Contract of Employment for Consultants - 17.04.07

Contract of Employment for Consultants employed in the Public Health Service 19th April 2007 Table of Contents Preamble ....................................................................................................................... 3 Section A – Terms and Conditions ............................................................................. 4 1) 2) 3) 4) 5) 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 24) 25) Appointment and tenure ......................................................................................... 5 Mutual Obligation .................................................................................................. 5 Probation ................................................................................................................ 6 Contract designation .............................................................................................. 6 Reporting relationship ............................................................................................ 6 Hours of work ........................................................................................................ 7 Location and Residence ......................................................................................... 7 Scope of post .......................................................................................................... 8 Role and discharge of responsibilities ................................................................... 8 Standard Duties .................................................................................................. 8 Consultant Teams............................................................................................. 10 Medical Education, Training and Research ..................................................... 10 Advocacy ......................................................................................................... 10 Scheduling and On-call .................................................................................... 11 Leave and holidays .......................................................................................... 12 Locum Cover ................................................................................................... 13 Type of Contract .............................................................................................. 13 Salary and superannuation ............................................................................... 14 Other income .................................................................................................... 14 Confidentiality ................................................................................................. 15 Records / Property............................................................................................ 15 Conflict of Interest ........................................................................................... 15 Clinical Indemnity ........................................................................................... 16 Grievance and Disputes Procedure .................................................................. 16 Acceptance of Contract .................................................................................... 18 Section B – Appendices.............................................................................................. 20 Appendix I – HSE Letter of Approval ......................................................................... 21 Appendix II – Disciplinary Procedure ......................................................................... 22 Appendix III – Sample Practice Plan ........................................................................... 29 2 Preamble The Consultant Contract is comprised of the following: a) The contractual terms and conditions; b) Appendices; c) Terms expressly incorporated by reference or by statute. These documents / terms shall be read together and embody the entire understanding of the parties in respect of the matters contained therein. 3 Section A – Terms and Conditions 4 1) Appointment and tenure a) This Contract is a contract of employment between (name and address of employer] and [name and address of employee). (name of appointee) 9 is appointed to a post of ___________ and accepts the appointment from (insert date). b) Appointment to this post is subject to fulfilling a probationary period (as set out in Section 2). The probationary period will be of 12 months duration unless extended or terminated at the discretion of the employer. c) The qualifications required for this post are set out in the Health Service Executive‟s Letter of Approval for the post as attached at Appendix I. d) Should you be required by the terms of this appointment to comply with specified requirements or conditions (including a requirement or condition that you shall acquire a specified qualification) before the expiration of a specified period your employment shall be terminated unless within that period you have complied with such requirements or conditions. e) In the case of a dispute arising regarding these terms and conditions, the employer and Consultant will have recourse to and, as necessary, complete the Grievance and Disputes Procedure at Section 24. f) With regard to resignation or retirement, the holder of a joint appointment must act similarly in relation to each of his / her component commitments (e.g. (s)he cannot retire or resign from one participating authority and not from the others). g) If you wish to terminate your employment you shall provide the employer(s) with 3 months notice of your proposed termination date. h) In the event that the Disciplinary Procedure (attached at Appendix II) is invoked you shall cooperate with the expeditious implementation of the procedure. i) Should you have been employed within the Irish public health system prior to 1st April 2004 and have not broken your service for a period of 6 months or more you shall retire on reaching the age of 65 years. 2) Mutual Obligation Both you and the employer recognise the need for mutual trust, confidence and respect in giving effect to the terms of this contract. 9 Hereafter referred to in the second person singular 5 3) Probation a) Appointment to a Consultant post is dependent upon the satisfactory completion of a probationary period of 12 months. The probationary period may be extended at the discretion of the employer for a period of not more than 6 months. In such event the specific reasons for the extension shall be furnished in writing to the probationary Consultant. b) At the end of the probationary period, the employer shall either: i) certify, with stated specified reasons, that the Consultant‟s service has not been satisfactory, in which case the Consultant will cease to hold his/her appointment, or ii) certify that the Consultant‟s service has been satisfactory and confirm the appointment on a permanent basis. c) There may be particular circumstances under which a Consultant will not be required to complete all or part of the probationary period and in particular where i) the Consultant currently holds a permanent Consultant appointment in the Irish public health service (in which case no probationary period shall be required) or ii) the Consultant has for a period of not less than 12 months acted in this post pending its filling on a permanent basis. d) During the probationary period, the probationary Consultant will be the subject of ongoing review and a formal review will take place not more than 6 months after the date of first appointment on a probationary basis. e) In the case of joint appointments, the holding of any one part of the post is contingent on continuing to hold the other part or parts of the post. f) Employment may be terminated by either party during the probationary period. Should employment be terminated by the employer, the employer shall set out in writing the specific reasons for such termination. 