On the ground The Doctor magazine highlights practical help given to BMA members in difficulty

JANUARY WINS: Recouping expenses claims, a fair deal for locums and working out daily pay rates – all quandaries the BMA has tackled and resolved for members

Pound for pound

Completing expenses claims is rarely a doctor’s favourite job, and the chore is often compounded by systems so complex that it’s almost like your employer doesn’t really want you to have the money.

A junior doctor knew she should have claimed some money back but was busy and found the system cumbersome and so let it go. However, her employer started trying to claim historic sums back. A payroll error on transferring to a new contract had led to an overpayment of around £1,200.

While talking to a BMA employment adviser about the trust’s claim, the doctor happened to mention the problem with expenses. The employment adviser got to work. It took many emails during 18 months but the adviser persuaded the trust to offset the salary overpayment against the unclaimed expenses.

Many of the expenses were far beyond the date when claims were usually allowed. Yet if the doctor was showing willing with the salary problems, the BMA reckoned the trust should show the same spirit with the expenses. The offset meant the junior doctor’s bill was cut from £1,200 to less than £400, which she described as an ‘excellent outcome’.

No time to chase pay

Imagine being owed thousands of pounds for work done but being so frustrated by the slowly grinding wheels of NHS bureaucracy that you almost give up on the chase. You probably don’t need to imagine it.

That was the situation a junior doctor found herself in, when she had helped her hospital out with some locum shifts at a time of need. She was owed more than £10,000.

There was no dispute that the money was owing but paperwork kept floating around different parts of the organisation, each time missing internal deadlines and finding itself on the bottom of the pile.

The doctor felt she was being ignored and called in the BMA. The employment adviser was able to bring the necessary persistence and focus – something doctors find difficult when balanced with the demands of their day jobs.

After about five months of chasing, the money was finally paid.

The doctor wrote to the employment adviser to say: ‘I had just about given up and you helped me finally get paid what I was owed.’

It shouldn’t be so difficult, but it often is – and the BMA is there to help.

All in a day’s work

A month might seem a solid and tangible thing – although that doesn’t explain why January always seems twice as long as December. And it was an employer’s definition of a month that almost had serious pay consequences for a junior doctor.

The trainee had a large amount of leave she was unable to take as a result of sickness absence, and so her employer was paying her in lieu for that time. To do this, it needed to establish her daily pay rate.

The employer worked it out by dividing her monthly salary by the number of calendar days in a month. The BMA disagreed, and said it should be calculated instead based on the average number of working days.

The implications of this are significant. It is the difference between dividing a monthly salary by 30 or 31 or by approximately 20. The latter approach, which the BMA insisted was correct, gives a daily rate around 50 per cent higher.

The problem was that the national terms and conditions allowed for an open-ended interpretation of how the rate should be calculated. However, having heard the strong arguments put forward by our solicitors and employment adviser, the employer agreed with the BMA and the junior doctor was paid at the higher rate. She thanked the BMA for its time and expertise.

DECEMBER 2018 WINS: Bullying, underpayment, keeping holiday entitlement and receiving rotas on time – all issues the BMA has tackled and corrected for its members after they sought the association’s help

Sick of the bullying

Sick leave is a common consequence of bullying behaviour in a toxic workplace, as it was for one associate specialist in psychiatry helped by a BMA employment adviser.

Without proper consultation her employer sought to bring her back on a phased return, which was not required, instead of seeking to resolve the workplace problems which forced her off sick in the first place.

With the support of our adviser, the psychiatrist was helped to draft emails and organise a meeting with senior staff, including the clinical director. There, an action plan was agreed to tackle some longstanding issues which had been previously passed over by managers, despite her highlighting them repeatedly. This allowed her to return to work, with confidence that some sources of stress would be dealt with.

‘Your advice on how to negotiate in difficult situations has been invaluable,’ the doctor said. ‘You have also been the person to have a “sanity and reality check with”.’

Out of pocket

The frustration of sorting out pay-packet problems is an experience many of us don’t want but struggle to purge from our memory banks. But for one GP trainee, matters were made much worse by the fact that she had just gone on maternity leave.

The first payment was missed and her tax codes found to be wrong. In total, she was temporarily £9,000 out of pocket until the problem was resolved two-and-a-half months later. It forced her to eat into savings as she prepared for the imminent arrival of her new child.

After dozens of emails from a BMA employment adviser, the situation was finally sorted and she is now receiving the correct maternity pay.

Carry on, carry over

A consultant psychiatrist has been allowed to carry over five days of his contractual leave to a new financial year after an intervention by a BMA employment adviser.

His trust had refused to allow him to carry over the days, which he had been unable to take, owing to sick leave.

Its policy, which is not uncommon in the NHS, allowed carry-overs only in ‘exceptional circumstances’ but the trust never gave the doctor the chance to make the case for carrying the days over.

After the BMA requested and secured a meeting, the trust agreed to allow an independent party to review the evidence we prepared. This set out how the doctor had been disadvantaged.

The trust finally agreed to carry over all five days and admitted to ‘communication errors’ on its part.

Timely rotas after BMA pressure

Incoming anaesthetic trainees at the Medway NHS Foundation Trust got their rotas 11 weeks before they were due to start, after intervention from BMA industrial relations officer and junior doctor representatives through the Junior Doctors’ Forum.

This is a huge improvement on what happened in August, when doctors in medical specialties received rotas 10 days in advance. Under the code of practice for the junior doctor contract, drawn up with NHS Employers and Health Education England, trainees should receive their generic work schedule and rota template eight weeks before they start work.

Their duty rotas should be with them six weeks beforehand. Employers often fail to achieve this, meaning this is a key focus of BMA activity around the country. The BMA is grateful to the trust regarding this positive engagement.

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