An effective contract for medical professionals. Efficient contract and performance evaluation criteria

The program for the gradual improvement of wage systems in state (municipal) institutions, which was approved by the Government of the Russian Federation on November 26, 2012, set clear goals:

maintain human resources;
increase the prestige of work in budgetary medical institutions;
bring wages medical workers according to the quality of their work.

One of the mechanisms for achieving the set goals is the introduction of an effective contract, including in healthcare. The term itself is not fixed in labor legislation and implies an employment contract containing the criteria for assessing labor efficiency, which are necessary to determine the size and conditions for incentive payments. We provide an example of an effective healthcare contract for a nurse.

What to include in an effective healthcare contract

Parameters of the stimulating part wages in healthcare should provide:

differentiation of wages for those who perform work of varying complexity;
pay scheme based on performance;
activities according to the given indicators.

In an effective contract in healthcare, the criteria for evaluating work can be as follows:

fulfillment of production norms, loads;
patient satisfaction with treatment outcomes;
no complaints;
absence of complaints during the quality examination (internal and external);
observance of discipline;
completeness of performance of official duties, etc.

Regulations on payment of healthcare institutions, as a rule, also provide for other incentive and compensation payments:

bonus for labor intensity;
award for high performance;
award for the performance of particularly important and responsible work;
for quality;
availability allowance qualification category;
seniority bonus;
allowance for continuous service;
additional payment for the performance of work of various qualifications;
extra pay for night work.

In addition to the agreement itself, which will be concluded with new employees, a budgetary institution needs to develop an additional agreement to the employment contract, which will be concluded with existing employees upon transition to an effective contract.

Download a sample of an effective healthcare contract for a nurse

Download a sample supplementary agreement to a doctor's employment contract

How to switch to an effective contract

Implementation algorithm as applied to a specific medical organization next:

The head of the organization issues an order to implement an effective contract.
A commission or working group is created to carry out the work. The composition should include representatives of workers (in the person of the primary trade union organization).
Indicators of the effectiveness of the activities of the organization's employees are developed on the basis of those approved by the executive state authorities or the local government.
Model labor contracts are being developed for newly hired employees.
Additional agreements are being developed to the employment contracts of those who are already working.
Employees are notified of changes in the employment contract in writing no later than two months in advance.
Amendments are being made to the Regulations on wages (and, if necessary, developed anew) on the appointment of incentive payments depending on the results of work and the quality of public (municipal) services provided. Employees get acquainted with the changes under the signature.
The job descriptions of employees are being adjusted in terms of new labor functions. Changed job descriptions brought to the attention of employees under the signature.

The employee may refuse to conclude an additional agreement to the employment contract. In this case, the employer is obliged in writing to offer him another job available in the organization, including a lower paid one that the employee can take (part 3 of article 74 of the Labor Code of the Russian Federation).

Most often, a budgetary institution completely switches to new system wages, so it will not be possible to find a vacancy that will not fall under the new conditions. In this case, there is only one way out - to terminate the employment contract (clause 7, part 1, article 77 of the Labor Code of the Russian Federation).

An effective contract in healthcare is a special form of employment contract with a health worker, which details and similarly sets out such provisions as his labor function, conditions for earning money and accruing payments that stimulate effective activity.

The procedure for drawing up a new form of an employment contract has its own characteristics, which are set out in legislative acts.

From the article you will learn:

Transition to an effective contract in healthcare

Legislatively, the transition to an efficient contract is enshrined in Decree of the Government of the Russian Federation No. 2190-r dated November 26, 2012. The end date for the planned activities is 2018.

With regard to the healthcare sector, it follows from the meaning of the document that changes in the budgetary sphere are taking place to motivate medical personnel in their activities, as well as to increase the attractiveness of medical profession for young professionals.

In the new forms of employment contracts, the medical institution should clarify and detail the content, criteria for evaluating the performance of its work, the size and conditions of incentive and incentive payments.

The legislator clarifies that the conditions that relate to the amount of remuneration must be set out in a form accessible to the employee, not to allow unambiguous wording.

Note that the concept of "effective contract" is not enshrined in the Labor Code of the Russian Federation. This means that “employment contract” is used as the main wording.

