We've compiled answers to some of the questions you might have as a junior doctor about the impact of COVID-19 on your contract terms and conditions.
What if my rota is changed during the crisis?
While contractual safeguards should be adhered to wherever possible, the BMA and NHS Employers previously agreed steps to take in instances where it is impossible to implement the working hours restrictions and rest requirements in the TCS for junior doctors.
There will be support to ensure that rotas remain safe for doctors and for patients. The Working Time Regulations 1998 (WTR) will be the fallback position for the duration of the pandemic.
Read more about the steps to take in the joint statement from the BMA and NHS Employers and in our guidance on the joint statement, this also covers implications for LTFT trainees.
Please note that from 5 August 2020, all junior doctor rotas in England must be compliant with all the contractual rest and safety requirements of the 2016 TCS.
We have decided to withdraw from the joint statement as COVID related service pressures have reduced and in the interest of junior doctor health and wellbeing.
Read more about the withdrawal from the statement.
Can my employer ask me to work on a bank holiday that I was scheduled to have off and will I receive TOIL?
Yes, your employer can ask you to work on a bank holiday. However, they should provide you with as much notice as possible if you were not previously rostered to work.
As NHS Employers guidance states: 'It is important to recognise that staff will need time off to rest and recuperate during these challenging times and, where possible, the individual needs should be balanced against the needs of the service, avoiding cancelling of leave where possible.'
If you do any work, including being on-call, on a bank holiday then you must be paid for the hours you work and receive a standard day off in lieu that you should be able to take at a time of your choosing in the future.
Now that my rotations are frozen, will my pay stay the same?
It is hoped that as little disruption as possible will occur to trainees undertaking their ARCPs (annual review of competence training). Trainees can progress as normally as possible through the different stages of training, and therefore see your pay change in accordance with the grade you are working at.
ARCPs will now take place with reduced panels and there will be an increased focus on competencies. ARCPs for trainees at critical points in their training will be prioritised, such as trainees completing core training.
Despite this, it is possible that due to Coronavirus, ARCPs will be affected for some trainees. This may affect your ability to progress through training and (in England) move up through contractual pay points.
However, the BMA has been told that as the epidemic subsides, the education and training bodies will be working to ensure that doctors are able to catch up with missed training where possible. This detail will be developed in due course.
In addition, the BMA will be lobbying the government to provide compensation for any doctors who have experienced financial detriment due to their training progression being delayed as a result of the COVID-19 pandemic.
Will this frozen rotation count towards my ARCP?
Yes, but this is dependent on your specialty and your stage of training. While working during this frozen rotation, you will continue to develop curriculum competencies that you will be able to enter into your portfolio and will be recognised at ARCP.
However, it is vitally important that you do not practice outside of your competence, or without appropriate supervision.
What do the new ARCP COVID outcomes mean?
Outcomes 10.1 and 10.2 have been introduced for consideration by ARCP panels across the UK, and for all grades and specialties. This is to track the impact of COVID on junior doctor progression and training and assist in administration.
These new, no fault outcomes ensure that trainees that have had their ability to acquire competencies and capabilities affected due to COVID can still progress.
Medical royal colleges have revised their curricula to identify where it is possible to proceed through training. This also ensures there is time to acquire those competencies that were missed.
There are two different types of outcome 10.
- 10.1. Progress is satisfactory, but acquisition of competencies/capabilities have been delayed by COVID-19 disruption. The trainee is not at a critical progression point, so may progress to the next stage of their training. Additional training time will be assessed at the next ARCP.
- 10.2. Progress is satisfactory, but acquisition of competencies/capabilities have been delayed by COVID-19 disruption. The trainee is at a critical progression point, and additional time is required.
A critical progression point could be:
- the end of your core training programme
- your CCT (certificate of completion of training) date
- the point in training where you would normally require an exam to proceed to the next stage of training.
However, this is not a finite list and your progress through training may have other key progression points.
If you are given an outcome 10.1
You will be able continue through to your next stage of training, including access to pay nodes as appropriate in your contract.
If you are given an outcome 10.2
Some specialties may allow you to progress using an outcome 10.2, even if you are at a critical progression point. Make sure that you are up to date with the developments in your specialty curriculum.
The use of normal ARCP outcomes
The introduction of outcome 10s do not prevent the continued use of normal ARCP outcomes, depending on the circumstances of your training.
Outcome 10.1 or 10.2 should not be used instead of awarding an outcome 1 or 6 if the trainee fulfils the requirements for these outcomes.
They will be used in place of awarding outcomes 2, 3 or 4, unless the reason for an unsatisfactory outcome is in no way related to COVID-19, and couldn’t have been mitigated were it not for COVID-19.
What do I do if I get an ARCP outcome I wasn’t expecting?
No ARCP outcome should be a surprise for any trainee. We know that there can be times when communication between supervisors and trainees has been challenging, or trainees are given an outcome that they weren’t expecting.
All trainees that receive an outcome 2, 3, 4, 10.1 or 10.2 will require a meeting with a senior educator, or ARCP panel member, within two weeks of being informed of their ARCP outcome. This is to provide a full explanation of how and why the decision was reached.
Contact us if you need support you with your appeal or any other issues in your postgraduate training that you face.
We have a range of services to support you.
- Peer support
- UK wellbeing support directory
Call our free and confidential helpline on 0330 123 1245
Are employers allowed to freeze rotations at such short notice?
HEE and the devolved nation education and training bodies have taken this unprecedented step to freeze this rotation in order to avoid disruption at this sensitive time.
If doctors were to rotate during the crisis, there is a risk that this could create instability that would not benefit patients, nor doctors who are rotating.
There is no provision that prevents freezing of these rotations, albeit the BMA expects rotations intervals to return to normal following the conclusion of the epidemic.
Will this affect any leave I had booked in my next rotation?
It is not yet clear when doctors will next rotate, given the nature of the outbreak. This is a fast moving situation, and further advice will be given when rotation is likely.
In any case, if you do have leave booked for a set time in the next 12 weeks that your current employer is not aware of, we advise you inform them as soon as possible in order to avoid any issues should the epidemic continue long term.
Due to the pressures that the NHS is currently under, it is possible that any pre-booked annual leave may be cancelled by your employer. Please see our guidance for all doctors regarding your employer’s ability to cancel annual leave.
I am concerned about the level of supervision that I am receiving for my post – what do I do?
If you have concerns about the level of supervision, then you must raise this with your training programme director as soon as possible.
If the issue is more persistent, we advise that you raise this further with your postgraduate dean, as well as your foundation school director if you are currently in the Foundation Programme.
If you have not moved from your department or employer, you must have a named ES (educational and clinical supervisor). You should seek to resolve any issues with them first.
Alternatively, trainees in England may wish to consider raising these issues with their freedom to speak up guardian in parallel, who may be able to provide additional support and information to you as you escalate issues.