Flexible working in surgery
When you have been appointed to a substantive post, a number of flexible working options are available. These options include:
- Annualised contracts
- Compressed hours
- Early/late contracts
- Part-time
- Flexible retirement options
- Term time working
To opt for any of these flexible working options you should first discuss this with human resources, your surgical colleagues and your directorate management to ensure that the proposed working patterns will not adversely affect patient care or cause undue detriment to other members of the surgical team.
Many Trusts support flexible working to enable patient-centred care to be delivered at more beneficial times and to increase efficiency and throughput. Examples of this include early bird and night owl clinics, three-session theatre lists, and elective weekend working.
Annualised contracts
An average clinical work schedule will take into account when each Consultant is available for clinical work, excluding annual and study leave. The full-time equivalent contract is then extrapolated, to identify how many clinical sessions in theatre/endoscopy/clinic etc. are required. Once this is established, the number of administration sessions and supporting professional activity sessions (SPAs) are agreed, and the total expected performance outcome for a one-year period is established. A basic working pattern may be undertaken, with flexible sessions at a time of increased clinical demand. Alternatively, a totally flexible working pattern, using orphan clinics and lists can be offered.
Once the agreed performance outcome is completed for the year, the contract is fulfilled. Annual leave is contracted at zero days, and can be taken flexibly to accommodates work flow patterns.
Compressed hours
Early/late contracts
Term time contract
Part-time contract
There is a pro-rata reduction in both clinical and SPA sessions. It is important to consider how many SPAs you need to undertake to maintain safe clinical practice. Some SSAs may be able to provide guidance on recommended procedure numbers etc.
Once the number of SPAs per week worked falls below 10, there are implications for both pension accrual and the reduction in monetary value of clinical excellence awards, which has a further knock-on effect on the size of the eventual pension pot. Therefore, any decision to undertake a less than full-time contract must be considered carefully.
If you decide to adopt any form of alternative working arrangement, you should think about the wider implications of your decision, including financial considerations. The BMA can provide comprehensive information about these. The following will provide a brief summary of factors you should consider.
If you work less than full-time, you can expect to receive a lower salary. Otherwise, your salary should not be affected.
Providing that the work commitment does not fall below a standard agreed basic 10 PA contract, there will be no reduction in pension entitlement. However, if any work is undertaken which exceeds 10 PAs, as with full-time standard contract workers, there will not be any increased further contribution to the pension pot. A proportional reduction in pension contribution will occur for any contract worth less than 10 PAs. You should also consider the effect on your pension payout.
You will need to consider the impact your decision has on your colleagues. Most people will be happy to work with your new arrangements, as long as you discuss these with them first. Colleagues may be wary about how their own work will be affected by changes with those appointed to work alongside them. It is important to reassure colleagues and to explain to them the projected workflow, throughput, and yearly achievable output.