Intended for healthcare professionals

Career Focus

Representing your colleagues

BMJ 1999; 319 doi: (Published 18 September 1999) Cite this as: BMJ 1999;319:S2-7212
  1. revor Pickersgill, deputy chairman,,
  2. Justin Cross, executive research officer
  1. Education and Training, Junior Doctors Committee
  2. Junior Doctors Committee, BMA House, London, WC1H 9JR

    Being a local BMA representative might seem a thankless task, but it's good practice for your future career, say Trevor Pickersgill and Justin Cross

    When a doctor takes up a consultant post or becomes a GP principal, he or she is suddenly confronted with managing a department or practice: dealing with NHS management; representing colleagues; doing committee and administrative work; becoming involved in training and education; making decisions that affect the services they provide; and taking part in audit and clinical governance. Most of these roles will be new, and are not part of a junior's training. Although juniors engage in audit, no training will have been given in how to manage a department—a serious defect in the way in which doctors are trained for their future non-clinical responsibilities.

    Opportunity knocks

    The BMA is now launching a network of junior representatives throughout the United Kingdom. They will be responsible at trust level for representing their colleagues, and will deal locally with problems faced by junior doctors. This role gives a junior doctor the unique opportunity to develop negotiating, management, communication, and leadership skills vital to his or her future success.

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    A consultant managing a department will be required to negotiate regularly with trust management about issues that affect the department—both the services it provides and the staff it employs. It is essential, therefore, that juniors have experience in negotiating on behalf of colleagues. This could be about the implementation of the New Deal, including safer working patterns, or dealing with local problems such as work intensity claims or study leave provisions.An integral role for BMA junior representatives will be to sit on the local negotiating committee. These committees negotiate with the trust locally on behalf of doctors in the trust. With active members representing doctors in the training grades, the local negotiating committees can work to improve the working and living conditions of junior doctors. Juniors should be able to raise issues in these committees and enlist the support of senior colleagues. Issues might include compliance rates in the New Deal, disputes over additional duty hours, or accommodation and catering standards. In addition, a number of issues are not directly related to juniors but have a serious impact on them, and juniors” views should at least be canvassed. These include waiting list initiatives, working time directive for all NHS staff excluding junior doctors, clinical governance, audit, and new buildings.The BMA will provide free training for representatives, as it already does for local negotiating committee members. Such training is taken up enthusiastically by consultants, keen to protect their own interests in the trust.It is essential that consultants and GP principals, as managers within the NHS, understand the structure and functions of the NHS, its management, staffing issues, and terms and conditions of service for medical staff. There is no better opportunity to gain this experience than by becoming a BMA junior representative. Sorting out working patterns, dealing with the regional task force, clarifying leave entitlement or pay issues, or even liaising with the facilities officer about the provision of accommodation and catering all provide insights into the management of the NHS. In addition, there are a several other committees on which junior representation will be essential: the New Deal local implementation group, staff liaison groups, trusts” junior doctors committees or even trusts” juniors accommodation and catering working groups. Representing colleagues on these groups gives valuable experience in working with management to achieve better conditions for junior doctors.

    Communication skills

    Central to the success of being a manager is communication. Clinical responsibilities provide numerous opportunities for developing communication and interpersonal skills—in particular, working with colleagues and dealing with patients and their relatives. No real opportunities exist, however, for developing proper working relationships with medical staffing and other parts of management, with other departments, with outside bodies (including the New Deal regional task force and the local BMA office), and with juniors from other trusts in the region.

    Becoming a BMA junior representative will give a junior doctor a much broader range of experience to develop communication and interpersonal skills. In addition, any training necessary for performing the duties of a representative, from presentation skills courses to information technology training, can be organised by the local BMA office.

    Employment relations

    The BMA is the principal professional association for doctors in the United Kingdom. The BMA is also a trade union. It negotiates all terms and conditions of service for every different group of doctors in the country. For hospital doctors in training, the BMA's Junior Doctors Committee, which is made up of junior doctor representatives from all the English regions, Wales, Scotland, and Northern Ireland, has sole bargaining rights concerning junior doctors” terms and conditions of service in employment in the NHS, including pay, contracts, hours of work, and living and working conditions.

