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Working
When you have been appointed to a substantive post, you may be able to consider a number of flexible working options, this may depend on the appointment being to a Trust which aspires to hold a Practice Plus award, or one which backs flexible working within its workforce.
These options include:
o Annualised contracts
o Compressed hours
o Early / Late contracts
o Compressed hours
o Part time
o Flexible retirement options
o Term time working
To arrange any of these, local discussions are necessary between human resources, surgical colleagues and directorate management to ensure that the proposed working patterns are not going to interfere with the smooth delivery of patient centred services, or cause undue detriment to other members of the surgical team. Many Trusts will actively 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, 3 session theatre lists, and elective weekend working.
Annualised contracts
These can be arranged with a Trust, when a mutually agreed timetable or schedule of clinical practice has been agreed, between your surgical colleagues, surgical directorate, and Human Resources.
An Annualised contract can be at either full-time or part-time. In order to calculate how many sessions are required to be worked each year, an annual availability for clinical work schedule is calculated, depending on the years of service previously worked, and thus the annual leave entitlement (between 32 and 34 days). An average clinical work schedule will take in to account when each Consultant is available for clinical work between 41 and 42 weeks per annum, 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 SPA sessions 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, utilising 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
Rather than undertake work over a five-day period, many surgeons prefer to work longer but fewer days i.e. for a standard full-time 40 hour week, which equates to a 10 PA contract, it is possible to undertake 4 x 10 hour days. This will reduce travelling time to and from work if distance is a potential problem.
Early / late contracts
Some surgeons are in possession of a standard full-time contract, but arrange to undertake their clinical work at slightly unusual hours i.e. early bird or night owl clinics, or a 3-session theatre lists. This is a form of compressed hour working, but will need more organisation.
At an extreme, some surgeons actually prefer to undertake work at weekends, when the standard PA is 3 hours of clinical work. Some Trusts are very supportive of this, since clinic and theatre space often stands idle at these times.
Term time contract
It is possible to negotiate to increase annual leave, on an unpaid basis, to enable 12 - 14 weeks of holiday to coincide with school holidays. This method of working becomes impractical if all members of staff have similar needs, but can work very well when this is not the case.
Part-time
True part time working as a surgeon, involves working less than 40 hours per week. Part time can either lead to standard days off, or can be undertaken as part of any of the contracts sited above.
There is a pro-rata reduction in both clinical and non-clinical (supporting) professional activity. However below 24 hours per week (6 PA's) it becomes increasingly difficult to maintain clinical practice with any degree of safety, unless participating in a job-share type of position.
Once the number of PA's per week worked falls to below 10, there are implications for both pension accrual and also 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 at Consultant level must be considered very carefully, and may lead inadvertently to the necessity of extending your working life considerably in order to accrue adequate pension funds.
