Making a significant and sustainable impact in resource-poor settings often requires a period of absence longer than your annual or study leave allocation can accommodate.
National employment break scheme
National contracts for doctors and other NHS staff require that NHS employers provide access to an employment break scheme for all NHS staff. This is set out in Specialty Doctor and Associate Specialist and Consultant National Terms and Conditions of Service for each of the four nations of the UK.
The NHS Employment Break Scheme is an extended period of unpaid leave available for approved purposes, including working or volunteering abroad in resource-poor settings. Specific conditions apply, and you will need to clearly state the anticipated benefits of taking time out when applying for an employment break.
Employers will consider break requests alongside service delivery needs. However, an employment break should only be declined if there will be a substantial negative impact on service delivery. If your application is declined, you are entitled to a written reason for the refusal.
The experiences gained from a break in employment working abroad in a resource-poor setting can enable doctors to develop skills that could not be achieved from regular work in the NHS.
All Trusts and Health Boards should have policies setting out how employees can take a period of unpaid leave as an employment break. The process for applying may vary between employers. In some cases, the employment break scheme may be incorporated into flexible working policies.
To use this scheme, you should ask your employer's HR department for their employment break policy and relevant guidance. This should include local policies and requirements, such as length of continuous service and minimum and maximum length of employment break. (Note that the scheme should normally be open to all employees who have at least 12 months' service).
Detailed provisions for sabbatical leave are set out in section 7.4 of the Terms & Conditions for Consultants in Scotland. Consultants in other nations, and SAS doctors in all four nations of the UK, can apply for sabbatical leave in accordance with the policies of their employing organisation.
Agreements with employers
The details of an employment break should be set out in a written agreement between you and your employer before the break begins. The agreement should cover:
- Duration - National guidance states that you may take a break of up to five years. This can be taken as a single long break or multiple shorter breaks. It should be possible to extend your break, with appropriate notice, or return early.
- Continuity of service – Your agreement with your employer will need to be clear about the effect of the break on various entitlements related to length of service. Policies should guarantee that if you return to work within one year, the same job will be available (where reasonably possible). If the break is longer than one year, you should be able to return to as similar a job as possible. Information about the impact on your pension should also be available.
- Notice periods – You must normally give at least three months’ notice. We recommend giving six months’ notice, or more if possible (see section on Notice periods below).
- Arrangements for keeping in touch during the break – The agreement should clearly state your responsibilities and those of the HR department or relevant professional development personnel (see section on ‘Recording your experiences’ below).
- Re-introduction to employment – Agree any re-orientation or training you may need before returning to work.
- Resignation – You should not be required to resign if you plan to return to the NHS after your employment break.
You are normally not allowed to undertake any paid work during an employment break. There may be exceptions if, for example, work overseas or charitable work could broaden you experience. If you have agreed private practice sessions, you should clarify the terms of the local practising privileges policy with your private employer and NHS employer.
In some cases, doctors working or volunteering abroad are paid a modest living allowance and travel expenses, for example, by a charitable organisation. This should not normally be a reason to refuse an employment break. We suggest that you ask your overseas employer to confirm your salary in writing and share this information with your employer when you apply for an employment break.
If you are employed by an NHS Trust or Health Board, your manager normally signs your application for an employment break. Their manager or the head of department will then approve it. You should also tell your HR department.