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November 30, 2015

CIC employed Juniors told that they do not have the right to be balloted or participate in Industrial Action
Filed under: Private Eye — Dr. Phil @ 1:20 pm

Junior doctors employed by a community interest company (CIC) in Plymouth have been told they do not have the right to be balloted or participate in Industrial Action – even if they are BMA members. Follow the e mails and meeting minutes below.

Dear all

Further to the LNC meeting that was held this week to discuss the Industrial Action (IA) for junior doctors it was agreed that I would write out to you on behalf of Steve Waite and the Board to give an overview of the BMA advice and agreement that was reached with LNC members.

Due to PCH being a non NHS employer (albeit the medical staff are employed on national terms and conditions) the trainees were not entitled to either ballot nor take part in the IA during December. I have attached a copy of the notes taken at the LNC meeting along with the e-mail that has been sent to PCH trainees on Wednesday.

Those trainees employed by Devon Docs and Plymouth Hospitals are entitled to strike and in view of this I have asked medical staffing to provide an overview of the key areas that will be affected. Teresa has detailed what action is likely to be required and I would ask those particular consultants to verify the details and add any further information to ensure that appropriate action can be taken on the 1st, 8th and 16th December. Can you please provide any updates to Teresa Duggan by the 1st December – thank you.

It was acknowledged at the LNC that the Consultant body along with the specialty doctors are likely to want to offer support to the trainees, both those who choose to strike along with the PCH trainees who find themselves unable to take this course of action. Senior management wished me to pass on their appreciation to you in helping to ensure that clinical services are maintained and patient safety and care remain the priority at this time.

David Furze

Head of HR & Interim Chair of LNC

Dear Trainee

I am writing to those of you who are directly employed by PCH. An LNC meeting was held yesterday, which both Jenny Price and Rbbiya Noor (previous core-trainee, now specialty doctor for West CMHT) were present.

Richard Griffiths gave an overview of the Industrial Action which is scheduled to take place on the 1st/8th and 16th December. I have attached a copy of the e-mail that Richard has sent outlining that you are legally not entitled to take strike action on any of these dates.

Trainees employed directly by Devon Doctors or Plymouth Hospitals are entitled to strike and their employing organisations have contacted them about this. I have copied those doctors into this e-mail so they are aware of the situation within PCH.

I will be e-mailing out again to medical staff and senior managers to clarify what cover arrangements are going to be in place for those areas particularly affected by the Action.

It is recognised that you, along with Senior medical staff are likely to wish to show support to those trainees during this period. Richard mentioned that the BMA are producing free badges etc. that are available off the website and advised that you contact the BMA direct about this.

Please do not hesitate to contact me if you have any queries or there is anything else that I can help with.

Kind regards


Teresa Duggan

HR Medical Staffing Manager

Plymouth Community Healthcare CIC

HR Department

Hi Teresa

Following are meeting this morning,

I can confirm the following:

The BMA had confirmation that legally the CIC is not regarded as an NHS employer for the purposes of balloting, although we do know that the junior doctors are employed by the CIC on national terms and conditions.

In the circumstances, we believe it prudent to advise the CIC employed Juniors that they do not participate in the Industrial Action but instead support their colleagues in the wider NHS in the same way as the consultants and SAS doctors who are not taking industrial action will be doing. That would mean that they would work normally on the IA dates and we have advised the employer accordingly.

This does not apply to junior doctors who are directly employed by PHT or Devon Doctors who were balloted and may participate fully in the planned industrial action

Richard Griffiths

Industrial Relations Officer

Regional Services: South West Centre

British Medical Association

The BMA is the voice of doctors and medical students in the UK.

We are an apolitical professional association and independent trade union, representing doctors and medical students from all branches of medicine across the UK and supporting them to deliver the highest standards of patient care.

This email and any attachments are confidential and intended solely for the addressee. If you have received this email in error please notify Email sent or received by the BMA is monitored.

The British Medical Association.
Registered as a company limited by guarantee in England and Wales under registered number 00008848.
Registered office: BMA House, Tavistock Square, London WC1H 9JP




David Furze (DF) (Chair)

Ben Jameson (BJ)

Naresh Buttan (NB)

Alin Mascas (AM)

Alison Battersby (AB)

Rbbiya Noor (RN)

Fernanda Garcia Costas (FGC)

Jenny Price (JP)

Richard Griffiths (RG)

Teresa Duggan (TD)

In Attendance:

Steve Waite (SW)

Michelle Thomas (MT)

Tracy Davis (Minutes)


Soni Bhate (SB)

Mohammed Ismail (MI)

Thorsten Brandt (TB)

Lara Strang (LS)

Ashley Dingle (AD)

Leanne Tozer (LT


DF welcomed everyone to this extraordinary meeting and noted apologies as above. He stated that the purpose of this meeting was to discuss the proposed industrial action to be undertaken by Junior Doctors nationally on three dates within December 2015 and the actions that could be taken to ameliorate the effect on our services.

2. TD confirmed that the BMA had stated that Junior Doctors employed by either Plymouth Hospitals NHS Trust or Devon Doctors (or other NHS employer) were entitled to join the industrial action as they had participated in the ballot. However, Junior Doctors who were directly employed by social enterprises such as Plymouth Community Healthcare (PCH) were not entitled to participate in the ballot and so not allowed to join the industrial action.

