P.L IT-TNAX-IL LEĠISLATURA

Transcription

1 IT-TNAX-IL LEĠISLATURA P.L Dokument imqiegħed fuq il-mejda tal-kamra tad-deputati fis-seduta Numru 130 tas-17 ta' Marzu 2014 mill-ministru għas-saħħa. Raymond Scicluna Skrivan tal-kamra

2 TOBBA U KONSULENTI CONTRACT B *8037. L-ONOR. CLAUDIO GRECH staqsa lill-ministru għas-saħħa: Jista l-ministru jpoġġi fuq il-mejda tal-kamra sample ta kuntratt kif iffirmat mit-tobba u konsulenti li jagħżlu li jaħdmu fuq bażi ta Contract B? 18/02/2014 ONOR. GODFREY FARRUGIA: Qed inpoġġi fuq il-mejda tal-kamra sample ta kuntratt li jiġi iffirmat mit-tobba u konsulenti li jagħżlu li jaħdmu fuq bażi ta Contract B. Seduta Numru /03/2014

3 Job Plan Contract for Consultants Contract B + Name: Surname: ID: Year: Department: Date of Appointment: 1 P a g e

4 Contract B + Standard no. of Hours: 40 (The basic working week for consultants on Contract B shall be of 32 hours of on-site work, and 8 hours of off-site work. The 32 hours on-site work shall be as follows : from Monday to Saturday the working day shall commence between 07:00-09:00. During the week there must be 4 days which are 6 hours long and 2 days which are 4 hours long.) On-site hours: Off-site hours: _32 8_ Extra sessions* (up to maximum of 6 per week between 08:00-20:00 (2013 Agreement, clause 9.6.3/9.6.6) extra sessions shall be operating theatre, outpatients, interventions or other sessions involving patient contact as per 2013 Agreement, clause The extra sessions performed by Consultants on Contract B shall only be programmed and worked as blocks of 4 hours each and be timetabled according to service exigencies (2013 Agreement, clause 9.6.8) Total no. of extra sessions : No. of sessions from 08:00-16:00 : No. of sessions from 16:00-20:00 : No. of sessions from 20:00-00:00 : *Serving officers who on the date of signing of the 2013 Agreement were Consultants on Contract B shall be offered at least 1 extra session per week which is to be performed between 12:00-16:00. (2013 Agreement, clause 9.6.4) According to the 2013 Agreement, Annex I - Policy for extra sessions for Consultants in terms of Section 9 of the Sectoral Agreement pertaining to the Medical Class, all serving officers who on the date of signing of the 2013 Agreement are Consultants on Contract B who opt for : - a Contract option of B+3 and B+4 must perform at least 1 session per week between 16:00-20:00 according to the applicable provisions of the Sectoral Agreement pertaining to the Medical Class - a Contract option of B+5 and B+6 must perform at least 2 sessions per week between 16:00-20:00 according to the applicable provisions of the Sectoral Agreement pertaining to the Medical Class New consultants appointed after the date of signing of the 2013 Agreement and opting for Contract B must perform a minimum of 2 extra afternoon sessions per week. The first of these shall be timetabled between 16:00-20:00 and the second between 12:00-16:00 respectively. (2013 Agreement, clause & Annex I) Consultants will have the option to choose between contract types A or B on their appointment. They may apply to change contract with a minimum of 3 months forward notice and with the approval of Management. (2013 Agreement, clause 9.1.7) 2 P a g e

5 Job Plan Agreement (All references in this document to the 2013 Agreement refer to the Gov-MAM Agreement signed on 27th February 2013) I confirm that I am in agreement with the activities and objectives as outlined in the attached Job Plan. I am aware that should my agreement lead to my working in excess of 48 hours per week I will be opting-out of the requirements of the Working Time Regulations regarding the maximum working week of 48 hours. (Refer to 2013 Agreement, clause ) Agreed Job Plan: B + (maximum 6) Signature: Signature: Consultant: Clinical Chairperson/Director: Date: Date: Approved by Medical Director/CEO in Health Care Setting: Signature: Date: 3 P a g e

