Proposed changes to doctors’ contracts – making our views known – what you can do

As part of the AAGBI’s on-going commitment to safety in anaesthesia and to supporting our members, we have been active in raising strong concerns about proposed changes to doctors’ contracts. Our latest response regarding the impact on trainees is published on our website and in The Guardian.

We are taking every opportunity to challenge Government plans and encourage our members to do the same. Members will have the greatest influence by writing to their own local constituency MP and we have provided some guidance below to assist.  

Please feel free to draft your own letter, and make it personal using examples drawn from your own professional practice and individual situation. It is important to set out what impact the proposed changes will have on you and colleagues in the specialty, and to emphasise how this could affect patient safety and care. We ask you to echo the primary concerns about the proposed changes outlined in the AAGBI’s statement.

You can find contact details for your local MP online at: or at

As well as writing letters, you may wish to make an appointment to see your MP at one of their local ‘surgeries’. Try and go as a group from the same constituency. Invite them to visit you at your hospital. Identify people who may be able to coordinate or share information; the AAGBI Linkman, the Trainee Network Lead or a member of the LTFT network.  Your MP is unlikely to understand much about anaesthesia as a specialty or career. Take this opportunity to educate them, while explaining the impact of the new contract on you and your specialty.

If your MP is a minister or member of Cabinet, don’t give up – they may have as much to learn as any other, and it does them good to hear that their constituents are unhappy. They need enough constituents to stay happy for them to be re-elected!

Particularly for trainees, don’t just write letters yourself – get anyone who may be affected to write to their MP. Spouses, partners, boyfriends, girlfriends, parents – even children can write effective cards or letters. For those that don’t remember the detail, the whole MMC fiasco only became a political issue when lots of backbench MPs,  and the Daily Telegraph began to get angry and concerned letters from the parents of medical students and young doctors.

Finally, don’t forget social media, but only if they go to someone. Posting into the ether makes you feel better, but all MPs have an email account, and most will have Facebook pages or twitter accounts – use all of these but be polite and professional whatever you send, whichever way you send it.

Thank you for your support.

Dr Andrew J Hartle, President AAGBI
Association of Anaesthetists of Great Britain and Ireland


Writing to your MP:  letter content ideas

  1. Explain that you are a working anaesthetist (trainee/consultant), stating the name of your trust, and that you are writing to express your concern about the Government’s plans to impose a new contract on trainee doctors and the knock on effect this will have on services in your MP’s area. State that you are calling on his or her support as your local MP to help ensure that a contract which threatens your future ability to deliver high quality care to the people of your region will not come into force.
  2. Mention that anaesthesia is the largest single specialty in the NHS (16% of consultants and approximately 4500 trainees, about 8.5% of the total).
  3. Your concerns could include:
    • Our ability to recruit new, talented trainees in order to meet the anticipated need for over 25% more anaesthetists by 2035 (referencing CfWI).
    • Some regions (e.g. the North East) are already struggling to fill all their training posts, leaving places on rotas unfilled and the hospital dependent on locums – the DDRB did not suggest that anaesthesia would benefit from Recruitment and Retention Premia.
    • Disproportionate impact on women or other individuals who take a career break for academic or Out of Programme Experience (OOPE). Talk about the number of female trainees in your department of School, the number taking maternity leave and working Less Than Full Time (LTFT).
    • Give other examples of people working LTFT.
    • The impact anyone who chooses, or has to work LTFT because of childcare, other care responsibilities, through ill health, or by choice.
    • Disadvantaging doctors who have gained additional experience, often backed up with exam success. These doctors increase their chances of being selected for training in anaesthesia, but they lose any financial benefit of greater experience.
    • Doctors who are already working to a seven day service but who will be further disadvantaged by the extension of ‘normal time’.
    • The NHS’ ability to deliver a world-class emergency service 24 hours a day, seven days a week to patients.
    • Anaesthetic trainees are likely to resident on call in a full shift pattern for almost all their training career, and thus will not be eligible for Availability Allowance.  Anaesthetists will therefore be entitled to only three of the five main pay elements proposed for trainees.
    • The impact on the morale of trainees both of the detail of the contract and the way it is being imposed, when morale is already at an all-time low, combined with a 15% pay reduction for all future acute service trainees. Positive morale transcribes into excellent care.
  4. You could give the number of anaesthetists your Trust currently employs. Insert an example of rota / recruitment or other challenges from your own experience. Explain what would happen to your hospital if it was no longer able to recruit the full number of trainees – the impact on call rotas, costs of locums, impact on consultants now doing emergencies and not doing elective lists.  Try to cost these.
  5. You could add that consultant and trainee anaesthetists play a vital role in the running of our hospitals. They are most often found working nights, over weekends and in critical care / emergency departments – caring for the very sickest members of your MP’s constituency. Anaesthetists are at the heart of the ‘seven day NHS’. And without the continual presence of an anaesthetist, maternity units would not be able to offer high quality pain relief in labour, or rapid access to emergency caesarean sections which may be life-saving for mother and baby.

You could finish your letter by saying that you hope that you and your colleagues can count on your MP’s support.

For members in Scotland, Wales and Northern Ireland the situation is very different. There are no contract negotiations in Scotland or Wales for consultants and the Scottish and Welsh Governments have announced they do not plan to impose a contract on trainees. There are negotiations in Northern Ireland about the consultant contract and the government intends to introduce a new trainee contract similar to that in England. The situation may change in Scotland and Wales after elections to the Scottish Parliament and Welsh Assembly in 2016. Now is the time to engage with MSPs, AMs and MLA to point out the many failings of the contract being imposed on trainees in England.