Therefore, all legal relations that, one way or another, are connected with the conclusion or change of an effective contract occur according to the same rules as before. The employer should be guided by them in the field of new rules.

The order of the Ministry of Labor of the Russian Federation No. 167n dated April 26, 2013 contains recommendatory provisions on the registration of employees budget institutions with the conclusion of an effective contract under new conditions.

Consider general provisions concluding a contract with employees who are working and only coming to work, then we will move on to special cases.

An effective contract in healthcare with a new healthcare worker

Since no new norms have been introduced in the Labor Code of the Russian Federation regarding the conclusion of an employment contract, the medical institution must conclude with its employees according to the previous rules.

However, in the conditions of transition to an effective contract, it is necessary to take into account the provisions that are provided for in the main acts:

existing in a medical facility;
the current system for calculating the salaries of medical workers, the procedure for establishing allowances and various payments for them, the size of official salaries, etc.;
working conditions according to the results of the conducted SOUT;
the mode of work time of employees and their rest from their immediate duties;
the staffing table of the medical institution, which sets out its structure and the number of positions and rates by profession;
specific conditions labor of certain categories of workers, if they are present - for example, traveling work, mobile, etc.

Since an effective contract provides for work with criteria and indicators of the performance of health workers, the employer must take into account guidelines on this issue, which are set out in the following documents:

order of the Ministry of Health of the Russian Federation No. 421 dated June 28, 2013 (criteria and performance indicators for employees of subordinate medical institutions, managers and main categories of employees);
order of the Ministry of Labor of the Russian Federation No. 287 dated July 1, 2013 (criteria and performance indicators for employees of institutions in the social services population).

Each medical institution should develop and approve a standard contract (labor contract) according to the new rules, which is supplemented and specified for each new employee.

Change of conditions upon transition to an effective contract

Once again, we note the conditions that should be detailed in an effective contract, as a form of an employment contract:

labor function of the employee;
sum official salary;
conditions for the provision and amount of compensation payments;
conditions for granting and the amount of incentive payments.

In other words, this is still the same employment contract, but which describes in more detail what exactly the employee does in his position, what volumes of his work are provided for and how he is calculated for a job well done.

In a programme, approved by resolution Government No. 2190-r dated November 26, 2012, an exemplary form of an effective contract is also given, which is the basis for budgetary organizations, including those in the healthcare sector.

Let's consider some practical questions which arise at heads of medical institutions.

1. Is it necessary to terminate the previous employment contract with an employee who already works in a medical facility?

It is impossible to terminate the current employment contract with an employee, since only some of its provisions have changed. They are drawn up in the form of an additional agreement, which will be an integral part of the previous document.

2. Is it necessary to enter into an effective contract with a part-time employee, for example, with a paramedic who works at 1.75 rates?

Any employment contract is concluded with all employees of a medical institution, and the form of an effective contract is no exception.
If a paramedic is hired part-time, above the main rate, then two contracts are concluded with him - one for the main rate (1.0), and the second - for 0.75 of the internal part-time rate.
Similarly, in a situation where a health worker has already been hired on a part-time basis and is undergoing the procedure for implementing an effective contract. Two additional agreements will be signed with him - at the main place and part-time.
The same rules apply to external part-timers.
These demands are quite justified, since the reform public sector involves specifying the labor functions of employees and indicators of their efficient operation. This means that in any case, changes must be reflected in all labor contracts in force at the medical institution.

3. Is it necessary to draw up an effective contract in healthcare with specialist consultants (for example, doctors), if not labor contracts were previously concluded with them, but civil law contracts?

The health worker refuses to switch to an effective contract

An effective contract in healthcare and its essence is not always clear to the employee, and he may refuse a new form of employment contract.

It must be understood that such a refusal always entails certain legal consequences.

If the health worker does not want to sign an additional agreement to the concluded employment contract, in which the conditions of his remuneration and labor function are set out specifically, then the head of the medical institution must offer him another job.

The proposed job may not suit the health worker, or the employer may not have vacancies at the moment - in this case labor Relations terminated with the employee.

We recommend that you initially explain in detail to the employee that the new form of the employment contract is supplemented, and it will always specify the conditions for the employee’s work and his remuneration for this work.

