Journal Article

935 Junior Doctors’ missing money: systematic pay errors across London trusts

Leach Hermione, Carr, Dominic

2023

Overview

ObjectivesThe ‘Terms and Conditions of Service for NHS Doctors and Dentists in Training (England) 2016’1 has substantially changed the way junior doctors are remunerated. Salaries now consist of multiple discrete elements, each with a unique method of calculation. For less-than-full-time (LTFT) doctors each element’s value is calculated differently, adding further layers of complexity. Both doctors and Human Resources (HR) struggle to understand these calculations, leading to common and often unnoticed underpayments. We outline the extent of the problem, financial impact and scale across trusts, and present our solutions to resolve these recurring issues.MethodsFrom 2020 to 2023 we have supported paediatric doctors across London to identify and rectify pay errors through informal support, roles as LTFT Trust rep, and through a recently developed Pay Clinic run through the London School of Paediatrics. With careful review of work schedules and payslips, contractually accurate salaries were compared to actual pay to identify errors. We have quantified the extent and breadth of errors encountered.ResultsErrors in pay were identified within all 12 trusts studied. 22 distinct errors are delineated, often replicated across trusts, with the most substantial being an underpayment of £20,836 per year affecting three doctors. While pay errors impact all doctors, we found that LTFT doctors are disproportionately affected.The most common error was miscalculation of the LTFT weekend pay supplement, which was often found to be systematic, affecting every LTFT doctor in affected trusts. The most challenging errors to identify pertain to ‘Prospective Cover’ calculations, a poorly understood but vital element of calculating accurate pay. Its misuse can cause pay errors upwards of £7,500 per year and has caused rotas in some trusts to illegally breach the European Working Time Directive.To date, this work has supported trainees to reclaim over £100,000 gross, with additional advice and supporting letters provided to numerous others. Formal intervention by NHS Employers was required for one trust that consistently refused to pay its workforce according to the national terms and conditions.ConclusionsThis work reveals the alarming extent of inaccurate remuneration and the disproportionate impact on LTFT doctors. Providing accurate pay is crucial to improve morale and wellbeing in the current challenging NHS climate. There is a vital need for education and support for all parties, including training for HR departments to mitigate these errors from the source, and education for doctors to improve recognition and resolution of these errors.Referencehttps://www.nhsemployers.org/publications/doctors-and-dentists-training-terms-and-conditions-england-2016

• Publisher: BMJ Publishing Group LTD
• Subject: Dentistry / Education / Pediatrics / Physicians / Training / Wages & salaries / Working conditions