Health Education England says implementation of contract will be key criterion for making decisions on investment in training

The government has told hospital foundation trusts that they could lose funding for training programmes if they refuse to impose the new contract for junior doctors.

The threat comes in a letter from Health Education England, the Department of Health body responsible for education and training, to chief executives of NHS trusts in England. It states that decisions on awarding funding for training posts will hinge in part on whether a trust decided to rebel against Jeremy Hunt over the new national contract.

Jeremy Hunt must back down – the survival of the NHS depends on it | Hannah Mitchell Read more

Last week, the health secretary announced that he would end protracted negotiations over changes to the junior doctors’ contract to facilitate weekend working by saying he would impose the new contract nationally from 1 August.

However, none of the 152 foundation trust hospitals in England, which are semi-independent, are legally obliged to force junior doctors to accept the junior contract, the Department of Health admitted last week.

The government had feared trusts could be tempted to offer better terms as a means to recruit enough junior doctors to start as trainees in early August.

In the letter, the HEE chief executive, Prof Ian Cumming, said: “We are not prepared to see a system where a competition based on a local employer’s ability to offer different terms is part of the recruitment process. The recruitment process should be based on patient and service need and quality of training as it always has been.

“Therefore implementation of the national contract will be a key criterion for HEE in making its decisions on our investment in training posts.”

The letter followed a separate memo with a similar message sent to chief executives from the NHS Improvement chief executive, Jim Mackey, urging trusts to “play our part in helping pull colleagues together again after this difficult process and ensure consistent implementation across the NHS.”

“I know that, from talking to colleagues over the last few days, we all want this to continue and must maintain this system and implement the contract consistently across the country,” he wrote. “We will do all we can to ensure that this is done effectively. This has, understandably, been a time of conflict and disagreement.”

No foundation trust has yet declared that it will refuse to impose the contract, though Peterborough and Stamford hospitals NHS foundation trust gave a strong hint on Tuesday that it was considering local contracts.

“As a foundation trust all contracts offered to staff are left to our discretion,” the trust’s deputy chief executive, Caroline Walker, told the Peterborough Telegraph.

“However, we will be monitoring the national and local position in the decision process with regards to any contracts offered to junior doctors. At this time no decision has been made, but we would like to reassure patients that high quality of care and their safety is our priority.”

More than 50 doctors at St George’s university hospitals NHS foundation trust have written a joint letter to its chief executive, Miles Scott, asking him to refuse to impose the contract.

Scott was one of the 14 chief executives of trusts cited as supporting the proposal by the government’s chief negotiator, Sir David Dalton, for the government to do “whatever it deems necessary”, and who later denied they supported forcing the terms on junior doctors.

A Department of Health spokesman said: “We expect all hospitals to implement the contract, which is much safer and will better support training and education.”

In their letters, both Cumming and Mackey also said they were concerned about the tone of the debate around junior contracts on social media, particularly with regard to “personal attacks”.

“It is clear that this whole issue has been controversial and many people across the NHS have wanted to ensure their voice was heard on the matter, that is right and proper,” Cumming said.

“However, I have received far too many reports on social media and elsewhere extending beyond fair comment in to the realm of abuse. I do not believe that anyone should have to put up with personal abuse because of their views on this matter,” the letter continued.

Johann Malawana, the BMA’s junior doctor committee chair, accused HEE of “helping to spin the narrative that the abusive party in this is junior doctors”.

“Interestingly, none of us received a letter like this when we were abused in the newspapers,” he tweeted. “We must be more robust.”

Around 2,000 doctors have signed a letter to chief executives of NHS trusts, calling on the hospital chiefs to reject the new contracts which they have been asked to impose on their staff.



Consultants, professors and other staff from more than 150 NHS trusts and 244 medical institutions have put their name to the letter, which claims the deal could have “serious implications for the safety of our patients” leaving staff dangerously stretched.



“Stretching junior doctors over 7-days will leave dangerous gaps in the week and exacerbate the recruitment crisis,” the letters says.



“We therefore request that you, together with colleagues at other Foundation Trusts, collectively reject the imposition of this new contract and urge the government to return to national negotiations to deliver a safe and fair contract.”