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Additional PAs

  • August 31, 2018


When applying for your first NHS post, you should always try and make sure you have a job description and as much detail about the post and Trust prior to interviewing. However, during your interview is always a great time to ask for further information such as proposed objectives, supporting resources available to allow you to carry out your work – all information which will show you are interested in the position.

Please note that prior to starting your position you may be given an idea of your working rota, however, the likelihood is that your rota will change slightly once you arrive at the Trust.

My contract is based on PAs, what are they?

PAs stand for ‘Programmed Activities’.

A PA is 4 hours of work if done within the normal working week (Monday to Friday 8am-8pm). A PA done outside of the normal working week is 3 hours of work.

All the activities in your job must be detailed in your job plan – and it is important to agree to the content of the job plan before taking up your post.

How many PAs should be in my contract?

The standard full-time contract is for 10 PAs, i.e. 40 hours of work per week (if that work is within the normal working week).

Posts that are less than full-time will be for fewer than 10 PAs.

However, some posts may advertise for more than 10 PAs, generally 11 or 12, (PAs greater than 12 would necessitate the doctor to opt out of the European Working Time Directive limit of 48).

Types of PAs

  1. Direct Clinical Care – work directly on patient care, includes ward rounds, theatre sessions, all administration connected with name patients
  2. Supporting Professional Activities – work underpinning patient care including teaching, audit, appraisal, research, training, clinical governance and clinical management
  3. Additional NHS Responsibilities – sitting on appointment or disciplinary panels, CEA panels, not necessarily for own employer but for benefit of NHS, Caldicott Guardian or Guardian of Hours
  4. Other / External Duties – Senior positions in Royal Colleges, BMA, GMC, DH working parties or negotiating groups

Do I have to work more than 10 PAs?

No, you do not. You are not obliged (or entitled) to undertake any more than 10PAs per week. As a new full-time Speciality Doctor or Consultant, you should be offered a 10 PA contract, and your job plan should clearly state the work to be undertaken in each PA.

However, where it is not possible for your department to maintain their service, then you may, at the discretion of your employer, be offered more than 10 PAs (and the post may have been advertised as such – see above).

Are PAs over 10 ‘special’ in any way?

PAs over 10 are called EPAs (extra programmed activities) and these are generally allocated for clinical duties.

EPAs must be contracted separately to your standard contract and the duties within the 11th or 12th PA should be clearly specified.

Can my employer demand that I work some of my PAs outside the normal working week?

Your hospital cannot require you to undertake scheduled work outside of 8am to 8pm Monday to Friday, 9am to 1pm on Saturdays or on public holidays.

Any PA undertaken outside of the hours 8am to 8pm Monday to Friday is regarded as taking place in ‘premium time’. This means that the PA must last 3 hours instead of 4.

Your contract should state that no more than 3 PAs per week should be out of hours other than in exceptional circumstances.

Please note that the definition of premium time does not mean that, Monday to Friday, has been designated as the ‘normal working week’. It simply sets a higher rate of pay for work outside of these hours.

How will my on-call duties be calculated?

Your on-call commitment should be clearly set out in your job plan.

Types of on-call:

  • Working out of hours: Some specialities (including anaesthetics, surgery, obstetrics), schedule out of hour PAs, where a Speciality Doctor or Consultant is mostly “hands-on” working and some rotas are now based on this working pattern. Your job plan must be structured to ensure adequate rest is provided before and after the hours period. Remember, that the number of PAs undertaken during the out of hours period should not exceed 3 per week other than in exceptional circumstances.
  • On-call rota: Participating in an on-call rota is recognised through the payment of an availability supplement representing a percentage of basic salary which reflects the frequency and level of availability. This supplement is separate from the actual work undertaken when you are on-call, which is recognised and paid through the PA allocation.

I am still not sure about my contract and the job plan I am being offered: what should I do?

The fundamental thing to do in this situation is to get advice

  1. Contact your Recruitment Consultant – they will be able to liaise between you and your HR department to provide clarification and a solution.
  2. Contact the BMA – if you are a BMA member you can phone the BMA for employment advice on 0300 123 1233 or email [email protected]

If you are an international doctor who wants to relocate to the UK and work within the NHS, please send your CV to [email protected] and one of our Specialist Advisers will be in touch.

Join our Facebook Group IMG Advisor – here you will have access to frequent blog posts, the opportunity to ask questions regarding relocating to the UK and working within the NHS with professional answers and the chance to meet others IMGs!


JOB PLANNING FOR YOUR FIRST CONSULTANT POST. (2014). British Medical Association.


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