Supporting professional activities (SPA) time

This article reflects the conversations in the breakout group on this topic at the Recently Appointed Consultants symposium on Friday 13 March 2015.


It can feel like a challenge to find enough time in a 9:1 contract for the completion of SPA. Ten years ago the typical job contract would include a 7.5/2.5 direct clinical care (DCC) to SPA split, as laid out in the 2004 contract. Having a clear understanding and agreement between employee and employer of what constitutes SPA time, direct clinical care and clinical extra programmed activities (EPA) can really help.

SPA time is contracted and paid for by the employer. All SPA time should be accountable to the employer, as it is paid for within your contract. SPA activities in general include CPD, trainee supervision, teaching, quality improvement, induction, audit, job planning, research, appraisal and revalidation. So-called ‘core’ SPA time, the 1 SPA session in a 9:1 job, is what is needed to successfully complete appraisal and revalidation, and so only includes such preparation, audit and CPD.  More SPA time would be required to do any teaching, training or involvement in service planning.  Formal roles, such as being an educational supervisor or an appraiser should bring with them additional SPA time. During job planning, any specific role agreed should be allocated recognised time.

Prior to entering into negotiations over SPA time it is essential to first accurately diarise work, ideally over a three month period. Keep descriptors as part of the diary and catalogue anything that is regularly creeping into your SPA time which was not part of the original job plan. If, on reflecting on how your time at work is spent, there are repeat difficulties with ‘spill-over’ of clinical work into SPA, this could be seen as service pressure, ultimately requiring the recruitment of extra staff by clinical line managers. Terms and conditions of service should also be referenced during discussions. Study leave is not included in SPA time.

When trying to categorise work, if work influences a specific patient or patients then it is categorised as DCC, e.g. patient-related dictation, ward rounds, clinics and theatre sessions. Multidisciplinary team meetings and discussing management of specific patients should be DCC.  Appearing in court in a professional capacity is direct clinical care.

Additional duty time is made up of non-clinical work.  This can be for specific roles within the Health Board such as clinical governance lead, or formal medical management roles, or for duties for the Scottish Health Dept.

Work for the greater NHS will be regarded as other external duties – such as, but not limited to, work for the Royal Colleges or GMC, SIGN or NICE guideline development, acting as external assessor on appointment committees and trade union activity. It is advisable to discuss in advance before taking on a role which will entail a significant commitment in what had been working time.  Immediate line managers may, however, be less supportive of such activity than very senior (board level) managers, and it may be useful to bear this in mind, and be prepared to ask for agreement from more senior medical managers.

Fee-paying work is that which is not part of contractual work and not reasonably incidental to it, such as (but not confined to) private practice. Expert witness work should not be undertaken during contracted NHS time, except by prior agreement.

EPA (extra programmed activity) is made up of time over and above the core contract hours and is contracted for separately. Anything may be EPA, usually extra clinical work, but time limited roles, such as time needed to plan a new department, formal management roles, formal educational roles, may sometimes be paid for as EPA time, to avoid a loss in clinical time.

Breakout group leader:  Dr Maeve McPhillips, Deputy Chair of BMA Scottish Consultant Committee & Consultant Radiologist, Royal Hospital for Sick Children