4) Contract designation This contract is designated as a Type ___ (insert in line with Letter of Approval) Contract as set out in the HSE Letter of Approval for this post attached at Appendix I. Details regarding Type of Contract are set out at Section 17. 5) Reporting relationship a) Your reporting relationship and accountability for the discharge of your contract is: 6 i) to the Chief Executive Officer/General Manager/Master of the hospital (or other employing institution) through your Clinical Director 10 (where such is in place). You may be required to report directly to the Hospital Network Manager or Assistant National Director HSE PCCC Directorate as determined by him/her from time to time. or ii) in the case of Consultant Psychiatrists, to a Local Health Manager, HSE PCCC Directorate (where the Consultant is employed by the HSE) / Chief Executive Officer/Master (where the Consultant is not employed by the HSE) through a Clinical Director who holds statutory responsibilities under the Mental Health Act 2001 and associated regulations. b) In line with governance arrangements particular to your employer, you will be required to work as part of a chain of professional accountability, initially to a Clinical Director and which may also include a Medical Director 11 and the CEO / General Manager. 6) Hours of work a) You are contracted to undertake such duties / provide such services as are set out in this contract in the manner specified for 39 hours on a five day over seven basis. This 39-hour period may be expressed as 13 sessions of 3 hours each. You may be scheduled to work in line with arrangements set out at Section 14 as follows: __________________ (insert relevant rostering provision). Scheduling arrangements may be changed from time to time in line with clinical and/or service need as determined by the employer. b) You shall participate in the provision of on-call and such arrangements as are introduced to respond to service need. c) As a senior professional employee you will be expected to work beyond your rostered period without additional remuneration as required by the exigencies of the service. Hours worked should comply with the provisions of the Organisation of Working Time Act 1997 or any amending legislation. d) You shall participate in such arrangements as are put into place by the employer to validate the delivery of your contractual commitments. 7) Location and Residence a) Your appointment shall be to ________________________ (name HSE area / Voluntary Hospital as set out in HSE letter of approval). Your initial assignment is to ___________________ (as per HSE letter of approval for the post). b) Your employment location may be changed within the functional area and service range applicable to your employer. In the first instance, this will be within the (Hospital Network area / remit of the Voluntary Hospital). You 10 11 A Job Description for the post of Clinical Director is available from your employer A Job Description for the post of Medical Director is available from your employer 7 shall be consulted should you be required to change to an employment location outside the (Hospital Network Area / Voluntary Hospital). In circumstances where a change of location is required, removal expenses calculated in accordance with the removal expenses scheme for the Health Service Executive will be paid if claimed. c) You shall be available to respond readily to clinical or service needs at these locations. This will require you to reside convenient to the hospital / agency in which you hold your appointment. 8) Scope of post The scope of this post is as set out in the HSE letter of approval for this position at Appendix I and the Job Description as issued by the employer. 9) Role and discharge of responsibilities a) Your role as a Consultant is to personally provide medical diagnosis, treatment and care to patients. b) As a Consultant, your clinical autonomy relates to an individual responsibility for the management, supervision and care of patients. Each patient has a named Consultant who has continuing responsibility for his/her care and treatment. c) You shall exercise independent judgement in clinical and ethical matters in line with professional standards and corporate systems and standards and are accountable for same to the employer. d) You may discharge your responsibilities directly in a personal relationship with the patient, or may exercise responsibility concurrently with another doctor or doctors, or you may delegate aspects of the patient's care to other appropriate staff. e) Delegation of responsibility to other doctors or staff by you is subject to the continued provision of a commensurate level of clinical care to the patient and to your assuring that the relevant staff member holds the necessary professional competencies. You shall retain a continuing responsibility for the care of the patient. 10) Standard Duties a) To participate in development of and, undertake all duties and functions pertinent to your area of competence, as set out within the Practice Plan12 and, in line with policies as specified by the employer. b) Your service commitments, accountabilities and specific duties are as set out in the HSE Letter of Approval and the Job Description. Your annual Practice 12 A sample Practice Plan is attached at Appendix II 8 Plan will detail how these are to be implemented and will be validated by a series of performance monitoring arrangements. c) The determination of the range, volume and type of service to be provided and responsibility for delivery of same within available resources rests with the employer. Certain decision-making functions and commensurate responsibilities may be delegated to you by the employer. These will be documented in your Practice Plan. d) The execution of the Practice Plan will be reviewed periodically with your Clinical Director / employer and at least every 3 months. e) To work within the framework of the corporate service plan and/or levels (volume, types etc.) as determined by the employer. Service planning for individual clinical services will be progressed through the Clinical Directorate structure or other arrangements as apply. f) To participate in the development and operation of the Clinical Directorate structure and in such management or representative structures as are in place or being developed. You shall receive training and support to enable you to participate fully in such structures. g) To provide, as appropriate, consultation in your area of designated expertise in respect of patients of other Consultants