In the resolution of the Plenum of the Armed Forces of the Russian Federation No. 2 dated March 17, 2004, it was said that when an employer notifies an employee of a change labor agreement, then it is his duty to indicate that the changes are due to new technological or organizational labor conditions.

Government Decree No. 2190-r states that the introduction of a new system of rationing and remuneration of employees in a medical institution can be indicated as new organizational conditions.

In accordance with Art. 77 of the Labor Code of the Russian Federation, one of the grounds for terminating an employment contract is the employee's refusal to continue his activities in the employment contract.

We summarize the procedure for the refusal of a health worker to issue an effective contract:

The medical institution warns its employees in advance that the terms of their employment contracts will change two months before them;
If the health worker does not agree to continue working in the new conditions, then in writing the employer is obliged to offer him another available position that corresponds to the level of knowledge and qualifications of the employee. In another locality, vacancies can also be offered, but only if this is provided for by the edition of the employment contract or local act medical institutions;
If there is no suitable job or the health worker refuses it, then the employment relationship with him ends. The personnel department in the order for the dismissal of such a health worker should note the absence of a suitable position, or that the employee refused the proposed options.

How to draw up an additional agreement with an employee

All those sections and clauses of the additional agreement that contain the amended terms of the employment contract should begin with the words: “The section ... of this employment contract should be stated in new edition: …».

The introductory section of the agreement with the health worker to the employment contract consists of the following information:

details of the document, the date of its preparation and registration number;
date of conclusion of the agreement to the employment contract;
full details of the health worker with whom the agreement is concluded (name, position);
name of employer and legal basis for action official on behalf of which the agreement is concluded (for example, on the basis of a power of attorney or a charter).

Below is an example of the design of the introductory section of an additional agreement with a health worker.

Additional agreement

to the employment contract No. ___ dated ____

"__" ___________ 20__

___________________________________________________________________________,

(name of the institution in accordance with the charter)

in the person of _____________________________________________________________________,

(position, full name)

acting on the basis ___________________________________________________

(charter, power of attorney)

__________________________________________________, hereinafter referred to as

employer, on the one hand, and ____________________________________________,

(Full name.)

hereinafter referred to as the employee, on the other hand (hereinafter referred to as the parties)

have entered into this Supplementary Agreement as follows:

Download an additional agreement with an employee, sample / form >>

Description of the work function of a health worker

When concluding an effective contract with a specific health worker, it is necessary to indicate in its text:

The name of his position (for specialists, employees and managers).
Working specialty or profession (for working personnel).
What kind of work is specifically assigned to the employee.

It must be remembered that if work in a particular profession or position is associated with the receipt by the employee of any preferences and benefits (preferential professions), its name must comply with the professional standard and the qualification directory.

The correct job titles are given for health workers in, which is approved by order of the Ministry of Health of the Russian Federation No. 1183n dated December 20, 2012.

To find the correct job title or profession for non-medical personnel, refer to the following sources:

single qualification guide(Order of the Ministry of Health and Social Development No. 541n dated July 23, 2010);
positions of managers and specialists (Decree of the Ministry of Labor of the Russian Federation No. 37 of 21.08.1998);
tariff-qualification directories of working positions;
all-Russian classifiers, approved by Rosstandart (for example, order of Rosstandart No. 2020-st of 12/12/2014, resolution of Gosstandart No. 367 of 12/26/1994);

For some positions, you additionally need to specify:

specialty - for a specialist doctor, in the direction in which he has training and directly performs these duties (for example, an endocrinologist);
the name of the section of medical activity - for the deputies of the chief physician (for example, the deputy chief physician for the medical part);
the full name of the medical position according to the profile - for the head of the department of a medical institution (for example, the head of the surgical department - a surgeon);
the name of the position with the specialty - for the doctor of the admission department (for example, the doctor of the admission department - general practitioner).

For the titles of positions of medical workers, in accordance with the Decree of the State Standard of the Russian Federation No. 367 of December 26, 1994, the words “senior”, “district”, “leading”, “district”, “chief” can be used in addition.

For example, head midwife, district paediatrician, head nurse, head nurse, etc.

