A simple question, ‘Please could you explain to me how my banding has been calculated for my current rotation as a junior doctor?’ This was the question I posed in an email to the medical human resources department for the Trust I worked in.
For those wondering what ‘banding’ is, it is the scale used for adjusting a junior doctor’s pay in relation to how demanding their particular rotation is. For instance, if a doctor is expected to work a lot of hours outside of normal weekday hours, they may for instance have their salary increased by a certain percentage. As an example, if Dr H had a basic salary of £28,000 and did a lot of CONTRACTED demanding out of hours work as part of their current rotation, pay may be increased by 50% under a certain banding, for instance 1A, giving an adjusted salary of £42,000. That’s the basic idea.
Since starting my new rotation, over 3 months ago, I have thought that my banding did not reflect the CONTRACTED hours I was putting in, i.e. I thought I was potentially being underpaid. Now, before you cry mercenary, remember that we, as doctors along with everyone else working in healthcare, are hardworking and put in loads of extra time above and beyond what our contracted hours demand and do not look for extra pay for this. However, it is reasonable to expect to be paid fairly for your CONTRACTED hours. I believed this wasn’t the case so I sent the email.
This was the start of what has turned into a long drawn out case with still no resolution and, as I change rotation next week, will probably be buried and forgotten about. Anyway, to make it a bit more concise, here is a bullet point time line of what’s happened with an accurate timescale. It is still a bit lengthy, maybe skim read it!
Day 0 – sent email to medical HR explaining my concerns regarding my banding
Day 8 – still no reply to email so called medical HR who said they would reply the next day
Day 9 – no email reply received
Day 10 – called them again and advised they will reply on Monday as person in meeting now.
Day 13 – no email reply received
Day 14 – no reply received yesterday. Called medical HR who advised they were very busy and would reply that week.
Day 21 – still no reply. Can I just highlight that literally all I asked for in the initial email was for a breakdown to show how my banding had been calculated. This should be easy, quick email with details and case would be closed.
Day 22 – enough is enough; it’s been 3 weeks now. I have been helpfully informed by a colleague that medical HR has a building on the hospital site. I manage to locate the manager of medical HR, he ‘kindly’ informs me he is very busy by showing me his desk piled high with paper – could be blank paper for all I know! Anyway, having justified his demanding work load with this visual display, he informs me he will look at my email when he gets to it but he has been on annual leave and has 300+ unread emails to work through. I have over 500 unread emails on my trust email, it does not quantify how busy I must be. I got nowhere.
Day 27 – medical HR email received asking for breakdown of hours. The same day, I sent an email showing how I calculated my hours for average week and month along with screen shot of BMA banding advice available online.
Day 34 – no reply received.
Day 38 – sent email to medical HR asking for a reply, advising them of how long it had been since my initial query and that I was still yet to get any answer.
Day 38 – email response received advising that they were looking into the issue and would be doing a monitoring exercise (every doctor records their hours for two weeks online and these are sent to medical HR to assess) soon. Critically as well though, the medical HR team had kindly copied in two consultants who’s team I was part of.
Day 41 – Unsurprisingly called into consultant’s office, explaining that he had received numerous emails from medical HR and they were, understandably so, doing his head in. I explained the predicament and he showed me a flow chart – which I had never seen before – which seemed to conclude the matter, i.e. I was on the correct banding given some unusual clause regarding the amount of time actually worked whilst on call. We concluded that I wouldn’t push it any further with HR but would do the monitoring exercise.
Day 48 – start of monitoring exercise which lasts for two weeks. All doctors in the team complete it showing all hours worked, breaks taken and on calls undertaken during this period.
Day 61 – monitoring exercise completed.
Day 81 – Nearly three weeks since monitoring done and no feedback. I send an email to medical HR asking for update.
Day 81 – Same day. Get an email from medical HR to advise they are very busy at the moment but hope to get a response with feedback to me as soon as they can.
Day 84 – Called into consultant’s office again. The consultant is being driven up the wall by the number of emails he has received from medical HR. It seems that the monitoring exercise may have raised the possibility that my banding is incorrect and it should be increased to reflect hours worked. The consultant is a bit concerned by this as he is responsible for making sure the rota is compliant with regulations. I feel some subtle pressure to drop the issue. I apologise for inconvenience caused to him and advise that I will just await the results.
Day 95 – still awaiting any further response from medical HR. I change rotation next week and move Trusts. This will make it a lot harder to follow up logistically. Also, I am now very tired by all of this and wonder what is the point as, if I am right and my banding is incorrect, they will no doubt fight tooth and nail not to recompense me. The consultant summed it up as, ‘if you are right, there’s no money anyway to pay you.’