at their request. h) To ensure that appropriate medical cover is available over the 24/7 period having due regard to the implementation of the European Working Time Directive as it relates to doctors in training. i) To supervise and be responsible for diagnosis, treatment and care provided by non-Consultant Hospital Doctors treating patients under your care j) You shall participate in selection processes for non-Consultant Hospital Doctors and other staff as appropriate and your employer will provide training as required. k) You shall maintain your professional competence on an ongoing basis pursuant to any Medical Council professional competence scheme applicable to you as a medical practitioner. The employer shall facilitate the maintenance of your professional competence pursuant to any Medical Council professional competence scheme applicable to you as a registered medical practitioner. Commitments in this regard will be reflected in your Practice Plan. l) To participate in and facilitate production of all data/information required to inform planning and management of service delivery within financial / budgetary parameters. m) To ensure that if at any time during your employment you make or participate in the discovery of any invention, process procedure or improvement on an existing invention or procedure it shall be communicated to your employer and it shall be the absolute property of the employer as shall all research undertaken involving the facilities and / or staff of the public health system. It shall be the responsibility of the employer to protect that discovery in the public interest. 9 11) Consultant Teams a) The primary purpose of Consultant teams is to ensure Consultant-provided services to patients on a frequent and continuing basis over the full day / week period. b) You shall work as part of a team of Consultants with respect to delivery of Consultant-provided services to patients. This will require that: i) you provide diagnosis, treatment and care to patients under the care of other Consultants in your team. This will encompass discharge and further treatment arrangements as required; ii) other members of your Consultant team will act similarly with respect to patients under your care. c) The team will be determined in the context of your local working environment and may be defined at specialty / sub-specialty level or under a more broadly based categorisation e.g. general medicine, general surgery. 12) Medical Education, Training and Research a) You shall, as part of your standard contractual commitment, contribute to the training and education and supervision of non-Consultant hospital doctors and other members of the multi-disciplinary team. b) You may, with the agreement of your employer, make an explicit commitment in respect of postgraduate medical education and training and/or undergraduate medical education and training. You may, with the agreement of your employer, have a designated responsibility for supervision of doctors in training. Your employer may allocate protected time to you for this purpose. These commitments, together with those of your employer, shall be set out in your Practice Plan. c) You may have the opportunity, subject to the agreement of your employer and the HSE (regarding the structuring of the post), to structure your contractual commitment to enable you to undertake research for a defined period, provided funding is available to support such activity for that period and, that the employer‟s commitment and that of the research body/bodies are set out in the Practice Plan. 13) Advocacy a) As a Consultant, you may advocate on behalf of patients or persons waiting for consultation or treatment. In the first instance such advocacy should take place within the employment context through the relevant Clinical Director or other line manager. b) If you wish to comment publicly, you should make it clear that you are speaking in a personal capacity and when doing so, should have regard to the impact your comments may have on the reputation of the hospital/agency for which you work and on the morale of other staff working there. 10 14) Scheduling and On-call a) Depending on your specialty, sub-specialty or work location, you will be required to participate in a range of scheduling arrangements as part of your 39-hour week. These arrangements will include some or all of the following: i) 5/7 working, scheduled Consultant presence on-duty during an extended working day i.e. 7am – 10pm, over the 7 day week; ii) 24-hour working, scheduled Consultant presence on-duty over the full 24/7 period (as in (b) below); iii) On-call / call-out arrangement. b) A Consultant-provided service will be established on some hospital sites for some specialties on a 24/7 duty basis to include e.g.: i) ii) iii) iv) Anaesthetics (to include Intensive Care) Emergency Medicine Obstetrics Paediatrics / Neonatology (a joint rota to cover neonatal intensive care) c) Other specialties will require a Consultant-provided service during an extended working day over an extended working week. The span of the extended working day will be over the period 7am – 10pm with appropriate arrangements in place to ensure 24-hour emergency cover over the 7-day week. Consultants will be scheduled on-duty within these hours as part of their 39-hour standard working week. These arrangements to include e.g: i) General Medicine, ii) Cardiology, iii) General Surgery, iv) Trauma & Orthopaedic Surgery, v) Paediatrics, vi) Radiology, vii) Haematology. d) Schedules will be developed at local level by Clinical Director / employer by reference to clinical need, specialty, location. The work pattern may be adjusted as Consultant numbers expand at local level. e) Each Consultant‟s Practice Plan will specify the planned level of duty to be undertaken. f) Consistent with the provisions of Section 9 of the Contract, patients will be seen by the Consultant „on-take‟ on a daily basis, acknowledging that each patient has a named Consultant. g) The Clinical Director / employer will oversee the development, amendment and approval of work schedules. 11 15) Leave and holidays a) Leave will be approved by the Clinical Director / line manager in line with agreed rota and service requirements and notice is required in accordance with hospital policies. b) All leave (other than that described under (e) and (f) must have prior approval from the Clinical Director / line manager. No monetary compensation may be granted in respect of untaken leave under (d). c) When planning absence from work for any reason you will provide your Clinical Director, fellow members of your Consultant team and your line manager with notice of at least 8 weeks of your intention to be absent. d) Annual Leave: Your Annual Leave entitlement is 31 working days per annum and as determined by the Organisation of Working Time Act 1997. e) Public Holidays Entitlement: i) Public holidays shall be granted in accordance with the Organisation of Working Time Act 1997. ii) Your public holiday entitlement is as follows: (1) A paid day off on the day of the public holiday (2) If you are required to work on a public holiday, you will receive single time extra for the hours worked and a paid day off at another time and. (3) If the public holiday falls on your rostered day off (rest day) you will get a paid day off at another time. f) Sick Leave: You may be paid under the Sick Pay Scheme for absences due to illness or injury. Granting of sick pay is subject a requirement to comply with the employer‟s sick leave policy. Details of the scheme are available on request. g) Other Leave: Details regarding Maternity, Adoptive, Paternity, Parental, Force Majeure, Compassionate and other leave in accordance with procedures can be obtained from the employer. h) Sabbatical Leave / Career Breaks: You may apply for Sabbatical Leave or Career breaks in accordance with the terms of the relevant Circular. Your employer shall have the right to approve or refuse such leave. You may accumulate such leave over no more than five years. i) Leave to provide services abroad: You may apply for special leave to provide services in countries where health services are underdeveloped in accordance with the relevant Circulars. Your employer shall have the ability to grant or refuse such leave. 