Junior doctors' contract: equality analysis and family test

Equality analysis and family test for the new contract for doctors and dentists in training in the NHS.



Equalities Statement: proposed junior doctors’ contract (published 27 May 2016)

During the most recent ACAS negotiations (May 2016), it was agreed that the Secretary of State would publish an equalities analysis document. This statement considers the new proposals and their impact on junior doctors, with particular reference to those with protected characteristics.

As part of the proposals, employers, Health Education England and the BMA will put in place comprehensive equalities monitoring mechanisms for all protected characteristics to be signed off via the Joint Negotiating Committee on Juniors (JNC(J)) for implementation from April 2017.

Several of the new proposals will benefit all junior doctors, such as the clarification of the role of the Guardian of Safe Working Hours and the processes supporting that role, the proposals on whistleblowing and the “period of grace” funding after completion of specialist training.

In addition, the following measures will, in particular, also help those with caring responsibilities (predominantly women) who might include part time workers taking longer to complete their training (and some of the proposals will also be of benefit to those with disabilities):

  • accelerated training support for those taking time out
  • the NHS Employers/BMA review of good rostering practice supporting greater flexibility of working and the Health Education England review of deployment processes
  • an extension of the pay protection period
  • pay protection for those who change training path for caring reasons or for reasons related to disability
  • the unsocial hours package which gives a weekend allowance for those working more than 6 weekends per annum and increased money to be spent for on call availability
  • nodal adjustments which will front load pay levels (so as to give more pay earlier)
  • comprehensive equalities monitoring systems

Equality analysis on the new contract for doctors and dentists in training in the NHS

The purpose of this analysis is to assist the Secretary of State for Health in giving effect to his Public Sector Equality Duty under s149 of the Equality Act 2010 (EqA). This requires the Secretary of State to have due regard to each of the statutory equality objectives (or strands) set out in s149 EqA. Having considered fully the equality analysis (EA) alongside the draft final terms of the new Contract, the Secretary of State is today publishing the EA alongside the new terms and conditions of service for doctors and dentists in training being published by NHS Employers.

The EA examines the provisions of the contract - for example, including pay linked to levels of responsibility, pay linked to the number of hours worked with additional pay for those working the most unsocial hours - and concludes that the new contract is fair and justified and is good for both staff and patients. We consider that the new contract will advance equality of opportunity. Where the new contract may have any adverse effect on people with protected characteristics, such an effect does not result in discrimination as the new contract is a proportionate means of achieving a legitimate aim, or aims.

As a result of considering the EA in accordance with his duties and obligations, including the Public Sector Equality Duties under the Equality Act, the Secretary of State has asked for a number of changes to the draft contract to address specific issues for certain protected groups. The changes are:

  • Previously the proposal was that all staff, full time and part-time, would have 3 years of transitional protection. Now doctors who are part-time or who take approved time out of programme will have 3 ‘full’ years of protection - for example, a doctor working part-time on a 0.5 whole time equivalent basis throughout transition would have 6 actual years of pay protection. This will particularly benefit senior trainees (at ST3 and above) who will receive pay under the existing contract including increments and banding possibly until 2022.

  • Previously, doctors who were absent on maternity leave or carers leave on 31 October 2015 (the base date for pay protection) would be protected based on their last salary before they went on maternity leave. They will now have protection calculated as if they had not taken leave so protection will be based on the salary they would have had on 31 October 2015 (which will normally be treated as the salary they return to).

  • Doctors working part-time should be able to access Saturday Intensity payments (SIPs) on a pro rated basis. This means that while a full time doctor receives a SIP when they work one Saturday in 4 or more, a part-time worker working for instance on a 50% contract would receive the payment when they work one Saturday in 8. This will be kept under review.

  • Doctors working part time will similarly receive on-call availability payments on a pro rated basis.

  • Doctors who have to change specialty because of a disability or caring for someone with a disability will receive pay protection on the same basis as someone who changes to a shortage specialty.

Family test

The family test was designed to complement the existing work of departments to consider the 3 aims of the Public Sector Equality Duty:

  • eliminate unlawful discrimination, harassment and victimisation and other conduct prohibited by the Act

  • advance equality of opportunity between people who share a protected characteristic and those who do not

  • foster good relations between people who share a protected characteristic and those who do not

The 5 family test questions are:

  • What kind of impact might the policy have on family formation?

  • What kind of impact will the policy have on families going through key transitions such as becoming parents, getting married, fostering or adopting, bereavement, redundancy, new caring responsibilities or the onset of a long-term health condition?

  • What impacts will the policy have on all family members’ ability to play a full role in family life, including with respect to parenting and other caring responsibilities?

  • How does the policy impact families before, during and after couple separation?

  • How does the policy impact those families most at risk of deterioration of relationship quality and breakdown?

Published 31 March 2016
Last updated 27 May 2016 + show all updates
  1. Added the Equalities Statement: Proposed Junior Doctors' Contract (published 27 May 2016)
  2. First published.