    Becoming a BMA junior representative will provide an opportunity to work as part of a leading professional association and trade union and to develop knowledge in industrial relations and employment law. The BMA junior representative will be encouraged to develop a basic understanding of the terms and conditions of service for hospital doctors. This may be about pay or contracts, or about leave entitlements or working and living conditions. The local BMA office provides specialist advice on all these areas.The BMA junior representative will also be an ex-officio member of the BMA's regional junior doctors committee. This will be an ideal opportunity to share ideas and experiences from other trusts in the region so that imaginative solutions and examples of best practice can be promulgated to the benefit of all juniors in the region. In addition, it is a vital link to the UK Junior Doctors Committee. It is essential that the UK committee has a direct link to juniors locally, and most importantly that juniors locally have a direct link to the UK committee. Such two-way information flows can do nothing but better the cause of juniors nationally. Such extra committee experience gives representatives the opportunity to tackle issues wider than their local remit.The Junior Doctors Committee has been mandated by its membership to negotiate with the government and the health departments on out of hours pay. Should a satisfactory conclusion to such negotiations not be reached by this autumn, there will be the first industrial action ballot of doctors for nearly 25 years. Should the BMA need to hold a ballot and possibly ultimately take industrial action, links with individual hospitals and trusts will need to be very strong. It is therefore essential for successful action on out of hours pay for there to be a robust network of junior doctor representatives in the workplace able to support and encourage their colleagues and most importantly give feedback to the UK Joint Doctors Committee.

    Appointment and training

    There are no special qualifications required to become a BMA junior representative, other than being a BMA member. Concern for working conditions, a desire to represent colleagues, a passing interest in medical politics, and an interest in the structure, functions, management, and workforce in the NHS are helpful for representatives. A degree of enthusiasm and motivation and the ability to get to know one's colleagues and managers will all be required at some time. Time commitment can be as little or as much as you want.

    Appointments to the post of BMA junior representative can be made in various ways. If the trust already has a junior doctors committee, it would be expected that the BMA junior representative would be a member of that committee and would be elected by that committee. Most trusts, however, do not have such committees. Although, ultimately, it would be desirable that their junior doctor colleagues elect the representative, in the first instance, any interested junior doctor should approach the local BMA. It is the local BMA office that must accredit the individual so that the representative receives trade union recognition and is eligible for time off and resources to help with carrying out duties. Representatives will initially be given an induction pack, and a series of supraregional training days for BMA junior representatives will be run during the autumn. Details will be avilable from local BMA offices. As an accredited trade union representative, the BMA junior representative has certain rights and entitlements to time off for activities and duties for which the BMA is recognised by the employer for the purposes of collective bargaining. Representatives will also be entitled to reasonable time off for relevant training.


    Now, more than any time before, is a vital time for junior doctors. Juniors are a strong force within the NHS, and they need local people willing to represent them. BMA junior representatives will gain experience and learn valuable skills that will be essential for the rest of their working lives. They will learn about terms and conditions of service for medical staff; they will be trained in and have experience of negotiation and representation at trust level. They will learn how to communicate with NHS managers, medical personnel departments, and their colleagues—all essential interpersonal and managerial skills for the future. They will be encouraged to become active in regional and national BMA structures and representation. They do not need to be great politicians; they do not even need to be elected on a tidal wave of enthusiasm from their junior messes. All that is required is for juniors to contact their local BMA office and talk about it. We look forward to hearing from you.

    See also:

    Gray C. Getting on in (and off on) medical politics. BMJ 1997;Classified suppl: 3 May

    Duties of the BMA junior representative

    Attending local negotiating committees meetings, regional Junior Doctors Committee meetings, and BMA mess meetings

    Attending local staff liaison groups

    Being involved in local disputesin particular, disputes over the New Deal or additional duty hours, and work intensity claims

    Being a point of contact, in addition to local BMA office staff, for local juniors with queries about their terms and conditions of service

    Where appropriate, accompanying BMA industrial relations officers to meetings with medical staff

    Campaigning on behalf of the BMA locally and recruiting new members to the association

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