Consider a practical situation:

It is necessary to correctly indicate the position of the head of the CDL, which medical education does not have.

The correct title of the position of the head of the CDL is “head of the clinical diagnostic laboratory - laboratory assistant”. A specialist who worked as a laboratory doctor before 01.10.1999 may be appointed to such a position.

As follows from the nomenclature of medical workers, approved by order of the Ministry of Health of the Russian Federation No. 1183n dated December 20, 2012, the title of the head of the department of the medical institution must be assigned the name of the medical position according to the profile of activity.

The only position that a specialist without medical education can take is a laboratory assistant. In this case, the document contains a clause that only a specialist who was hired for this position before 10/01/1999 can work as a laboratory doctor. If the relevant specialist was hired later, then he cannot take the position of head of the CDL or laboratory assistant.

Specification of the labor function in an effective contract

An effective contract in healthcare allows you to explore in detail labor obligations employee during his working hours.

It is not necessary to indicate exactly how many positions an employee occupies, for example, 0.25 rates. You must enter the total number of hours worked per week.

Also, in an effective contract that specifies the working conditions of a health worker, you can also indicate that the employee combines several positions or professions.

For example, in conditions of shortage of personnel, many nurses also perform the functions of a nurse. This time is not worked out in excess of the norm, since the employee performs this work during his main working day in addition to the main duties stipulated by the employment contract.

The employee is involved in the combination by agreement with the employer, the volume, content and are discussed.

The consent of the employee is reflected in writing. So, you can conclude an additional agreement with an employee or take from him written agreement, after which the corresponding order of the chief physician is issued.

The description of the labor function should be supplemented with specific duties performed.

It can be indicated that labor standards health worker are established by the official system of work rationing of the medical institution.

The job description can be taken from the job descriptions, which are based on qualification characteristics, approved by order of the Ministry of Health and Social Development No. 541n dated July 23, 2010.

If for specific position a professional standard has been developed - the necessary wording can be taken from this document.

Below is an example of a job description for a pediatrician.

The duties of the employee is to provide medical assistance to the children's population. Including:

Examination of the patient in order to establish his diagnosis;
Appointment of medical and diagnostic measures for the children's population, monitoring their safety and effectiveness;
Development and implementation of individual rehabilitation programs;
Sanitary and educational work with children and their parents, the formation healthy lifestyle life of the population;
Preventive activities of the health status of children in various age groups, as well as an analysis of its effectiveness;
Supervising the activities of a subordinate middle and junior medical staff.

It is undesirable to record in an additional agreement that the employee must perform a certain amount of work (for example, to conduct a certain number of tests, studies, appointments, medical examinations).

Also, it cannot be said that a health worker provides assistance only to certain groups of the population, for example, only for paid medical services.

Indication of the specific type of work assigned to the employee

An indication of the specific duties assigned to the employee must be made if the health worker does not perform all the duties provided for the position of a doctor, but, for example, part of them.

Job responsibilities of specialists are formed based on the qualification characteristics approved by the order of the Ministry of Health and Social Development No. 541n dated July 23, 2010.

If a doctor performs only a part of the functions provided for a specific position, for example, he will conduct an appointment and consultation, conduct only a specific study - an ECG, then they should be listed in an effective contract.

Also specific view assigned work is indicated at the conclusion of a fixed-term employment contract. For example, if an employee is hired to carry out preventive vaccinations for specific indications, for example, during a flu epidemic.

An employment contract or an effective contract in healthcare must necessarily contain the name structural unit in which the health worker will carry out his activities.

When specifying the structural unit, it is important to check with staffing medical institution and the list of departments of medical institutions, which are approved by the Decree of the Government of the Russian Federation No. 781 of October 29, 2002.

The employer's mistakes will lead to negative consequences for the employee - with inaccurate wording, the employee may lose his right to receive a preferential early pension.

Salaries in an effective contract

When reflected in the text of an effective contract official salary, it is necessary to indicate its amount in accordance with the regulations of the subject of the Russian Federation, which determine the salaries for the PCG.