12 j) Special Leave Leave for special circumstances shall be available to you in accordance with the relevant Circulars and subject to the agreement of your employer. k) Other HR Policies All other human resource policies which apply in your employment, e.g., Flexible Working, Dignity at Work, etc. apply to you equally. 16) Locum Cover a) In the event of your being absent on a scheduled or unscheduled basis, your Clinical Director will determine the requirement and make necessary arrangements for cross / locum cover during such absence. b) You will work with the Clinical Director in the development and execution of such arrangements as required. 17) Type of Contract Type A Consultant Contract a) A Type A Consultant is remunerated by salary only and is not entitled to charge fees or receive remuneration for services provided by him/her as a medical practitioner except as provided for in Section 19. b) With the exception of those activities described in Section 19, the professional medical practice of a Type A Consultant is limited to those publicly funded facilities provided by and under the governance of the employer or such activities outside the hospital that arise as part of the employment contract (e.g. home visits). c) The employer shall use such mechanisms as are required to validate compliance with (a) and (b) above Type B Consultant Contract a) A Type B Consultant is remunerated on a salary basis and may engage in private practice only in public hospitals, public community facilities and colocated private hospitals13 on public hospital campuses or as part of such activities outside the hospital that arise as part of the employment contract (e.g. home visits) up to a maximum of 20 % of total clinical output. b) With the exception of those activities described in Section 19, the professional medical practice of a Type B Consultant is limited to those publicly funded facilities provided by and under the governance of the employer, such activities outside the hospital that arise as part of the employment contract 13 As being pursued by the HSE on the basis of the directive from the Minister for Health and Children to the HSE. 13 (e.g. home visits) and to co-located private hospitals on public hospital campuses. c) Type B Consultants are not entitled to charge fees in respect of the following: i) Emergency Department Services; ii) Public Outpatient Services; iii) Radiological investigations or laboratory procedures emanating from private hospitals or clinics or other external sources. d) The employer shall use such mechanisms as are required to validate compliance with (a), (b) and (c) above. 18) Salary and superannuation a) Your annual salary shall be follows: i) for Type A Contracts a salary scale of €180,000 to €205,000 in five points of €5,000 each will apply. Consultants holding Type A Contracts may also be eligible for a performance related award of up to 20%. ii) for Type B Contracts a salary scale of €160,000 to €185,000 in five points of €5,000 each will apply. (these salary scales are subject to review) b) Salaries shall be increased in accordance with the general provisions governing pay adjustments under national agreements and also on foot of Government decisions based on the recommendations of the Review Body on Higher Remuneration in the Public Sector. c) You will be covered by the terms of the HSE/VHSS/NHSS Superannuation Scheme and appropriate deductions will be made from your salary in respect of your contributions to the scheme. d) Premium payments for unsocial hours will be in accordance with the Department of Health & Children‟s approved rates. 19) Other income a) Income arising from an individual‟s work for or on behalf of: i) ii) iii) iv) Mental Health Commission, other statutory bodies, medical training bodies and other agencies dealing with public patients or aspects of the public health system; is uncapped but absences from work must be planned and reflected in Practice Planning as required by the employer. b) Income arising from the provision of expert medical opinion relating to insurance claims, preparation of reports and court work is uncapped. Time 14 taken for court appearances or other related attendances must not result in reductions in service and is subject to the agreement of the employer. Other services must be delivered outside scheduled hours, are subject to the agreement of the employer and must be reflected in Practice Planning as required by the employer. c) Business activities other than those relating to the provision of expert medical opinion must be in compliance with the conflict of interest provisions set out at Section 22 below. 20) Confidentiality a) In the course of your employment you may have access to, or hear information concerning the medical or personal affairs of patients and / or staff. Such records and information are strictly confidential and in whatever format and wherever kept, must be safeguarded. b) Consultants should take all reasonable measures to ensure that other health professionals and ancillary staff maintain confidentiality and that records are stored in such a manner that ensures confidentiality, security and ready accessibility for clinical staff when required for patient management. 21) Records / Property a) Subject to Section 20 (b) above, you shall not remove from the premises any records in any format, electronic or otherwise, belonging to your employer / Health Service Executive at any time without proper advance authorisation. b) You will return to your employer / Health Service Executive upon request, and, in any event, upon the termination of your employment, all records and property and equipment belonging your employer / Health Service Executive which are in your possession or under your control. 