• Participation in training
• Medical education
• Continuing professional development
• Formal teaching
• Audit
• Job planning
• Revalidation and appraisal
• Research
• Clinical management
• Local clinical governance activities

The model consultant contract currently provides for a typical weekly split of 7.5 Direct Clinical Care (DCC) PAs to 2.5 SPAs (paragraph 7.3 of the model contract). However, this is not a universally applied allowance, and the precise balance will be agreed as part of job plan reviews and may vary. Since the 2003 contract has been implemented, SPA time has been a constant source of disagreement between some employers and some consultants.

The BMA is currently aware that some Trusts have taken steps to unilaterally convert consultants’ SPA time to clinical activities as a means of dealing with system pressures and managing flow. It is important for consultants to properly understand their contractual rights when it comes to SPA time and how they should respond if a Trust takes these steps, especially as we expect the situation to become more widespread due to winter pressures.

There has been no agreement nationally that SPA activity can be suspended or 'swapped' for additional clinical activities, either in full or in part, as a means of dealing with system pressures.
Any conversations at a local level should take place on a purely voluntary basis  and no changes should be made to a job plan without consultants’ prior agreement. There are serious implications with shifting a doctor’s focus solely to direct clinical care and employers should only consider having such conversations if they have exhausted all other options, including recruiting more staff. The practice can lead to exhaustion and burnout, it is also unsustainable as it will lead to adverse clinical outcomes over time. The BMA believes that SPA time is critical to both improvements in the safety of patient care, the development of new services and plans for existing service redesign.

FAQs

Can my employer unilaterally revoke or change my SPA time?

No, cancelling or repurposing SPA time is a change in your working pattern that requires your agreement. If you find yourself agreeing to convert SPA time to more direct clinical care, your employer should work with you to ensure that it is done safely and proportionately. Discussions regarding recompense and when SPAs will be restored should be had so that changes do not influence your ability to plan and deliver a safe, effective service. The details of the agreement on compensation and when SPAs will be restored must be shared in writing beforehand. 

What happens if I agree to undertake additional clinical activity?

If you undertake additional clinical activity, your SPAs should be maintained, and the extra clinical work fully remunerated at a mutually agreed rate. This means that changes do not influence your ability to plan and deliver a safe, effective service.

When discussing this with your employer it is worth emphasising the important clinical and educational governance reasons for this approach.

Does a trust’s major incident policy overrule/take precedence over national contractual rights?

No, a Trust’s local policy does not overrule your national contractual rights or entitle your employer to unilaterally change the amount of time allocated to SPA time that has been mutually agreed as part of your job plan.

How should I respond if my employer unilaterally revokes my SPA time?

Your employer cannot do this unilaterally and any changes to your SPA time must happen on a voluntary basis. If your employer insists and agreement is not possible, please get in touch with the BMA for further support.