PKG are reflected in the following regulations:

Order of the Ministry of Health and Social Development of the Russian Federation No. 526 of 08/06/2007 (for pharmaceutical and medical workers);
Order of the Ministry of Health and Social Development of the Russian Federation No. 247n of May 29, 2008 (general industry job titles of specialists, managers and employees); Order of the Ministry of Health and Social Development of the Russian Federation No. 248n of May 29, 2008 (working specialties and professions).

In which PCG is the position of the head (chief physician) of the medical institution?

Professional qualification groups in accordance with Art. 144 of the Labor Code of the Russian Federation are dedicated groups of positions of specialists and professions of workers.

They do not include the positions of heads of medical institutions, including the chief physician.

In addition, the PCG of a doctor is not provided for by orders of the Ministry of Health and Social Development No. 526 and No. 247n.

The remuneration of the heads of medical institutions is established in the manner established by the Decree of the Government of the Russian Federation No. 583 of 08/05/2008, in regional acts, in documents municipalities and in the constituent documents of the medical institution.

In regional medical institutions, it is possible to establish official salaries for employees not according to the PCG, if such an order is directly regulated by a regional act.

Federal medical institutions can also use non-PCG salaries, however, this is not recommended.

Consider two practical situations that are associated with the establishment of official salaries for health workers.

1. Can an employee be given an official salary below the minimum wage.

The medical institution can set official salaries that are lower minimum wage labor, but the amount of the entire monthly salary of a health worker cannot be lower than the minimum wage established for the region or country.
It should be taken into account that the salary of medical workers consists, in addition to the salary, of other payments - stimulating and compensatory in nature. Therefore, a salary that is lower in size cannot be regarded as a violation.
However, it is important to remember that often other payments may depend on the fulfillment by the employee of certain conditions in his activity, so it is important to take this into account when determining the salary.
In recent years, medical institutions and other public sector organizations have been striving to increase their employees precisely the guaranteed part of their wages, i.e. raise their salaries first.

2. Is it possible for a health worker to establish a reduced basic salary for the period of probation.

This approach does not meet the requirements of the law.
When hiring an employee for a probationary period, this condition must be spelled out in his effective contract. It also indicates the conditions for remuneration of his work, including the specific amount of the official salary.
In accordance with the requirements of Art. 22 and 56 of the Labor Code of the Russian Federation, a medical institution, as an employer, must pay wages to its employees in full size, equally evaluate the equal work of their employees, including in terms of money.
This is due to the fact that the probationary period in accordance with Art. 70 of the Labor Code of the Russian Federation is initially established in order to check whether the health worker corresponds to the work assigned to him.
Official salaries are always set in terms of money, in Russian rubles.

3. Does an effective contract need to reflect the amount of the employee's official salary, taking into account personal income tax?

An employment contract and an effective contract in healthcare assume that the salary of an employee will be set in it, taking into account the income tax of an individual. As you know, personal income tax should tax all the income of an employee, his entire salary.
In this case, the medical institution acts as a tax agent for the employee, transferring the withheld amounts to the appropriate budget.
Also, in a medical institution, it is permissible to use, in addition to official salaries, daily or hourly fixed wage rates, when a health worker performs certain complex work in a certain unit of time.
The amount of such a rate does not include social, incentive and compensation payments.

Efficient healthcare contract and employee compensation

In order to reflect in an effective contract the compensation payments due to the employee, it is recommended to reflect them in the form of such a table:

in an effective contract, it is worth mentioning only those payments that form the salary of a health worker;
it is not worth mentioning the compensation associated with the processing of an employee who overfulfilled monthly rate work;
you can indicate fixed amounts of payments in rubles, or reflect them as a percentage of the amount of the salary (for example, payment for continuous work experience in healthcare - 30% of the official salary);
if the amount of a particular payment and the conditions for its calculation are precisely determined by the legislator, you can use the following wording in the contract - "other compensation payments are made to the employee in the amount determined by the legislation of the Russian Federation."

By order of the Ministry of Health and Social Development of the Russian Federation No. 822 dated December 29, 2007, lists were established compensation payments for employees of budgetary and state organizations.

The Labor Code of the Russian Federation establishes the following types such payments:

for work at night;
for work in working conditions deviating from normal (harmful factors of production);
for work in irregular working hours;
for work in special climatic conditions (Far North);
for work on weekends and holidays.

