COVID-19 terms and conditions: junior doctors

Rota changes and workforce challenges for junior doctors in Northern Ireland

Audience: Junior doctors
Last reviewed: 12 October 2021
Topics: COVID 19

COVID-19 continues to present the health service and all its staff with unique and unprecedented challenges. This, alongside the backlog of elective work, and anticipated winter pressures, will result in an extraordinary burden falling on the health service and those working within it.

This may bring disruption to working patterns, conditions, teams, roles and the settings in which you work for the foreseeable future. The level of disruption is likely to vary as the state of the pandemic changes.

To ensure that efforts are sustainable in the weeks and months to come, it is of paramount importance that staff are not working in a manner that compromises their health, safety or wellbeing, nor that of their patients.


Summary of key principles

The T&Cs (Hospital medical and dental staff and doctors in public health medicine and the community health service (Northern Ireland) terms and conditions of service 2002) contain nationally agreed working hours and rest requirements, designed to protect junior doctors from excessive fatigue and burnout.

It is therefore crucial that these protections must continue to be applied in full whilst managing the ongoing COVID-19 pandemic.

All junior doctor rotas must adhere in full to the T&Cs.

Currently, trusts in Northern Ireland are not experiencing significant pressure to require redeployment of junior doctors or make significant changes to rotas, therefore rota monitoring should be taking place as normal.

The statement produced by BMA NI junior doctors committee is maintained for reference in the event that any local surges in hospitalisations due to COVID-19 require the current situation to change.


Ensuring your health and wellbeing

All rotas 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.

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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.

  • 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.
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