22) Conflict of Interest a) You shall faithfully discharge your duties and shall refrain from knowingly engaging in any outside matters which would be in contravention of the terms of your Contract or incompatible with the impartial, objective, and effective performance of your duties. b) You shall not realise personal gain in any form which would influence improperly the conduct of your duties nor knowingly use service property, funds, position or power for personal gain. You have a duty to inform your Clinical Director / employer in writing of reasonably foreseen potential conflicts. c) Any outside employment or business activities and interests must not interfere with your regular duties nor represent a conflict of interest. d) Before you engage in a business activity which overlaps with your employer‟s teaching, research, or service functions, you shall make full disclosure, in 15 writing, to your Clinical Director / employer. The Clinical Director / employer must approve or disapprove in writing the proposed activity. e) Any conduct that violates corporate policy pertaining to conflict of interest shall constitute a breach of this contract. f) You will work with the Clinical Director / employer in the development and execution of such arrangements as required. 23) Clinical Indemnity a) You will be provided with an indemnity against the cost of meeting claims from personal injury arising out of bona fide actions taken in the course of your employment. b) Notwithstanding (a) above, you are strongly advised and encouraged to take out supplementary membership with a defence organisation or insurer of your choice, so that you have adequate cover for matters not covered by this indemnity such as representation at disciplinary and fitness to practise hearings or Good Samaritan acts out of the jurisdiction of the Republic of Ireland. c) Under the terms of this indemnity you are required to report in any agreed form which may be prescribed, all adverse incidents which might give rise to a claim from a patient to an officer designated by your employer and to otherwise participate in your employer‟s risk management programme as may be required from time to time. 24) Grievance and Disputes Procedure The text of this procedure is as agreed by health service employers and medical representative organisations in 2000: a) The purpose of this procedure is to deal with problems arising under the Contract. To the greatest extent possible, such problems should be addressed and resolved within the normal structures of the employing authority and at the earliest possible point. The parties recognize the finite nature of resources and agree that issues involving the resourcing of services, roles of hospitals and other general service issues are not amenable to the Grievance and Disputes Procedure. However, the parties further agree that the disputes may arise, which although touching on or concerning such issues, are essentially concerned with the operation of the individual contract and are therefore amenable to the procedure b) Stage 1 Local level discussions must be undertaken and completed within three months from the date on which each party to a dispute indicates in writing that it wishes to avail of this procedure. Where individual issues of an urgent nature arise, such as difficulties in obtaining locum cover, the Consultant shall 16 have the right to process the matter up to the level of the Chief Executive or his nominated representative /deputy. c) Stage 2 – Mediation / Adjudication In exceptional cases where resolution at local level does not prove possible, the matter may be referred by way of written submission to the Mediator/Adjudicator by either party. The said submission shall be transmitted in the first instance to the Secretariat who shall immediately forward the complaint to the Mediator/Adjudicator. It is pre-requisite to the invocation of this procedure that local discussions have taken place prior to referral to the Mediator/Adjudicator. The Mediator/Adjudicator shall decide whether all avenues at local level have been adequately explored and exhausted and further whether the matter is appropriate for his/her consideration. The respondent will have a period of 6 weeks within which to prepare and lodge a counter statement with the Secretariat and shall forward a copy of same immediately to the complainant. Mediation/Adjudication shall commence within two weeks of the expiry of the aforesaid time limit. Should the dispute not be resolved by mediation the Mediator/Adjudicator shall proceed to issue a recommendation within 4 weeks of the completion of the adjudication hearing or such further time as might be agreed between parties. i) disputes about the admissibility of particular cases shall be decided by the mediator/adjudicator; ii) hearings before the Mediators/Adjudicators hall be held in private; iii) both parties shall be entitled to representation at their own expense; iv) decisions of the Mediator/Adjudicator shall be non-binding but the parties agree that such decisions shall be afforded the status of a Labour Court Recommendation; v) the costs of the mediator/adjudicator process shall be borne by the employing authority; vi) the Health Service Employers Agency shall provide the Secretariat. d) List of Mediators/Adjudicators A list of Mediators/Adjudicators have been agreed between the parties as suitable nominees for appointment in any individual case14. It shall be for the Secretariat to determine the precise Mediator/Adjudicator to be employed in any given case. The Secretariat will have due regard in the appointment of Mediators/Adjudicators from the panel to any possible conflict that might arise e) Review The parties agree that the Grievance and Disputes procedure shall be reviewed within 2 years of date of implementation i.e. not later than 17th October 2004. However in the event that difficulties arise concerning individual issues of an urgent nature then an earlier review may take place in respect of such matters 14 These are available from the HSE Employers Agency at 63-64, Adelaide Road, Dublin 2, tel: 01 6626966. web: www.hseea.ie 17 at the election of any of the parties hereto not earlier than the end of June 2003. 25) Acceptance of Contract a) This Contract, the associated Terms and Conditions and Appendices and terms expressly incorporated by reference or by statute contain the terms of your employment with _____ (insert name of employer). b) Please confirm your agreement to the following declaration by signing below: i. I declare that I am not the subject of any investigation by a medical registration or licensing body or authority in any jurisdiction with regard to my medical practice or conduct as a practitioner. I have not been suspended from registration or had my registration or licence cancelled or revoked by any medical registration or licensing body or authority in any jurisdiction in the last ten years nor am I the subject of any current suspension or any restrictions on practise. Also, I confirm that I am not aware that I am the subject of any investigation by the police in any jurisdiction. ii. I am aware of the qualifications and particulars of this position and I hereby declare that all the particulars furnished by me are true and that to the best of my knowledge there is nothing that would adversely affect the position of trust in which I would be placed by virtue of this appointment. iii. I understand that any false or misleading information submitted by me will render me liable to automatic disqualification or termination of employment if already employed. I understand that this appointment is subject to the receipt of appropriate registration with the Medical Council, satisfactory references, Garda/Police Clearance and Occupational Health clearance. Name (Block Capitals): Signature