It has seemed like this has all been a tactical game by medical HR to make me drop my case. They have clearly employed the delaying tactic and also, possibly the more potent tactic, of involving my direct bosses who consciously (or inadvertently) put pressure on me to seemingly drop the issue as medical HR are now making it their issue. This is hard to deal with as consultants have a lot of sway on any junior doctor’s career and it is in my interest to impress them and therefore, implicitly implied, not to rock the boat as I might be the one who falls out.
This whole situation has left me very frustrated. I just wanted to know an answer to a simple question. A question with still no answer. And to be honest, it is not about whether I am right or not. I may well be wrong. It is just the way these issues are handled that is discouraging. It has made me feel undervalued and to feel like a spoilt child. I have felt as if medical HR have made it seem by their conduct and delay as if what I am asking for is unreasonable or does not require explanation and should be just accepted. Additionally, involving my consultant – the parent – to come in and put me in line has further embedded this feeling.
However, was this just my experience and a one off? Maybe other doctors have had a lot better experiences in dealing with medical HR. Sadly this doesn’t appear to be the case from what I have heard from colleagues.
You always hear stories around the hospitals about experiences people have had with medical HR and sadly it is rarely good; I am sure there are good experiences too but nothing sells papers like bad news and plenty must have been sold riding off this department.
There was a story I heard recently about a group of doctors who thought they were on the incorrect banding and challenged the Trust in question. The Trust did not back down and it became a legal dispute with the Trust eventually conceding before getting to the courts. This group of doctors moved on at rotation time and the new group of doctors that came in were put back on the previous incorrect banding (and consequently lower pay) with no change in the contracted hours. Thankfully the doctors were in contact the previous ones and were given the evidence/support to re-challenge the Trust and eventually win again. I heard that this happened with the following group after this as well but none of this has been verified.
I’ve heard lots of stories about annual leave issues, this is the real biggie! Doctors requesting six months in advance for annual leave for life events (such as their own wedding!) and for medical HR to not grant leave for this period of time or worse still, rota them for night shifts over the dates requested – this actually happens! It then falls on the amenability of fellow colleagues to engage in a game of shift swaps to get the time off, night shifts being notoriously difficult to get out of due to logistics of having to change entire chunks of rotas.
When I was working in a previous Trust, all the doctors at my level got an email on a Friday afternoon informing us that some ‘calculations’ had been made and we were all on too high a banding for the job we were doing and consequently our pay was to be cut by 10% per month. Firstly, if this was the correct regarding our pay, the way to communicate it is not by sending a mass email. I had been working in this job for over 2 months and had financial commitments (based on what I could afford on my salary) so it is a huge deal to get a pay cut. This requires consultation, at the very least a face to face meeting as a group of doctors where it is explained to us and questions could be asked and concerns raised. Secondly, the medical HR person was incorrect. Some of my more forward thinking colleagues quickly contacted the BMA (British Medical Association – the union for doctors) who contacted the hospital directly and an email quickly followed saying no change in pay would be made. No apology made though for concern caused.
There was doctor I know who needed time off for their husband’s dad’s funeral on a date which she was scheduled to work and medical HR informed her that father-in-law was not a close enough family member to warrant compassionate leave for the funeral. That is diabolical! And that’s forgetting that in this particular incident, the doctor had known their father-in-law for over 10 years. Not close enough family, please. Where was the compassion from medical HR? The doctor had to swap the shift and a few others – due to feeling not great (grief I believe) – and ended up having to work 19 days in a row with one day off later in the month to make up for it.
This brings me to my point, what is the view of our employers regarding our value; are we considered as humans who provide services in the hospital or just as pure robotic resources, essentially just given a number, no need for a name? From what I have experienced, and of others mentioned above, it would be to go with the latter. This shouldn’t be the case. Surely, the way for medical HR to get the most out of the humans they oversee is to look after them, make them feel valued and treat them with dignity.
Sometimes, to me, it seems as if the primary focus of medical HR is to keep the purse strings tightly closed and ensure that any disagreement is crushed through various tactics, some of which I feel were employed in my experiences given earlier. This is very viable I think as medical salaries take up a big chunk of total expenditure. It logically costs a lot to employ a large staff of highly trained professionals who work long hours. It would make sense that Trusts might be happy for the medical HR team to play the role of the villain to save the Trust money by whatever means necessary.
Alongside this, medical HR ensures that the rota is filled in what often seems to be the easiest way possible for the medical HR team to manage, disregarding trying to accommodate doctors’ preferences.
Now, maybe I am being unfair in my assessment, I would definitely be open to the possibility. However, I know lots of colleagues feel very similarly (or more strongly) and surely the medical HR departments and Trusts would want to address this and show that this is not the case. It wouldn’t be that hard to do, we are not asking for much. Just to be treated as humans with feelings and lives outside of working.
Again though, maybe they won’t come forward because I have hit the nail on the head. We will see.
My thoughts in words 