Incentive payments for health workers in an effective contract

An effective contract in healthcare, among other things, is designed to stimulate effective labor activity employees. In this regard, it provides detailed criteria and performance indicators for the staff member to receive these payments.

Reflect the conditions and amounts of these payments in a special table, which will include the following information:

the name of the payment due to the employee;
the condition of its accrual;
criteria for evaluating the activities of an employee;
the purpose of achieving a particular criterion (its indicator);
terms of payments and their frequency;
amounts or amounts of payments in relation to the official salary.

All payments specified in an effective contract must correspond to the payments and their values approved by the medical institution's remuneration system.

It is not recommended to establish payments that are not related to the performance of employees and medical institutions, as well as immeasurable and specifically uncertain payments and their conditions, for example, incentive payments for intensive work.

And on payments, an effective contract in healthcare may provide for the following wording: “on the basis of local acts of a medical institution, an employee can be given one-time incentive payments, which are provided for by the current remuneration system.”

The condition of an incentive payment is a specific requirement that a health worker must fulfill in the course of implementing their professional duties for its calculation.

For example, such a requirement may be the absence of comments from management or disciplinary sanctions.

The order of the Ministry of Health of the Russian Federation No. 421 dated 06/28/2013 refers to the use of the principle of scoring for the calculation of incentive payments. However, this provision is advisory in nature.

The frequency of specific payments can be different - once a month, once a year, once a quarter, based on the results of work.

The concept of an effective contract is enshrined in the Decree of the Government of the Russian Federation of November 26, 2012 No. 2190-r, which approved the Program for the gradual improvement of the wage system in state (municipal) institutions for 2012-2018. It is an employment contract, which describes in detail the scheme for calculating the amount of remuneration, depending on its effectiveness. All public sector employers were required to conclude such contracts with employees. Health workers are no exception.

Tasks and criteria for an effective contract in healthcare

The introduction of a system of effective contracts in the healthcare system pursues the following tasks:

increasing the prestige of work in budgetary medical institutions;
maintaining human resources;
bringing the amount of wages in line with the quality and volume of services provided.

From these tasks it follows that the main goal of the new type of contracts is to motivate medical workers to achieve more high results in professional activity, as well as a comprehensive improvement in the quality of services. For this, special criteria for evaluating the effectiveness of work are introduced, which are fixed in the employment contract. When determining them, it is recommended to rely on the Order of the Ministry of Health of the Russian Federation No. 421 of 06/28/2013 and the Order of the Ministry of Labor of the Russian Federation No. 287 of 07/01/2013.

An effective contract in healthcare: performance evaluation criteria

Examples of criteria for assessing the quality of work of doctors can be the absence of:

medical errors and deaths;
errors when working with documentation, violations of workflow and other procedures;
justified claims to the quality of work;
violations related to the performance of official duties and instructions.

As for nurses and other paramedical personnel, their work should not include:

violations in reporting, storage and accounting of drugs;
violations in the order of care and observation of patients;
complaints from doctors, etc.

The list of criteria is far from complete and may include various statistics, such as the number of patients admitted, the percentage vaccinated, and so on.

An example of an effective contract in healthcare

In the new contract, in addition to the scheme for assessing the quality of work, the procedure for various payments should be described. Usually, payment in medical institutions consists of a salary, incentive payments, compensations and bonuses. The amount of compensation cannot be lower than that established in the labor legislation. They can be accrued for combining positions, difficult and harmful working conditions, night work, for replacing an absent employee, etc.

Incentive payments, according to the Letter of the Ministry of Health No. 16-3/10/2-6752 of 09/04/2014, are paid for:

high labor intensity;
the quality of the services provided;
work experience and length of service;
performance results for a specific period.

All accrual terms additional payments must be specified for each employee.

You can download a sample of an effective contract in healthcare below.