6 JOB PLAN CONTRACT B Date: Section 1: Job Plan for Consultant (please refer to Annex 1, Pg.15 General Provisions for all Consultants as per 2013 Agreement, clause 9.7) The Government recognises the key role, which consultants play in providing health care, and the necessity to be flexible and have specific work arrangements. On the other hand, the employer needs to have a clear understanding of the work which is being undertaken by consultants and to reach an agreement on changes as necessary. A consultant job plan is a prospective agreement that is mutually agreed between the consultant and the employer. A job template will offer the opportunity to identify his/her main duties. In accordance with the Agreement signed between the Government of Malta and the MAM on 27 th February 2013, the number and timetabling of programmed activities to be worked by consultants in a calendar week will normally be defined on an annual basis in the job plan Alternative approaches may, however, be agreed between the consultant and the employer to allow for flexible timetabling of commitments over a period (e.g. a reduction in number of hours worked during school holidays) as a family friendly measure. The number of programmed activities may therefore vary from week to week provided that the total number worked over the period of each year equates to the number for which the consultant is contracted to work in terms of his/her job plan. In these circumstances the job plan will be expressed in terms of the average number of programmed activities worked per week, allowing for periods of authorised leave (2013 Agreement, clause ). Base* *(Clinic, Hospital, Office, Other) Employer Government of Malta Position Accountable to* * (Clinical Chairman, Director General Health Services, Regulatory, EU, Others) Department Principal Job Purposes* *(Clinical, Administrative, Team Management) Other Responsibilities* *(Academic, unions, Research, Committee/s, Boards, Leader of Multidisciplinary Teams, Others) 4 P a g e

7 Section 2: Are you a Clinical Chairperson, Deputy Clinical Chairperson*, Lead Clinician or Training Coordinator? (Please refer to Annex 2, Pg. 16) Clinical Chairperson: Y N Department: No. of consultants in the department: (+3sessions (>=15 consultants) (+2sessions (<15 consultants) Deputy Clinical Chairperson* Y N (+2 sessions) Department: *Clinical departments having more than ten consultants shall also have a Deputy Clinical Chairperson. Deputy Clinical Chairpersons will be appointed from amongst Consultants by an internal call for application for a period of three (3) years. The position of Deputy Clinical Chairperson will be open to both Contract A and Contract B holders with five (5) years specialist experience. Deputy Clinical Chairpersons will continue to benefit from the Consultant s pay package with the additional remuneration for the two on-site administrative sessions specified in clause (2013 Agreement, clause 10.11). Deputy Clinical Chairpersons shall be required to work two on-site administrative sessions (2013 Agreement, clause 10.12) Lead Clinician: Y N (+1 session) Department: Sub-speciality: Training Co-ordinator: Y N (+1 session) Department: Sub-speciality: 5 P a g e

8 Section 3: Programmed Activities: (2013 Agreement, clause ) (2013 Agreement, clause ): Programmed activities will be separated for timetabling purposes into the categories of: a. direct clinical care duties b. supporting professional activities c. additional responsibilities d. other agreed external duties Please fill in the following tables in detail for each section: a) Direct Clinical Care Duties: (2013 Agreement, clause ) ( ) The direct clinical care duties of the post will include: Emergency duties (including emergency work carried out during or arising from on-call) Operating sessions Pre and post-operative care Ward rounds Outpatient clinics Clinical diagnostic work Other patient treatment Public health duties Multi-disciplinary meetings about direct patient care Administration directly related to patient care (e.g. referrals, notes, complaints, correspondence with other practitioners) On-site medical cover Any other work linked to the direct clinical care of patients a) Direct Clinical Care Duties: Day Average Start Time Average Finish Time Location (ward, outpatients, theatre no., clinics, other) Programmed Activities Measurable Indicators 6 P a g e

