GP practices are not obliged to offer the 2016 terms and conditions. If they choose to, there are many non-negotiable contractual requirements that must be in place.
They apply to GP trainees employed by practices directly, and to those under a lead employer arrangement.
GP trainees employed under the 2016 contract are issued with a generic work schedule prior to starting their placement. This sets out the working hours and training opportunities in their placement. The generic schedule is then personalised, jointly by the trainee and their clinical supervisor, according to their learning needs and opportunities available in the post.
The supervisor should arrange an educational meeting to agree a personalised work schedule either before or at the start of the trainee’s placement, and they are responsible for reviewing the work schedule to ensure it remains fit for purpose.
- Read more about work scheduling
- NHS Employers - template work schedule
- NHS Employers - managing work scheduling in general practice
Work schedule review
If sessions overrun frequently, it may be necessary to undertake a work schedule review.
This is a conversation between the trainer and trainee about whether the work schedule is fit for purpose, which may prompt one or more of these outcomes:
- No change to the work schedule, but compensation in the form of pay or time off in lieu is required for one or more individual breaches of the work schedule.
- Prospective changes to the work schedule so that going forward, the trainee’s hours and/or training commitments are changed.
- Organisational changes, such as a review of the clinics and administrative tasks. It may take some time to make organisational changes, so temporary alternative arrangements should be made where necessary.
If a trainee is unhappy with the outcome of the work schedule review, they can escalate this by requesting a level 2 work schedule review within 14 days of being notified of the outcome of the first review.
If the trainee is still unhappy, they can request a final stage work review. This will involve a formal hearing with a panel including a BMA or other trade union representative.
If an educational session is cancelled, the session should still be used for educational purposes. For example, if a structured session is cancelled, an independent educational session should be taken in that time.
Trainees should exception report any changes to planned training sessions. A work schedule review may be required to agree the soonest possible date that the missed session can be arranged.
Guardian of safe working
All trainees employed under the 2016 contract must have access to a guardian of safe working. If there is a lead employer, it is their responsibility to appoint a guardian. If the practice employs trainees directly, it is the practice’s responsibility.
Practices that directly employ trainees and who have fewer than 10 GP trainees should jointly appoint a guardian. The guardian must be responsible for at least 10 trainees, OR enter a contract with a neighbouring trust to provide the guardian function for the practice.
- oversees compliance with the safeguards in the 2016 terms and conditions
- identifies and either resolves or escalates problems
- acts as a champion of safe working hours for junior doctors
- provides assurance to the employer or host organisation that issues of compliance with safe working hours will be addressed as they arise.
Scheduling out-of-hours shifts
- When designing a rota, you must ensure a minimum of 11 hours’ rest between shifts.
This means that instead of having a trainee carry out a day shift and then arranging a separate evening shift for OOH work, a single shift must be rostered to encompass OOH without any gaps.
- Individual shifts must not exceed 13 hours.
- OOH (out-of-hours) work must be deducted from a clinical shift in the same week, or a later week (if agreed), to ensure the working hours on average per week do not exceed 40 hours.
- Work schedules – including rotas – should be planned in advance, and personalised together with the trainee.
- For LTFT (less than full-time) trainees, OOH will be pro rata. This means that if a trainee works 50%, their OOH requirement will be 36 hours over the course of the year.
BMA members can check whether their rota is compliant using the rota checking tool.
GP trainees are paid a salary linked to their grade, calculated on an average of 40 hours’ work per week.
Trainees can be rostered and paid for an additional 8 hours per week on average above their 40 hours.
Additional hours will normally be considered as service provision and therefore not be eligible for reimbursement by HEE.
Breaches of hourly limits
A penalty fine, equal to four times the hourly rate, is levied by the guardian of safe working if a trainee:
- works over 48 hours on average per week
- works over 72 hours in seven consecutive days
- misses more than 25% of breaks across a four-week reference period
- if the minimum rest period of 11 hours between shifts is reduced to less than 8 hours.
|Total value of the penalty||Hourly penalty rate paid to the doctor|
|Additional hours worked attract a basic rate||x4 the basic hourly rate||x1.5 of the basic hourly locum rate|
|Additional hours worked attract an enhanced (night) rate||x4 the enhanced hourly rate||x1.5 of the enhanced hourly locum rate|