COVID-19 terms and conditions: all doctors

Guidance on some of the concerns you might have as a doctor about the impact of COVID-19 on your contract terms and conditions.

Location: UK
Audience: All doctors
Updated: Friday 20 November 2020

Annual and study leave

Cancelling leave

Employers can lawfully cancel pre-booked days of annual leave, however they have to act reasonably. For example, if it is an important family event then it might not be lawful to cancel your holiday.

You have a good argument for asking for reimbursement of any reasonable losses you suffer (unless already covered by insurance).

You employer is obliged to offer at least one day notice for each day of leave. In the first instance, employers should do this on a voluntary basis rather than enforcing cancellations.

We are emphasising the importance of our members having enough rest and recuperation time in order for their own personal wellbeing and that of patients.

Please ensure that your LNC rep/chair is aware of your concerns.

Study leave

Employers can cancel pre-booked days of study leave to meet service requirements, however the employee has a good argument for asking for reimbursement of any reasonable losses they suffer.

Read more about annual leave and study leave for junior doctors.

Carrying over leave

Temporary statutory rules introduced by the Government mean that employees who are unable to take their annual leave entitlement due to COVID-19, can carry over up to 20 days (pro-rated for part-time staff) of annual leave over a two year period.

For contractual annual leave, NHS Employers have issued guidance for England stating where employees cannot use their full entitlement of annual leave because of the pandemic, employers should consider revising their local policies to exercise maximum flexibilities in relation to carrying over of leave to the next leave year.

 

Acting outside of your usual role

Due to the exceptional circumstances of the pandemic, staff or students can be asked to act outside of their normal role.

However, you need to continue to work within your scope of competence and receive adequate training and supervision.

No doctor or student should feel pressured to undertake duties which they do not feel competent to perform and should feel entitled to challenge any request that they do not feel comfortable with. Contact the BMA for support if this is the case for you.

You should seek confirmation of indemnity cover for any revised roles and you may wish to contact your MDO (medical defence organisation) and employer to confirm this before starting work in a new area.

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If you are pregnant

Employers have a legal obligation to assess the workplace risks for pregnant employees and their unborn children. They must keep these risks under review as circumstances change and as your pregnancy progresses.

If risks are identified they must mitigate those risks and, if that is not possible, redeploy you to suitable alternative work with no loss of pay. If redeployment is not possible there should be suspension on normal pay (not sick pay). 

An employer’s duty to take action in relation to infectious diseases is where the level of risk at work is in addition to the level to which a new or expectant mother may be expected to be exposed outside the workplace.

The RCOG (Royal College of Obstetricians and Gynaecologists) have published Occupational health advice for employers and pregnant women during the COVID-19 pandemic. It says pregnant women of any gestation should be offered the choice of whether to work in direct patient-facing roles. Your choices should be respected and supported by your employers.

It says if you are in your first or second trimester with no underlying health conditions, you should practise social distancing but can choose to continue to work in a patient-facing role. If you choose to continue working, it is strongly recommended the necessary precautions are taken.

The BMA urges you to speak with your manager, HR or medical staffing, and if possible occupational health, to ensure that risk assessments happen and action is taken to keep you and your unborn child safe at work. If risks cannot be properly managed then your employer should identify suitable alternative work that does not involve direct patient contact, including home-working.

The RCOG guidance says if you are in your third trimester (more than 28 weeks pregnant), or have an underlying health condition – such as heart or lung disease – a  more precautionary approach is advised and you should work from home.

Starting maternity leave early

The earliest that maternity leave can begin is 11 weeks before the due date. 

The question above answers some steps you can take first. 

If you are off work sick and it is less than four weeks before your due date, your employer can require you to commence your maternity leave earlier. 

You may have the option to start maternity leave early by taking annual leave which leads into your maternity leave. You will need your employers agreement to do this. 

 

If you are at increased risk

Governments are advising that those who are at increased risk should be particularly stringent in following social distancing measures.

This includes those under 70 with an underlying health condition, and those aged 70 or older, regardless of whether they have any medical conditions.

While this stops short of recommending self-isolation, it does recommend measures which would be hard to reconcile with delivery of some frontline services.

NHS employers are being advised to engage with staff who are categorised as being at ‘increased risk’ and jointly consider whether adjustments to work or redeployment might be appropriate.

In the event that you are asked to self-isolate, you should do so as quickly as possible. NHS staff receive full pay whilst in self-isolation.

‘Full pay’ is paying what the staff member would have otherwise earned if they were not in isolation, inclusive of any enhancements. 

Read more about doctors isolating and those in vulnerable groups.

 

If you have a recognised disability

Your employer still has a duty to make reasonable adjustments under the Equality Act 2010 to enable you to work safely and effectively and avoid any substantial disadvantage linked to your disability.

What is reasonable might change, or different adjustments may be needed as the COVID-19 pandemic progresses. You should speak with your line manager, and if necessary occupational health, if you require further adjustments. You should work together to identify what adjustments are going to be practical for the employer and effective for you in the current circumstances. If you have any difficulties contact the BMA.

If you have a disability or long-term health condition which has not previously required adjustments but the current circumstances are likely to make adjustments necessary, you should inform your employer as soon as possible.

If you have an underlying condition which increases the risk of serious illness from COVID-19, NHS Employers guidance encourages adjustments to be made or redeployment to work such as virtual patient consultations to protect you.

 

Working outside of your specialty and indemnity

If you're concerned about indemnity - you should explain your concerns immediately to your manager. Ask that other arrangements are made if you are asked to perform tasks you do not feel competent to carry out.

In an emergency, where there are no alternatives available, you should provide the safest care that you are able to provide in the circumstances, with the aim of providing overall benefit for the patient.

NHS clinical negligence indemnity schemes will cover any doctor working outside their normal field of practice during the COVID-19 pandemic.

If your clinical duties have changed, you may need to inform your medical defence organisation to ensure you maintain your indemnity cover.

Specific advice on personal professional indemnity and working outside your usual field of practice is available from the MDU, the MPS and the MDDUS.

 

Reducing your hours for childcare

You can discuss this with your clinical manager and, if necessary, HR.

We would expect employers to consider these issues sympathetically in current circumstances so that both parties can achieve a solution through altering your hours.

Your pay should not be reduced if your request is directly related to increased childcare responsibilities from your normal childcare stopping due to social distancing restrictions.

You have a legal right to take time off work to look after dependants (including children). You should refer to your employer’s policy to check whether this would be paid or unpaid and the process for this.

If agreement cannot be reached you should contact us. We may be able to discuss this matter with your employer directly and, in extreme situations, support you in a work schedule appeal or with the job planning process.

Need help? For 24/7 emergency COVID advice please call us. For all other non-emergency enquiries normal opening times apply.