In August 2016, new terms and conditions of service for junior doctors were introduced.
The 2016 contract was rejected by the BMA and the Association remains opposed to the imposition of this contract.
GP practices are not obligated to offer the new terms and conditions to any trainee they employ. However, if they choose to do so there are non-negotiable contractual requirements that practices need to have in place before offering the new contract to the trainee. These terms and conditions will apply to the GP trainee if employed directly by the practice, or under a lead employer arrangement.
It is important that GP practices understand the contractual requirements that they must adhere to.
Read our guidance for GP practices
GP trainees can find helpful guidance on the new junior doctor contract 2016 below.
As a GP trainee employed under the 2016 contract, you will be issued with a generic work schedule prior to starting their placement. This will set out the working hours and the training opportunities in your placement.
This generic work schedule is then personalised.
The personalised work schedule is developed jointly by you and the clinical supervisor, who is also responsible for reviewing the work schedule and ensuring it remains fit for purpose.
The trainer (clinical supervisor) should arrange an educational meeting to agree a personalised work schedule with you either before or at the start of your placement. This should be developed according to your learning needs and the opportunities available within the post. The meeting will take into account your personal circumstances, including any specific training needs that you may have.
For more on work schedules and what information they should include, see our guidance on work scheduling
Exception reporting is a feature of the 2016 contract which allows junior doctors to immediately report instances where your actual work and training opportunities vary from your work schedule.
Your employer must provide some form of electronic system for you to submit exception reports.
The report is sent to educational supervisors (in GP practice placements these will be approved clinical supervisors) and copied to guardians of safe working (for work issues) or the Director of Medical Education (for training issues
Clinical supervisors will review exception reports and discuss them with you to agree what action is necessary to address the issue.
See our exception reporting guide for senior doctors.
This could involve revising your work schedule, and approving claims for additional pay or time off in lieu. If a solution agreeable to both parties cannot be found, this needs to be raised with the guardian of safe working.
For further information, see our detailed guidance on exception reporting
Work schedule review
If sessions overrun frequently, it may be necessary to undertake a work schedule review.
This is a conversation between you and the trainer about whether the work schedule is fit for purpose, which may prompt one or more of the following outcomes:
- No change to the work schedule is required, 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 are made to the work schedule so that going forward from the review, the trainee’s hours and/or training commitments are changed.
- Organisational changes are needed, such as a review of the clinics and administrative tasks. If such organisational changes are needed, this may take a while to happen. In the meantime, temporary alternative arrangements should be made where necessary.
If you are unhappy with the outcome of the work schedule review, you 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 you are still unhappy with the outcome of the level 2 review, you can request a final stage work review. This will involve a formal hearing with a panel that must include a representative from the BMA or other trade union representative.
For more on work schedule reviews and detail surrounding each stage of the escalation process, see our guidance on exception reporting outcomes
Guardian of safe working
The guardian of safe working hours is a key feature of the 2016 contract.
All trainees employed under these terms and conditions of service must have access to the guardian. This is a non-negotiable contractual requirement.
If there is a lead employer, it is their responsibility to appoint a guardian. If the practice employs trainees directly, then it is the practice's responsibility to appoint a guardian.
Practices that directly employ trainees and who have fewer than 10 GP trainees should:
- Jointly appoint a guardian with a similar employer(s) so that the guardian is responsible for at least 10 trainees; or
- Enter a contract with a neighbouring trust to provide the guardian function for the practice.
The guardian is responsible for overseeing compliance with the safeguards outlined in the 2016 terms and conditions of service. The guardian will identify and either resolve or escalate problems, and act as a champion of safe working hours for junior doctors.
The guardian provides assurance to the employer or host organisation that issues of compliance with safe working hours will be addressed as they arise.
For more on appointing a guardian and what the role involves, please read our guidance for doctors undertaking the guardian of safe working hour’s role.
You may be interested in being on a recruitment panel for the appointment of a guardian of safe working.
Read our advice for junior doctors on guardian recruitment panels.