Transition to efficient contracts in healthcare

An employee who gets a job signs an agreement drawn up according to the new rules. With those who worked in the organization before, an additional agreement is concluded, in which all innovations are introduced. At the same time, the employer is obliged to notify employees of the planned changes at least two months before they are introduced. If an employee refuses to sign an additional agreement, then the employment contract with him can be terminated, in accordance with paragraph 7 article 77 of the Labor Code of the Russian Federation. It is recommended to make the transition in accordance with the following algorithm:

The head issues an order on the implementation of new contracts.
A working group is being created, which includes representatives of the trade union, workers, and managers.
Efficiency criteria are being developed.
Model employment contracts are drawn up for new employees and supplementary agreements for existing employees.
Employees are notified of upcoming changes.
Amendments are being made to the Regulation on remuneration (on the introduction of incentive payments depending on the results of work), employees are familiarized with the document for signature.
Changes are made to job descriptions, employees get acquainted with them under the signature.

Hello, friends! In this article, I would like to talk about how, from the point of view of law, relations between a medical worker and an employer are being built today. If not so distant Soviet times the concept of an employment contract existed more in theory than in practice, today no enterprise or institution works without it.

Why is an employment contract necessary?

Your social security depends on how the employment contract is drawn up, what rights and obligations are included in it. The law strictly regulates such concepts as the duration of working hours, rest, minimum wage, working conditions, which is reflected in the contract. It is important for both parties.

However, today in a number of industries, ordinary employment contracts are undergoing changes. This applies primarily to employees. social sphere, including healthcare workers. In recent years, such a form of contract as an effective contract in healthcare has become widespread.

Exemplary examples of such a contract can be easily found and downloaded on the Internet. However, it must be understood that these are just exemplary samples, since an effective contract in force in one institution may differ significantly from that adopted in another. Therefore, you need to figure out what kind of document it is, how it differs from a regular employment contract, and whether it is really effective.

Similarities and differences

To begin with, we note by whom and when it was regulated. In November 2012, the Russian government issued a decree, the purpose of which was to regulate the issues of remuneration for employees of social institutions, including healthcare institutions. It is this document that contains the requirement to switch to the conclusion of an effective contract in the industry by 2018.

Is it possible to say that an effective contract and an employment contract are directly opposite concepts? No, this statement is incorrect. Both fit Labor law. In fact, the contract is the same contract, but more detailed. It outlines what specific labor duties the employee must perform. This important point, since before in the contract they were not repelled from them, but from the position.

Efficient work needs to be encouraged

In addition to describing responsibilities, an effective contract details the terms of remuneration. Not the minimum wage, but all together - wages, incentive payments, compensation for work during harmful conditions labor, in special weather conditions etc. The premium is also indicated, if it exists.

The contract also includes such an indicator as efficiency. To evaluate it, criteria for evaluating the work of medical workers are being developed. This is a rather difficult moment, causing different reviews when switching to a new system. It was assumed that the work will be evaluated on a point system. However, as it turned out, a special staff is needed to calculate points, which is not always possible.

Nevertheless, each health care institution itself accepts the conditions under which incentive payments are established. Their adoption must be documented and reflected, for example, in such documents as the Regulation on remuneration or incentive payments.

These payments necessarily take into account the quality of the work of the doctor, nurse and other medical workers. For example, if an emergency occurred due to the fault of an employee, a medical error was made, patients reasonably complain about the quality of treatment, then incentive payments can hardly be discussed.

On the contrary, if the work is carried out intensively, it causes good feedback, leads to a result, the employee improves his qualifications, has a long work experience, then he has the right to count on incentive payments. This approach is important not in itself, but for improving the quality of services, which occurs, among other things, due to material interest.

If an employee refuses

How does the transition to the new kind contracts? Firstly, it is not at all necessary to conclude a new employment contract with employees who are already working in the institution. It is enough to draw up an additional agreement and reflect in it all the changes that an effective contract carries. If the employee does not agree, he is offered another position. In case of refusal, the employment relationship is terminated.

Employees must be notified two months prior to switching to new form. It is developed by responsible employees of the labor department, taking as a basis the annex to the government order mentioned above. Before the transition to new conditions, documents must be developed to determine the effectiveness.

Pitfalls of innovation

The introduction of an effective contract pursued the goal of stimulating health workers to improve the quality of service delivery. At the same time, the government is taking steps to significantly increase their wages. It is assumed that this form will increase the salary so that it will be 200% of the average in the region.