9 b) Supporting Professional Activities: (2013 Agreement, clause ) ( ) Supporting professional activities of the post will include: Continuing professional development Teaching and training Management of doctors in training Audit Job planning and work related to sitting on the Appeals Panel Appraisal Research Contribution to service management and planning Clinical governance activities Any other supporting professional activities Administration not directly related to patient care b) Supporting Professional Activities: Day Average Start Time Average Finish Time Location Programmed Activities 7 P a g e

10 c) Additional Responsibilities: (2013 Agreement, clause ) ( ) Additional responsibilities are duties of a professional nature carried out for or on behalf of the employer or Department of Health which are beyond the range of the supporting professional activities normally to be expected of a consultant. Additional responsibilities are: Clinical Audit leads Clinical Governance leads Postgraduate coordinators of training Formal medical management responsibilities Other additional responsibilities agreed between a consultant and his/her employer which cannot reasonably be absorbed within the timetable for supporting professional activities ( ) Where a consultant has agreed additional responsibilities with his/her employer, the time for these additional responsibilities will be substituted for other work or remunerated separately. Where such additional responsibilities are substituted, the consultant and employer will agree which other work should be substituted taking full account of the consultant s professional requirements in respect of supporting professional activities and his/her commitments to direct clinical care. Where they are remunerated, this will be by contracting for extra programmed activities If the additional responsibilities are to be substituted for other work (as part of the 12 basic sessions - see above) then please complete the table below. If they are to be timetabled as extra sessions then please refer to Section 6 Extra Programmed Activities Pg. 11 c) Additional Responsibilities: Day Average Start Time Average Finish Time Location Programmed Activities 8 P a g e

11 d) Other External Duties: (2013 Agreement, clause ) ( ) Other external duties comprise work not directly for the employer, but relevant to and in the interests of the Health Division and in accordance with the Public Service Management Code guidelines in force from time to time. Examples include: Trade Union and professional association duties Acting as a member of an appointments Selection Board Work for the Medical Council, Specialist Accreditation Committee or other national bodies concerned with professional regulation Disciplinary procedures Inquiry, peer review and appeals boards or procedures ( ) Other external duties must be explicitly agreed in advance. Where such duties are of a regular nature and might affect the performance of direct clinical care duties, the consultant should agree with the employer a revision on an ad hoc basis of the timetabled programme of activities agreed in the job plan. Unless otherwise agreed, this should be done at least a month in advance. Programmed activities may be substituted with the agreement of the employer, or otherwise undertaken with the approval of the employer. ( ) Where it is anticipated that the volume of work involved may be such as to affect on a predictable basis the performance of programmed duties, the consultant should, at the initial job plan meeting, or thereafter at job plan review or interim job plan review, raise the matter and seek agreement to the substitution of other external duties for programmed duties. d) Other External Duties: Day Average Start Time Average Finish Time Location Programmed Activities 9 P a g e

12 Section 4: On-Call: On-call rota: 1: N.B: For those consultants working a 1 in 2 roster or more frequent (1 in 1) whose workload exceeds 120 patients per annum, management may consider the payment of an additional half session per week to cover such workload. The addition may be increased to one session per week should the annual workload exceed 200. These payments will be in addition to and not instead of the Actual Attendance Allowance (2013 Agreement, clause ) No. of patients if on-call rota is more frequent than 1:2: Agreed no. of sessions according to no. of patients: patients sessions Section 5: Off-site activities 8 hours Please describe in detail the off-site activities involved: Off-Site Activities: 10 P a g e

