COVID-19 terms and conditions: junior doctors

Rota changes and workforce challenges for junior doctors in Northern Ireland

Audience: Junior doctors
Updated: Friday 20 November 2020
Topics: COVID 19

COVID-19 presents the health service and all its staff with unique and unprecedented challenges. It has become clear that this is likely to bring significant disruption to your normal working patterns; your working conditions; your teams, your role and the locations in which you work. Your employer will seek to change your working arrangements.

Our key principles:

  • employers and rota coordinators should involve junior doctors in any change to rotas

  • flexibility and good communication by both doctors and employers is key

  • any changed rota will be temporary and must be kept under review

  • keep a written record of what is agreed as it may be required at a later time – even if this is in the form of email correspondence

  • you cannot be required to work outside of your competency level.


Risk assessment

  • All doctors should have a risk assessment, including those returning to the HSC and existing staff.
  • Risk assessments should be done in a one-to-one setting, recognising this will require sensitive discussions. For doctors who work in multiple settings, you may require separate assessments.
  • Whilst it is your employer’s duty to provide a risk assessment for all doctors, you may request one if, for example, you have been previously shielding or feel that you are in a high risk group.
  • If you are working in a hospital, it is generally your line manager who will carry out a risk assessment with input from an occupational health service where available.
  • You can also ask for an existing risk assessment to be repeated if you think there has been a significant recent change in your circumstances which might increase your risk of COVID-19.


Trainee redeployment

Any redeployment of trainees as a consequence of COVID-19 must be with agreement with the postgraduate dean and in consultation with relevant trainees. It will follow the principles set out in the four nation statement by NIMDTA and the other national NHS education bodies.


Ensuring your health and wellbeing

  • Any revised rota must still provide you with sufficient rest and breaks to ensure both patient safety and your own health and wellbeing.
  • Rotas should, where at all possible, incorporate a degree of redundancy to ensure unexpected absences can be covered.
  • Annual leave requests should be honoured as far as reasonably possible and factored into any changes to avoid burnout, excess fatigue and ill-health.

If you have difficulty in working the new temporary rota due to caring responsibilities, disability etc, discuss this with your employer. If you encounter any difficulty, contact us.


Hours limits

Current rules regarding working hours still apply to ensure your safety.

You are at liberty to opt out of the EWTR maximum hours limit if you wish - you cannot be forced to do this. The EWTR maximum average hours limit is 48 hours over a 26 week reference period. By opting out you can work up to an average 56 hours per week. You can opt back in at any time.

EWTR also require you to have a 20-minute break rest after six hours work, a minimum 11 hours rest between each shift, and either 24 hours continuous rest in seven days or 48 hours continuous rest in 14 days. There is no opt-out from the rest requirement. 

LTFTs (less than full-time trainees)

LTFTs may voluntarily agree to work more hours for appropriate payment and this must not prejudice any application you make to work less than full-time in the future.


Rota monitoring

Current pressures on the workforce may make the monitoring process more challenging. However, monitoring is the only method to provide empirical evidence to ensure you are appropriately remunerated.

  • In the unlikely event that your temporary rota is banded lower than your current rota you should continue to receive the banding supplement that previously applied.
  • To check the banding for a new working pattern, use the BMA banding calculator.
  • Doctors in the training grades, including flexible trainees and locum doctors in training employed during the whole monitoring period, should be monitored.
  • For a monitoring exercise to be valid, 75% of eligible doctors need to fully participate and 75% of duty periods worked need to be monitored
  • Monitoring is not a contractual obligation for non-training grade doctors, and they should not be compelled to complete it, nor they should be included as part of the 75% returns that are required.
  • You are required to take part in monitoring even if you are on annual, study or sick leave and on days when you are not on site.
  • You can request rota monitoring at any other time if you feel that your rota doesn't reflect the hours you work. For example, changes made to your rota due to COVID-19.
  • The banding should reflect the new working arrangement, although sometimes employers will pay for additional hours separately via locum payments.
  • Contact your trust medical staffing department to request monitoring.
Need help? For 24/7 emergency COVID advice please call us. For all other non-emergency enquiries normal opening times apply.