Unfortunately, in practice it does not always work out as intended. Reviews of health workers indicate that the new form has disadvantages. One of them is the insufficient financing of the industry, as a result of which there is a contract, incentive payments are prescribed, people work well, but there are no funds to implement the promised.

Not everything is simple with the definition of work efficiency - it still raises a lot of questions and dissatisfaction on the part of doctors and nurses. Although, in general, the idea of an effective contract is a positive moment in the development of healthcare and in the activities of every medical worker.

If you have already switched to a new form of contract or are just about to do it, we will be glad to hear your opinion on the topic, as well as feedback on our article. Leave comments on our site, we are interested in everyone's opinion.

For any employee of a budgetary organization, the criteria for an effective contract (an employment contract with him) are extremely important. After all, the labor income of the employee, as well as the social package, directly depends on the quality of fulfillment of the relevant specified indicators in his position. We tell how the criteria are set and what they are.

Criteria as mandatory terms of the contract

Since 2012, the Program for the gradual improvement of the wage system in state and municipal institutions. Among other things, it obliges to include criteria for evaluating performance in the content of an effective contract. this employee according to accepted criteria.

The practice so far is such that often indicators and criteria for the effectiveness of an effective contract for employees:

underdeveloped;
their application is formal.

Incentive payments are of low efficiency if in the system of remuneration of employees of the institution such criteria as:

conscientious performance of duties;
labor intensity;
quality of work, etc.

This practice should be a thing of the past. Performance criteria in an effective contract must be specific and quantifiable.

In addition, the management of a budgetary organization is obliged not to stop there and constantly improve the system of criteria.

The aforementioned Program for the gradual improvement of the wage system in state and municipal institutions prescribes to clarify the criteria for evaluating the effectiveness of activities for each employee. It is when:

the conditions for receiving remuneration are clear to both the management and the employee;
criteria are not ambiguous.

EXAMPLE

One of the criteria for evaluating the performance of a manager when assigning incentive payments to him is the ratio average salary personnel of the institution headed by him for the entrusted to them official duties from all sources and the average salary for this region, taking into account the achievement of average for certain categories employees indicators for each subject of the Russian Federation.

Establishment procedure

At the institution level, the criteria for evaluating the effectiveness of an effective contract are prescribed in the internal normative act. Usually - in the Regulations on wages. It can also be:

collective agreement;
agreements;
employment contracts.

At the same time, the position of the trade union, another representative body of workers, must be taken into account.

The criteria for an effective contract are always determined taking into account the achievement of the goals and performance indicators of the institution itself.

Each state institution is supervised by the corresponding higher ministry or department. They also set the criteria for effective labor contract for your industry.

For example, the criteria for an effective contract in healthcare are enshrined in Order No. 696n dated October 31, 2014 (as amended in 2018) of the Russian Ministry of Health.

Here is a sample of criteria for an effective contract for a general practitioner:

№	Indicator	Criterion	Periodicity
1	Quality Defects medical care according to the results of inspections of the medical commission, higher and control and supervisory bodies	Absence / 1 or more	Every quarter
2	Justified complaints about the quality, volume of medical care, compliance with the dental aspects of the activity on the conclusion of the medical commission	Absence / 1 or more
3	Compliance with the quality of medical care established requirements(compliance with the timing of the examination of the patient, the volume and timeliness of diagnostic and therapeutic measures, etc.)	Compliance / Non-compliance
4	Coincidence of clinical and pathoanatomical diagnoses	Match/Divergence
5	Design defects medical records, non-compliance with reporting deadlines	Absence / 1 or more

Below is an example of an effective contract criteria for the chief accountant of a medical institution:

№	Indicator	Criterion	Periodicity
1	Compliance with budgetary and tax legislation, government decrees Russian Federation, orders of the Ministry of Health of Russia and other regulatory legal acts	Compliance / 1 or more cases	Every quarter
2	Compliance with reporting deadlines	Compliance/Non-compliance
3	No wage arrears	Compliance/Non-compliance
4	Unjustified receivables and payables	Absence / 1 or more
5	Defects in monitoring the timeliness and validity of write-offs of fixed assets	Absence / 1 or more cases