of Applicant: Date: c) Please confirm that: i. I have read and understood the Medical Council's 'Guide to Ethical Conduct and Behaviour' and any other relevant guidance provided by the Medical Council in relation to ethical or professional conduct matters. I undertake to apply the Medical Council's ethical and professional conduct guidance to the clinical and professional situations in which I may work. ii. I have read this document and I hereby accept the post of _____________ in accordance with the terms and conditions specified and I undertake to commence duty on: Name (Block Capitals): 18 _________________________________ _________________________________ _________________________________ _________________________________ Signature of Applicant: Date: _________________________________ _________________________________ Employer (Block Capitals): _________________________________ Signature of Employer: Date: _________________________________ _________________________________ 19 Section B – Appendices 20 Appendix I – HSE Letter of Approval (The HSE Letter of Approval is individual to each post and will be inserted at this section of each contract) 21 Appendix II – Disciplinary Procedure 1. Purpose The delivery of a high quality health service is dependent on all staff meeting the highest standards of performance and conduct. Where possible, and as appropriate, the Clinical Director / Divisional Head or such person(s) as is/are determined by the employer will deal with individual shortcomings through discussion, counselling and appropriate assistance. If, however, the Consultant continues to fail to meet the required standards then the disciplinary procedure will be invoked. Where a Consultant‟s capability, competence or conduct does not meet the required standards, the matter will be dealt with under the following procedure. Stage 1 Oral Warning The Consultant will normally be issued with a formal oral warning by the Clinical Director/Divisional Head. The warning will give details of the precise nature of the complaint, the improvements required and the timescale for improvement. S/he will be advised that the warning constitutes the first stage of the disciplinary procedure and failure to improve within the agreed timescale may result in further disciplinary action under Stage 2 of the disciplinary procedure. A record of the warning will be kept on the Consultant‟s personnel file and will be removed after six months, subject to satisfactory improvement during this period. The Consultant will have a right to appeal the oral warning to a more senior level of management*. Appeals must be made in writing setting out the grounds for appeal within 7 days of the Consultant being notified of the decision. Stage 2 Written Warning If the Consultant fails to make the necessary improvements, s/he will normally be issued with a formal written warning by the Clinical Director/Divisional Head. The written warning will give details of the complaint, the improvements required and the timescale for improvement. The Consultant will also be advised that failure to improve within the agreed timescale may result in the issuing of a final written warning under Stage 3 of the disciplinary procedure. The warning will be removed after 9 months, subject to satisfactory improvement during the specified period. The Consultant will have a right to appeal the written warning to a more senior level of management*. Appeals must be made in writing setting out the grounds for appeal within 7 days of the Consultant being informed of the decision. Stage 3 Final Written Warning If the Consultant fails to make the necessary improvements, s/he will normally be issued with a final written warning by the Clinical Director/Divisional Head. The warning will give details of the complaint, the improvements required and the timescale for improvement. The Consultant will be advised that failure to improve within the agreed timescale may lead to dismissal or some other sanction short of dismissal under Stage 4 of the disciplinary procedure. The warning will be removed 22 after a specified period, usually 12 months, subject to satisfactory improvement during this period. The Consultant will have a right to appeal the written warning to a more senior level of management*. Appeals must be made in writing setting out the grounds for appeal within 7 days of the Consultant being notified of the decision. * Appeals will be to the Hospital General Manager/CEO/Network Manager/Assistant Director PCCC, as appropriate. Stage 4 Dismissal or Action Short of Dismissal Failure to meet the required standards of performance/conduct following the issuing of a final written warning will lead to a disciplinary hearing under Stage 4. The decision-maker will be the relevant National Director, HSE or CEO / General Manager in other health agencies. The outcome of the disciplinary hearing may be dismissal or action short of dismissal. The HSE National Directors may delegate authority to the Network Manager or Assistant Network Manager, as appropriate. 2. Serious Misconduct The following are some examples of serious misconduct which will be dealt with from the outset under Stage 4: • Theft. • Deliberate damage to property. • Fraud or deliberate falsification of documents. • Gross negligence or dereliction of duties. • Incompetence • Incapacity to perform duties due to being under the influence of alcohol, unprescribed drugs or misuse of prescribed medication. • Serious breach of health and safety rules. • Serious abuse of electronic communication policy. • Serious breaches of confidentiality. • Serious bullying, sexual harassment or harassment. (This would only arise where a complaint has been upheld following an investigation under the Dignity at Work policy.) • Serious abuse of a patient/client. (This would only arise where a complaint has been upheld following an investigation under the Trust in Care policy.) • Violent behaviour within the scope of the employee‟s employment. • Sexual assault. • Downloading/disseminating pornographic material from the internet. • Circulation of offensive, obscene or indecent e-mails or text messages. Note: The above list is not exhaustive. Complaints of serious misconduct will be dealt with as follows: (i) Notifying the Consultant of the allegation Upon being made aware of any instance of apparent serious misconduct, the Clinical Director/Divisional Head will arrange for the gathering of preliminary facts relating to 23 the issue in order for the precise allegation to be formulated. The Consultant against whom the allegation is made will be advised of the precise details of the allegation and invited to make an initial response. When dealing with the allegation, management will ensure, insofar as possible, that confidentiality is maintained and the Consultant against whom the allegation is made is fully protected throughout the process. (ii) Protective Measures Pending the outcome of the investigation, management may take whatever protective measures are necessary to ensure that no patient, client or employee is exposed to unacceptable risk. These protective measures are not disciplinary measures nor an indication of guilt and may include:  Providing an appropriate level of additional supervision.  Amendment or restriction of certain clinical duties.  