13 Section 6: Extra Programmed Activities* (2013 Agreement, clause ) In the agreement consultants have been given the choice to perform a number of extra programmed activities. These extra programmed activities, in agreement with the employer, will be part of the job plan and will be contracted for separately under the same terms and conditions as the main contract. Approval will also depend on the availability of resources. Extra programmed activities (EPAs) are those in excess of the contractual 12 programmed activities per week for consultants, up to a maximum of 16 per week. (2013 Agreement, clause ) An agreement to undertake extra programmed activities that would require a consultant to work in excess of 48 hours per week for the employer is subject to the consultant having signed a waiver opting-out of the requirements Working Time Regulations regarding the maximum working week of 48 hours. (2013 Agreement, clause ) If you are a clinical chairperson/deputy clinical chairperson/lead clinician please refer to Annex 2 Section 10.13/10.12/10.16 respectively with regards to the extra sessions associated with the particular post. Activity* Day Average Start Time Average Finish Time Location *Refer to Section 3c) Additional Responsibilities (Pg.8) and Section 3d) Other External Duties (Pg. 9) Section 7: Special Programmed Activities: According to the 2013 Agreement, Annex I - Policy on Extra Sessions for Consultants in terms of Section 9 of the Sectoral Agreement pertaining to the Medical Class, any special programmed activities required by Management are to be timetabled separately and will be given half or one session remunerations: e.g. audit. patient safety, hospitals/mhec committees, etc Do you carry out any special programmed activities: Y N If Yes please specify what the activity is: 11 P a g e

14 Section 8: Leadership and Managerial Duties as Consultant: Please provide details where applicable Managerial Responsibilities Details Supervision and delegation of tasks Maintaining quality and clinical standards Management of multidisciplinary teams Ensuring that the local service objectives and developments are met Auditing Report writing Correspondence Schedule V, Non-formulary items, Adhering to protocols Establishment and review of protocols for non-formulary items Establishment of guidelines and protocols for work practice Others 12 P a g e

15 Section 9: Objectives and how they will be met: Objectives will vary according to speciality or field of clinical practice. As per clause , objectives have to be set out on a mutual understanding of what the consultants with respective clinical chairman and employer will be seeking to achieve over the next 12 months and they have to be achievable within the available resources. Should any problems arise which threaten the achievement of the objectives, the consultant and/or the employer is duty bound to rectify them at once and not wait until the annual job plan review. Objective Output Outcome Timescale Measurable Indicators e.g. Outpatients e.g. 18 sessions as e.g. Earlier e.g. Ongoing e.g. Expedite turnover per HAA diagnosis treatment database: - 13new cases - 5 follow up Improve prognosis outcome and 13 P a g e

16 Supporting Resources: The employer will set out in the job plan the facilities and resources necessary to support delivery of the consultant's duties and objectives for all programmed activities. This will include staffing support, accommodation, equipment and any other identified resources necessary. (2013 Agreement, clause ) Facility and Resources Required for Delivery of Duties and Objectives 1. Staffing Support Details 2. Accommodation 3. Equipment 4. Any other required resources (including budget) 14 P a g e