This meant for PCH that the following posts would be affected:

· GPVTS trainees (3 x Psychiatry and 4 x HCE)

· Foundation Year 1 (2 x Psychiatry)

· Foundation Year 2 (4 x Psychiatry)

Discussions took place on the reasoning behind the decision by BMA to not allow Junior Doctors employed by social enterprises to participate in the ballot and resulting industrial action. It was confirmed that all Core and Higher Trainees directly employed by PCH were not entitled to join the industrial action.

3. RG provided an overview of the situation that had arisen and the BMA’s rationale that social enterprises were viewed as non-NHS Employers as they had ‘no strict obligation’ to adhere to the national terms and conditions. He further commented that though PCH did employ medical staff under the national terms and conditions they could not be imposed and any changes would have to be agreed through the LNC. He reiterated that the advice from the BMA was that if Junior Doctors had not been balloted they were not entitled to join the industrial action.

4. NB requested confirmation that it was legal advice that had clarified who was a NHS employer. RG agreed that this was the case. NB further queried how this would affect other grades of medical staff, i.e. Specialty Doctor and Consultant. RG was not sure this could be challenged – he saw PCH as an NHS employer with national terms and conditions.

5. DF queried whether these other grades of medical staff would be balloted. RG stated that he would seek to work with PCH and ensure that everyone fully entitled to national terms and conditions. SW commented that PCH had a Trade Union Recognition Agreement that included the BMA. He confirmed that PCH were happy to work with Trade Unions but within a legal framework.

6. DF remarked that industrial action occurred across a range of healthcare organisations. Members were balloted and action occurred, which showed that it can be done but trade unions did not always recognise social enterprises.

7. MT stated that she was keen to clarify the impact on any industrial action. TD confirmed the following areas that may be potentially impacted:

· F2’s – Inpatient Units: Plym Bridge, Glenbourne, Cotehele

· F1’s – Psychiatric Liaison

· GPVTS – Community Mental Health Teams

· GPVTS – General Medicine: Local Care Centre and Liskeard

RG commented that PCH should assume 100% support for the industrial action and plan accordingly.

8. MT enquired if PCH needed to communicate with all staff on who would be participating in the industrial action and the reasons why other staff would not and the plans that would be in place to support those areas affected. RG stated that this would be useful in providing clear information to clarify the position of who was and was not participating in the industrial action and the reasons.

TD confirmed that the proposed dates for the industrial action were:

· Tuesday 1st December – 24 hours (equivalent to Public Holiday emergency cover)

· Tuesday 8th December – 8am to 5pm

· Wednesday 16th December – 8am to 5pm

AM stated that it would be good to explain what constituted an emergency, i.e. medication management for an acutely unwell mental health patient. RG confirmed that medical staff would do exactly what they would do if this was Christmas Day. TD commented that Glenbourne had a ‘full shift’ rota at Christmas.

MT requested a written plan of what cover will be in place. Action: T Duggan

9. MT enquired what would happen if there was a major incident on any of the dates, as PCH was a second responder. TD replied that we would call staff. The LNC supported this occurring if a major incident was called during any of the industrial action dates.

10. NB questioned what would happen if staff requested leave for any of the proposed dates. TD stated that only leave that had already been approved would be accepted.

11. MT queried what if nothing happens as a result of the industrial action, would the BMA ballot again? RG stated he was not sure, the BMA were encouraging employers to write to the Secretary of State in support of the Junior Doctors. There were no plans for further action at present, but this was now in the hands of the Department of Health.

12. Discussions took place on the current situation and the perceived lack of trust between the BMA and the Department of Health. It appeared that the Department of Health had been surprised by the level of support for industrial action. The new contract was not due to start until August 2016.

13. NB asked what other local Trusts were doing. RG stated that there would be a picket line at PHNT.

14. NB requested advice if the media contacted any doctors. RG suggested that if doctors were not confident they could contact the BMA for support/information. JP stated that the Plymouth Herald had contacted her, she had requested support/advice from PCH Communications but had still not received a response. RG commented that if the interview was off-site then there was no need to contact an employer. SW agreed there was no issue if the doctor was not representing PCH.

15. AB commented that RG mentioned other ways trainees show support, what were they. RG replied that they could wear badges and if at Derriford they could give verbal support to the trainees. SW stated that he was conscious that those trainees who were not entitled to join the industrial action could face criticism, as it may not be understood that they were not against the action they just could not legally participate. We needed to ensure that it is know that they had no choice.

16. NB queried how to raise public awareness of the reasons why some staff were participating and others not. MT stated that she would discuss this with the Communications Team to provide a pro-active statement for the public. TD commented that Devon Doctors had written to their trainees about the situation and she was proposing to do the same for PCH staff.

17. SW thanked everyone for attending and participating in this meeting.


The next LNC regular meeting will take place on Tuesday 12th January 2016 at 10.00am in the HR Meeting Room, Admin Building, Mount Gould. The Staff Side pre-meet will start at 9.00am.