Placing the Consultant on paid administrative leave. Criteria will be agreed with regard to placing Consultants on administrative leave  Other appropriate action. The views of the Consultant will be taken into consideration when determining the appropriate protective measures to take in the circumstances but the final decision rests with the Hospital General Manager/Chief Executive, HSE Network Manager, Assistant Director PCCC or another appropriate person. This would also include the Masters of Maternity Hospitals, Chief Executives/General Managers of Intellectual Disability Agencies and Chief Executives of specific agencies. Placing the Consultant on paid administrative leave pending the outcome of the investigation will be reserved for only the most exceptional of circumstances. The Consultant will be advised that the decision to place him/her on administrative leave is a precautionary measure designed to ensure his or her personal safety and wellbeing / the safety and well-being of patients and staff and not as a disciplinary sanction nor an indication of guilt. (iii) Investigation An investigation will be conducted by person(s) who is/are acceptable to both parties. The principles governing the conduct of the investigation and the steps in conducting the investigation are set out in Appendix 1. If the findings of the investigation uphold the allegation of serious misconduct, a disciplinary hearing will be held as at Stage 4. Both the Consultant and the employing authority shall co-operate with the investigation team to ensure that any investigation is conducted as expeditiously as possible. (iv) Disciplinary Hearing The decision maker will be the relevant National Director, HSE or the Hospital Chief Executive / General Manager as appropriate. The HSE National Directors may delegate authority to the Network Manager or Assistant Network Manager, as appropriate. 24 The Consultant will be provided with a copy of the investigation report and all relevant documentation and will be informed of the following in writing in advance of the disciplinary hearing:  The status of the hearing, i.e. that it is a formal disciplinary hearing under Stage 4 (Dismissal or Action Short of Dismissal) of the Disciplinary Procedure;  The purpose of the hearing, i.e. to consider representations on the Consultant‟s behalf and to decide if disciplinary action is appropriate and the nature of the sanction if any;  The possible outcome of the hearing, i.e., it may result in a decision to terminate his or her employment; and  The right to be accompanied by a representative or work colleague. The disciplinary hearing will be conducted as follows:    The Consultant will be informed of the purpose of the disciplinary hearing, the nature of the allegation and the findings of the investigation. The Consultant and his/her representative will have the opportunity to present his/her case in response to the findings of the investigation. The disciplinary hearing will allow the Consultant to raise any concerns regarding the investigation process if s/he feels that these concerns were not given due consideration by the investigation team. The hearing will be adjourned to allow the decision maker to carefully consider the representations made on the Consultant's behalf. The hearing will be reconvened and the Consultant will be advised of the outcome.   The outcome of the disciplinary hearing will be confirmed to the Consultant in writing and copied to his/her representative. The decision may be to dismiss the Consultant or to take disciplinary action short of dismissal which may include final written warning, suspension without pay, or such other action as is deemed necessary. The Consultant will be advised of his/her right to appeal the decision. Appeals under Stage 4 Appeals against Disciplinary Sanctions Short of Dismissal Appeals against Stage 4 disciplinary sanctions short of dismissal will be heard by an independent adjudicator who is acceptable to the Consultant. The Consultant will be required to submit the grounds for the appeal in writing within seven days of being notified of the original decision. 25 Appeal against Dismissal Decisions If the outcome of the disciplinary hearing is a decision to dismiss, the Consultant may appeal the decision to a committee of three persons. The appeal may be on any of the following grounds:  Mitigating circumstances.  Non-adherence to procedures.  Specific evidence submitted.  Severity of the sanction imposed. The Consultant will be required to submit the grounds for the appeal in writing within 14 days of being notified of the original dismissal decision. An appeal against dismissal decisions will be heard by a committee comprising persons selected from a nominated panel which has been agreed between the HSE and the IMO and IHCA. Membership of the panel will consist of:  A chairperson;  A staff side representative; and  A management representative. Membership of the panel will be reviewed every three years. The Chair will be selected from an agreed panel of appropriately qualified legal practitioners or other appropriate persons that may be agreed between the parties. The Committee will adopt its own procedures and may conduct such enquiries as it deems appropriate. The Committee will decide whether to confirm or vary the original dismissal decision. If the original decision is confirmed, the employee will be removed from the payroll. Ad Misericordium Appeal In the event of an appeal against the decision to dismiss being unsuccessful, the Consultant may make a final “mercy appeal” to the Hospital Chief Executive Officer, HSE, or other appropriate persons in the case of non-HSE agencies. The grounds for this appeal must be submitted in writing within 21 days of the employee being notified of the Committee‟s decision. A Consultant who feels that s/he has been unfairly dismissed may refer a case under the Unfair Dismissals Acts, 1977-2001 within 6 months of the date of dismissal. 26 Appendix to Disciplinary Procedure - Investigation The investigation into allegations of serious misconduct will be carried out in accordance with the following principles:   The investigation will be conducted as expeditiously as possible and without inordinate delay; The investigation will be carried out in strict accordance with the terms of reference and with due respect for the right of the Consultant who is the subject of the allegation to be treated in accordance with the principles of natural justice, including a presumption of innocence; The investigation team will have the necessary expertise to conduct an investigation impartially and expeditiously; Confidentiality will be maintained throughout the investigation to the greatest extent possible, consistent with the requirements of a fair investigation. It is not possible, however, to guarantee the anonymity of the complainant or any person who participates in the investigation; A written record will be kept of all meetings and treated in the strictest confidence; The investigation team may interview any person who they feel can assist with the investigation. All employees are obliged to co-operate fully with the investigation process; Employees who participate in the investigation process will be required to respect the privacy of the parties involved by refraining from inappropriately discussing the matter with other work colleagues or persons outside the organisation; and It will be considered a disciplinary offence to intimidate or exert pressure, directly or indirectly, on any person who may be required to attend as a witness or to attempt to obstruct the investigation process in any way.       