17 Annex 1 - General Provisions for all Consultants (2013 Agreement, clause 9.7) 1. Post admission take rounds will be performed on Sundays provided that the frequency will not exceed more than 1 in 7 weeks. Post admission take rounds on Sunday will be remunerated as one session, while post take rounds on Saturdays, for Consultants whose job plan includes Saturday off, will be remunerated as one session, over and above the regular scheduled sessions. 2. It is a recognised principle that Consultants are in duty bound to attend and treat any patient in hospital even outside working hours and during week-ends in accordance with the best needs of the patients. Consultants are required to carry out evening attendances and Sunday attendances when on call or admitting. 3. The Consultant shall be accountable for the performance of his/her team within the overall direction laid down by the Clinical Chairperson or Medical Director/ Administrative Director of his/her department. 4. Consultants on both Contract A and Contract B shall be entitled to all statutory leave applicable to public officers. A consultant on paid vacation leave or any other paid leave shall be paid in full including full salary, allowances and remuneration for sessional work to compensate for the cover provided by the consultant for leaves. 5. Sessions may be offered to retired consultants if the Management is unable to recruit enough consultants in that specialty, or if the need arises. These shall be paid as per clause Consultants on reduced hours shall be free to choose any of the 2 available contracts and have the same ratio of on-site and off-site work. The QAIAC (merit) award, where applicable, shall continue to be paid in full but all other allowances shall be paid on a pro-rata basis. 7. In order to further help decrease waiting lists and the load on Out-patients Services, consultants and resident specialists can continue to refer patients directly from their private practice to the Pathology Department for laboratory investigations. 8. When a Consultant on contract A or B is offered a performance management agreement/position at Director or Director General level within the Department of Health, the consultant will have to possibility of choosing between the relative package of the post or Contract A at 12 sessions (for Director) or 13 sessions (Director General) respectively. He or she will be expected to maintain at least 2 sessions of clinical practice assigned at the discretion of the Department of Health. 9. The pensionable income for Consultants on Contract A will be Salary Scale 4 or Scale 3 as applicable. 10. CEOs of Health Care Agencies have the discretion to make reasonable charges to consultants for the use of facilities outside programmed activities, although consultants should not be charged for the use of patient records. Such fees shall be agreed between the employer and the Medical Association of Malta. 11. All Consultant grades covered by this agreement are of an indefinite nature with the exception of Clinical Chairperson and locum contracts. 12. An annual Special Duty Allowance of 4,800 will be paid to Consultants who perform duties on roster basis in the Accident and Emergency Department, in the Intensive Therapy Unit (ITU) or at the Health Centres. This allowance will be paid quarterly in arrears. Consultants performing duties in these areas will not be entitled to a shift allowance. 13. Consultants working on part-time basis or on reduced hours shall be eligible to pro-rata payment of the Special Duty Allowance in accordance with all the provisions stipulated in this clause. The revised allowance as per clause (9.7.12) shall be payable as from 1 st July 2013, with arrears being given as from 1 st January P a g e

18 Annex 2: 10. Clinical Chairpersons Clinical departments having more than ten consultants shall also have a Deputy Clinical Chairperson. Deputy Clinical Chairpersons will be appointed from amongst Consultants by an internal call for application for a period of three (3) years. The position of Deputy Clinical Chairperson will be open to both Contract A and Contract B holders with five (5) years specialist experience. Deputy Clinical Chairpersons will continue to benefit from the Consultant s pay package with the additional remuneration for the two on-site administrative sessions specified in clause (10.12) Deputy Clinical Chairpersons shall be required to work two on-site administrative sessions Clinical Chairpersons with departments with more than 15 consultants shall be required to work a minimum of three on-site administrative sessions per week. Clinical Chairpersons responsible for departments of up to 15 consultants shall be required to work at least 2 administrative on-site sessions per week Clinical Chairpersons cannot retain their position beyond the statutory age of retirement unless no suitable candidate would have been found to fill the post in a recruitment process initiated at least six months prior to the date of retirement Clinical Chairperson Other Duties It shall be the duty of respective Clinical Chairpersons to approve or otherwise study leave, provided that every effort shall be made to allow doctors to attend meetings overseas and provided further that study leave required for a period of overseas training approved by the SAC shall be approved It shall be the duty of the Chairperson of a clinical department to ensure smooth running of services under his charge, to monitor performance and attendances, distribute resources within his Department in the best interest of the service and generally to administer and be accountable for the department under his charge Lead Clinicians: Lead Clinicians will be appointed from amongst Consultants by an internal call for applications for a period of three (3) years. The position of Lead Clinician will be open to both Contract A and Contract B holders. The Department of Health may revise the number and designations of Lead Clinician posts from time to time according to service exigencies Lead Clinicians shall be required to work at least one administrative on-site session per week. Such appointees will be required to work those extra sessions over and above their normal consultant contracted hours unless otherwise agreed with management. Lead Clinicians will continue to benefit from the Consultant s pay package with the additional remuneration for the one on-site administrative sessions mentioned in this article. HRA1054v01.0 Data Protection Statement All personal data is processed in accordance with the Data Protection Act, and as permitted by law. information about your data can be obtained on request. Further 16 P a g e