Less than one per cent of NHS consultants use control loophole to 'opt out' of weekend work

Freedom of Information responses from 23 hospital trusts show that only 35 out of the 5,661 consultants they employ 'actively opt out'

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Jeremy Hunt’s justification for reforming NHS working practices has been called into question, after it was revealed that less than one per cent of consultants actually use a contract loophole to “opt-out” of weekend work.

Freedom of Information responses from 23 hospital trusts show that only 35 out of the 5,661 consultants they employ “actively opt out” of doing non-emergency work at weekends. 

The Health Secretary, who has angered doctors by calling on their union, the British Medical Association (BMA) to “get real” over the need for more weekend working in the NHS, has said he wants to remove the “opt-out” clause for newly qualified doctors.  He argues that 6,000 people were losing their lives every year because of a lack of a “proper” seven-day hospital service.

The opt-out refers to non-emergency work, which hospitals may wish to carry out at the weekend to improve efficiency and patient choice.

However, the new FOI figures, obtained by Dr Kiara Vincent, a junior doctor in Leicester, suggests that very few senior doctors use it to avoid this kind of work. 

The BMA has said it is willing to see the opt-out clause dropped, but wants new safeguards in place to protect doctors from overwork and burnout. 

The Department of Health also contends that some consultants use the threat of opting out to negotiate local rates of pay for non-emergency weekend work.

According to a National Audit Office report from 2012, these rates average at £119 an hour – significantly more than contractual pay rates. In his speech last month, Mr Hunt said that the Government would end “extortionate” local rates.

Doctors have reacted furiously to Mr Hunt’s criticism of the BMA, which is representing doctors in a renegotiation of both the consultant and junior doctor contract.

Last week the union released a survey showing that nine out of 10 consultants are already on rotas that require them to be on-call for emergency work in the evening and at the weekends.

A survey conducted by the Royal College of Surgeons found that, while three-quarters of members support the introduction of 24/7 consultant-led care, the same proportion thought it would was not possible without increasing the workforce.

RCSEd president and orthopaedic surgeon Ian Ritchie said: “Simply asking clinicians to work more hours will not solve the problem, it is imperative that services and rotas are designed so that consultant-led care is possible throughout the week. This will require an increase in the number of consultants and the generalist capacity across the surgical workforce.”

A Department of Health spokesperson said the FOI data did not show how many consultants have exercised their opt-out and worked for local rates.

“Fundamentally, we believe patients deserve the same high quality care every day. Hospital leaders, senior clinicians and the independent NHS pay review bodies all say that consultants’ weekend opt-out must end,” the spokesperson said.

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