Steps in conducting the Investigation   The investigation will be conducted by person(s) nominated by senior management and acceptable to both parties. The investigation will be governed by predetermined terms of reference based on the alleged misconduct (which will be set out in writing) and any other matters relevant to the allegation. The terms of reference shall specify the following:  The timescale within which the investigation will be completed; and  The scope of the investigation.  The Consultant against whom the allegation is made will be advised of the right to representation and given copies of all documentation prior to and during the investigation process, e.g. o Details of alleged misconduct. o Witness statements (if any). o Minutes of any interviews held with witnesses. o Any other evidence of relevance. The investigation team will interview any witnesses and other relevant persons. Confidentiality will be maintained as far as practicable.  27   Persons may be required to attend further meetings to respond to new evidence or provide clarification on any of the issues raised. The investigation team will form preliminary conclusions based on the evidence gathered in the course of the investigation and invite the Consultant concerned to provide additional information or challenge any aspect of the evidence. On completion of the investigation, the investigation team will form its final conclusions and submit a written report of its findings to the Hospital General Manager/Chief Executive/HSE Network Manager/Director PCCC/Assistant Director PCCC, as appropriate.  The Consultant against whom the allegation is made will be given a copy of the investigation report. On completion of the investigation, the investigation team will submit a written report in accordance with its terms of reference. However, no decision regarding disciplinary sanction should be decided upon until the decision maker has held a disciplinary hearing with the Consultant. 28 Appendix III – Sample Practice Plan 1) Introduction a) The Consultant Practice Plan sets out the Consultant‟s duties, responsibilities and objectives for the coming year. Because of the variations between specialties (clinical and support), size and type of hospital and other factors it is accepted that the plan will require to be adapted for individual Consultants. Sample Practice Plans for a range of specialties are available from the HSE. The Practice Plan below deals with admitting Consultants. b) Effective Practice Planning aims to: i) prioritise work; ii) specify the Consultant‟s commitment to team arrangements; iii) define how the Consultant supports the wider service objectives to meet the needs of patients; iv) specify a work schedule that covers all professional work, including teaching, research, management and other service responsibilities; v) provide the Consultant with evidence of maintenance of professional competence and support for Continuing Professional Development and Continuing Medical Education; c) Practice Plans should also set out: i) personal objectives and their congruence with the employer‟s broad service objectives; ii) commitments outside the hospital / local health sector if relevant; iii) location(s) at which Consultants carry out their duties and responsibilities; iv) arrangements for public and private practice in line with the Type of Contract held by the Consultant; v) specific commitments e.g. OPD, Theatre, Teaching, Multidisciplinary Conferences, Ward Rounds etc. vi) any decision-making functions and commensurate responsibilities delegated by the employer to you. 2) Locations a) All activities will normally be undertaken at (name location(s)). b) List any exceptions: 3) Arrangements for review; a) Targets set out in the plan will be reviewed quarterly with a detailed review after one year, unless either party wishes to have an earlier review. 29 4) Schedule of Previous and Planned Activity a) It should be noted that these measures would apply to admitting Consultants. Different measures would apply to other Consultants. b) Categorisation of activity as public or private will not apply to Consultants holding a Type A Contract. The contractual limit on private practice as outlined in your contract will be reflected in the schedule below. Activity Number of inpatients discharged (subject to adjustment in relation to delayed discharges): Number of bed days used: Average length of stay (subject to adjustment in relation to complexity and casemix): Bed occupancy: - By specialty: - As it relates to the individual Consultant: Emergency admission rate: - Specialty, - Personal; Elective admission rate: - Specialty, - Personal; Number of day patients discharged: Ratio of inpatient to day care activity: Number of outpatients clinics: - New patients - Return patients Previous Year Public Private Total Planned for this year Public Private Total 30 5) Waiting List Current Status Public Inpatient: - 0-3 months - 3-6 months - 6-12 months - Other Day case: - 0-3 months - 3-6 months - 6-12 months - Other Outpatient: - 0-3 months - 3-6 months - 6-12 months - Other National Treatment Purchase Fund activity by specialty and the admitting Consultant: - Referred out - In-house Waiting list Private Total Target reduction for coming year Public Private Total 6) Specified duty over the 7 day week Specified Commitment OPD Ward Rounds Theatre Management and administration: MultiDisciplinary Conferences Formal medical education and training commitments Formal research commitments Other (specify) Monday Tuesday Wednesday Thursday Friday Saturday Sunday 31 7) On-call / Cover arrangements Detail: 8) Professional Competence This shall include: i) ii) iii) iv) professional Competence requirements of the Medical Council; continuing Medical Education / Training; continuing Professional Development; conferences attended. 9) Quality and Risk Management a) Arrangements for conduct of Medical Audit i) ii) iii) iv) audit Report for this period; actions / Changes to clinical practice; effect on other members of the clinical team; recommendations agreed. b) Accreditation i) participation in a named team; ii) development of integrated care pathways – specify: ______; iii) other (specify). c) Risk Identification and Control i) ii) iii) iv) number of incidents issues arising; actions / changes to clinical practice required; next steps. 10) Comments and Compliments i) ii) iii) iv) 11) Leave Number; issues arising; actions / changes to clinical practice required; next steps. 12) Arrangements in case of dispute 32 In the case of a dispute arising regarding this Practice Plan, the employer and Consultant shall have recourse to the Grievance and Disputes Procedure. Practice Plan as authorised by Clinical Director / Chief Executive Name: Signed: Date: ____________________ ____________________ ____________________ Signed by Consultant: Name: Signed: Date: ____________________ ____________________ ____________________ 33