at The Royal College of Surgeons
35/43 Lincoln’s Inn Fields
Telephone: 0207 869 6681
Position statement on NHS Pensions
The Association of Surgeons in Training (ASiT) is a professional body and registered charity (Charity No. 274841) working to promote excellence in surgical training for the benefit of trainees and patients. With a membership of over 3000 surgical trainees from all 10 surgical specialities, ASiT provides representation and support at both regional and national levels throughout the United Kingdom and Republic of Ireland. ASiT is governed by an elected executive and council and is independent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations.
ASiT is not a trade union and, therefore, is not involved in industrial relations. However, we are acutely aware of the dispute surrounding NHS pension contributions and are concerned about the unintended consequences of the current situation on patient safety, surgical training and recruitment. As such, we are issuing this statement to highlight our concerns prior to the opening of a commission on this issue. We constrain our comments to the impact on surgical patients and surgical care, but we are sensitive to the fact that this issue affects all other clinical medical specialties, Senior Nurses, NHS management and other non-medical public sector workers.
The NHS already faces a workforce deficit. 10,000 more doctors are required to meet the current demands of the patient care. Waiting times for treatment have expanded and legal targets for planned, consultant-led hospital treatment are now not being met. Efforts to reduce the long waiting lists are critically dependent on senior staff taking on extra clinical sessions to facilitate supplementary operating lists and outpatient clinics.
However, current pension regulations profoundly disincentivises this practice. The tapering of annual allowance above threshold income rates results in senior clinicians, with marginal threshold income, ultimately being personally charged should they assist in providing the sorely-needed extra surgical capacity. Indeed, greater than 40% of senior clinicians have already reduced the number of extra shifts worked as a response to this.
Furthermore, the tapered annual allowance has encouraged early retirement: Research commissioned by NHS Providers has found 1/3 hospital doctors and GPs are considering early retirement. In combination this exacerbates the existing workforce deficits in the NHS and contributes to unacceptable waiting times. This is particularly concerning for those awaiting cancer treatment or with painful or debilitating conditions.
The current pension arrangement detracts from surgical training. Firstly, any reduction in theatre activity reduces the opportunities for trainees to develop technical skills.
Secondly, Consultant trainers, who are remunerated for their direct support of surgical training and trainees, are forced to limit these activities to avoid breaching the marginal threshold incomes. It is unacceptable that current Consultants, dedicated to improving the surgical trainees of today to protect the surgical patients of tomorrow, are expected to sacrifice part their salary in order to do this.
It is for these reasons, ASiT welcomes the announcement of a consultation on this issue. We urge all involved to develop a pension structure which protects patients and training, and thus safeguards NHS surgical care for the future.