck.

If thats the case my pay is worse than I thought it was. So how does the person in dayshift dept get paid the same as me then?

They have already started on the nurses - bursaries going means less applicant's, whose going want take on uni debt to end with nurse salaries? Or the high number of mature students who could only make it because of the bursary?

Nurses, midwives, porters, consultants etc etc are all supportive of this action. They are all aware that they are in the firing line of Mr Hunt next.

Out of interest what is the definition of "unsocial hours" for NHS Nurses, midwives & porters? ie The times at which they get extra pay for being at work.

They have already started on the nurses - bursaries going means less applicant's, whose going want take on uni debt to end with nurse salaries?

Nurses already earn more than the median average wage - which of course covers many other graduates working in other professions, so simply puts them on a par with everyone else when it comes to how the training is paid for.

The Royal College of Nurses made a sustained push for nursing to become a degree level qualification. Arguably this at the root cause of so many people dropping out of nursing training (because it's now very removed from patients for the early years) and the experience/ complaints from patients which is many newly qualified "degree level" Nurses are much less inclined to do hands on care than their non-degree qualified peers of 20 or 30 years ago.

Nurses already earn more than the median average wage

Average Nrurses wage is around £23k for 3 years of study.

And of course it switching degree level wasn't the cause of so many dropping out. Utter rubbish.

Out of interest what is the definition of "unsocial hours" for NHS Nurses, midwives & porters? ie The times at which they get extra pay for being at work.

The national agreement on unsocial hours payments is set out in Section 2(a) (England) in the NHS Terms and Conditions of Service Handbook. To help employers deal with any questions from staff we have prepared the FAQs below.

Under this system, shifts starting on week days will be paid at the rate which applies to the majority of the hours worked as part of the shift, while Sunday enhancements will apply to the 24 hours from midnight to midnight. The effect of this for shifts starting at 7.00 pm and ending at 6.00 am, for example, will be:

shifts starting on Monday, Tuesday, Wednesday or Thursday: all of the shift would be paid at the enhanced rate;
shifts starting on Friday and ending on Saturday morning: all of the shift would be at the enhanced rate;
shifts starting on Saturday and ending on Sunday morning: the Monday to Saturday rate of enhancement for the hours 7.00 pm to 12.00 midnight and the Sunday rate of enhancement for the rest of the shift; and
shifts starting on Sunday and ending on Monday morning: Sunday rate of enhancement for the hours 7.00 pm to 12.00 midnight and Monday to Saturday rate of enhancement for the rest of the shift.

"Normal" hours for those on the Agenda for Change contract (which I believe includes nurses and other allied health professionals) are 6am-8pm on weekdays. Saturdays and evenings/nights attract a 30-50% premium. Sundays and bank holidays attract a 60-100% premium.

[url= http://www.nhsemployers.org/your-workforce/pay-and-reward/nhs-terms-and-conditions/nhs-terms-and-conditions-of-service-handbook/unsocial-hours-payments ]Link[/url]

Edited for rogue apostrophe