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An ace to play

The consultant had been attracted to working at the trust by the promise of a number of incentives, but years later he faced a huge bill and found his integrity was in question.

Before the consultant was appointed, the general manager had offered him the payment of two additional sessions per week. This was in part to reflect the high volume of work he would be expected to undertake.

Eight years after their verbal agreement, however, a letter arrived from the service manager claiming the consultant had been overpaid by £81,000 and asking for that money back.

The doctor contacted the BMA; those in similar situations should do the same. It enables the BMA to provide advice from the very beginning of cases, and can save members from being coerced into actions that might prejudice them.

The consultant assumed his trust had simply made a mistake, and explained the nature of the payment to the service manager. This was not accepted, however, which meant we needed to use the trust’s grievance procedure.

Ultimately, we had to pursue the grievance procedure to its final stage because previous meetings had found in favour of the trust. So we found ourselves at stage four, in front of the trust’s chief executive, with one last chance of resolving matters internally.

I outlined the case, questioned management and summed up, and the doctor answered the questions that were directed to him.

But we also had an ace to play. The general manager who had made the original agreement with the doctor had left the trust, but we managed to track him down. He provided a verbal and written statement confirming that this agreement had been a recruitment incentive.

It had been made under the old contract, which was not time-sensitive (unlike the one negotiated in 2003), but which had provision for extra sessions to be paid as recognition of high workload.

I believe the general manager’s statement was pivotal to the case being resolved in the doctor’s favour. The payments were accepted as contractual and were resumed, and the doctor was given back pay for the period that the payments had been suspended.

This was a difficult experience for the consultant, who faced not only a large, unjustified bill, but also the sense that his honesty and integrity were in question.

Within the trusts that I look after, queries about overpayments made to doctors are increasing, perhaps because of the current financial climate. And trusts might exploit a lack of written evidence to withdraw payments and change contracts.

The existence of verbal agreements can be harder to prove than that of written ones, but they still have legal force.

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