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NHS Additional PAs for Doctors

• March 12, 2023

Are you applying for senior NHS positions? If you’re looking to become a consultant, speciality doctor, or specialist, chances are you have looked at many job descriptions. Once you have applied and received an offer, you’ll be given a job plan, which is part of your employment contract. It’s essential to be thorough when reading this so that you understand your responsibilities, duties, and goals.

Part of your job plan will state exactly how your time will be scheduled throughout the working week, ensuring you cover all the necessary duties and meet your goals. These get sectioned into ‘programmed activities’.

What Are Programmed Activities?

Programmed activities (PAs) are four-hour sections of work. In an average, full-time job plan of a consultant, specialist, or speciality doctor, you’ll be given ten full PAs for each working week, totalling forty hours. Of course, that number will be less if you take a part-time role. These PAs dictate your hours and what you’ll do within those hours. It makes up the entire contract.

The Four Categories of PAs

These programmed activities get split into four sections that make up your contract. How many PAs you get for each category depends on your role and career goals.

Direct Clinical Care

During direct clinical care PAs, you will provide direct patient care, including diagnosis, treatment, and prevention. You might give medical advice, do diagnostic work, or perform ward rounds during this time.

Supporting Professional Activities (SPA)

This part of your contract usually accounts for four to six hours, equal to 1 or 1.5 PAs. SPA focuses on your professional development. With this time, you might embark on teaching, education, clinical governance, research, and appraisals. Whatever your task is, it must always lead towards clearly defined objectives.

Additional Responsibilities

Additional responsibilities cover any extra duties you have within the NHS, perhaps as a service direction or a divisional medical direction.

External Duties

Lastly, external duties cover responsibilities outside of the NHS trust but are still supported by the trust. So, for example, you might work at a university, for a trade union, or another NHS trust.

What Are Additional PAs?

Additional PAs – also called extra programmed activities – are any PAs that exceed the usual ten. These are separate from your general employment contract. Often, additional PAs are for clinical duties – usually when the hospital requires more work due to a large workload.

As mentioned, additional PAs are any that go over ten. So, for example, you might work eleven PAs one week, which would equal 44 hours of work, or you might work twelve, equalling 48 hours. However, any PAs that take outside of usual working hours (7 am-7 pm Monday-Friday) only last three hours.

When Are Additional PAs Necessary?

You might be offered regular, ongoing EPAs in your contract. These should be set in stone. The reason for these EPAs is to ensure that the hospital can always reach professional capacity. In the situation of a higher-than-usual workload, you can use your additional PA to ensure there is enough staff in the hospital. Many senior doctors are happy to take on these extra PAs for a higher quality of care and a boost in pay.

Are You Required to Take On EPAs?

No – you are not required to take on additional PAs. You are only required to take on ten PAs if you are in a full-time contract as a consultant, specialist, or speciality doctor. The amount will be lower if you take on a part-time role.

Of course, just because you aren’t required to take on additional PAs doesn’t mean you shouldn’t. It’s entirely up to you. However, if you take them on and they fall outside of working hours, that means a higher pay rate for those hours, which many doctors find appealing.

It’s important to consider getting a separate, signed, written contract if you take on additional PAs, as this will set it in stone and make it easier to track your hours. Accurately tracking your time means being able to prove your workload and receiving extra pay for the hours you’ve put in.

What Are the Benefits of Additional PAs?

The main benefit of doing additional programmed activities is that you’ll experience better pay. On top of that, the NHS hospital you work for will benefit from your additional hours dedicated to clinical duties, increasing the quality of patient care.

Of course, it’s important to be aware of some disadvantages, too – taking on too many additional PAs can cause excessive stress, especially if they eat into your personal hours outside of your contracted PAs.

How Do You Get Paid for EPAs?

If the EPAs are a part of your regular working week and specified in your contract, they will be included in the set pay you receive each week/month. Any additional PAs will receive an additional uplift of 10%.

It’s important to note that PAs over ten hours are not pensionable. For part-time consultants/specialists, any additional PAs you take on up to ten hours is pensionable.

What Should You Do If You’re Unsure of a Contract?

When signing a contract of employment, you must pay close attention to what your contract asks of you before signing it. If you are unsure about any part of your contract, including PAs, contact your recruitment consultant, who can liaise with HR for you. Alternatively, contact the HR department directly, who can provide in-depth employment advice. Remember, it’s always better to be 100% sure of a contract before signing it!

In Summary

Programmed activities are blocks of hours that make up your employment contract. These PAs last four hours, except when outside of working hours.

If you’re considering your options for working in the NHS as an IMG or UK based doctor then let us know and we’ll be happy to guide you through all the latest job opportunities.