Junior doctor England Contract

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On-call working

Read the latest guidance on the junior doctor contract 2016

The new terms and conditions for the 2016 junior doctor contract includes a range of new rules and restrictions around on-call working.

This includes the definition of on-call working, declaration of fatigue when on-call to your employer plus how these arrangements are agreed locally by your LNC (local negotiating committees).

Read our guide on the new rules for on-call working.

Key information

  • New on-call rules

    It is important to note that in the new TCS (terms and conditions) of the new contract, the definition of on-call has changed.

    On-call is when you are required by the employer to be available to return to work or to give advice by telephone but are not normally expected to be working on site for the whole period.

    A junior doctor carrying an ‘on-call’ bleep whilst already present at their place of work as part of their scheduled duties does not meet the definition of on-call working.

    The principle behind the way on-call duty works in the new contract is that an ‘availability allowance’ of 8% of basic pay is paid for the whole duty, and all hours worked while on-call are paid at the prevailing rate.

    The average number of hours work expected to be done during the duty are calculated prospectively, and the doctor is paid for these hours. There is a mechanism to claim payment for extra hours of work done on top of the prospective average, and similarly rules ensuring a doctor is sufficiently rested if they end up having to work more hours than was expected.

  • Sufficient rest and declaration of fatigue

    Within the TCS of the new contract, there is a clear definition of what ‘sufficient’ rest during an on-call period looks like:

    “Whilst on call, a doctor should expect to get eight hours rest per 24-hour period, of which at least five should be continuous rest between 22:00 and 07:00”

    It is vital that junior doctors are able to exercise their right as defined in the new contract to self-declare as too tired to work safely if this on-call period rest requirement has not been met. The contract (schedule 3 paragraph 33) states clearly that:

    “If, as a result of actual hours worked during the on-call period, a doctor’s rest has been significantly disrupted, as defined in paragraph 30 above, the default assumption is that the doctor may be unsafe to undertake work because of tiredness, and if this is the case, the doctor must inform the employer that the doctor will not be attending work as rostered, other than to ensure safe handover of patients. No detriment to pay will result from the doctor making such a declaration.”

    There is to be no assessment by the employer of the doctor’s ability to work safely or level of rest received, and if a doctor has not received the required rest and feels unable to work, they do not request to not attend work but inform their employer that this is the case. Arrangements for dealing with this issue must be agreed locally.

  • Negotiating local agreements

    As part of the new contract, LNCs (local negotiating committees) are now responsible for arrangements relating to declaring fatigue as a part of on-call working.

    We've outlined what LNCs can do as a part of this new negotiating role.

    Advocacy role

    LNCs should take the lead in advocating for what they believe is a practical and fair protocol for the arrangements for this new rule. The contract specifies that the arrangements must be agreed locally, so you do not have to accept an arrangement that is unsatisfactory.

    Involving the new local junior doctor forums in this process, if these have been developed locally already, is a good way to ensure the new arrangements have buy-in from the junior doctors who are going to be using them.

    Negotiating in different regions

    All employers and regions are different, therefore it is not useful to have one centrally prescribed process that is recommended to be used everywhere. This is an opportunity to negotiate the best deal possible in your particular area. Ask local junior doctors what they want and how they want this to work for them, and use this as the basis for your proposal.

    Informing employers

    Ensure the timeframe for informing the employer is reasonable – employers will understandably want as much notice as possible if a rostered doctor is not going to be able to work.

    It is important to ensure the process for informing the employer is simple and easy to use.

    Arbitrary notice periods (such as X hours before the shift is due to start) may well not be practical, if the on-call period was immediately prior to the shift due to be worked. If you have a sickness absence notification policy that you are happy with, this may be a useful point of reference.

    Make sure the process agreed allows for quick submission and response, for example a written form or notification in person is obviously not going to be not fit for purpose as the doctor must be able to inform the employer from home. Given the likelihood of the short notice being given in this situation a range of options, for example text message, phone call and email, could prove an ideal solution.

    Working with junior doctors

    Ensure juniors are fully informed of their rights, and resist any attempts to incorporate a ‘request’ or ‘permission’ element to the process. Juniors will be informing their employers they are not able to work if they feel they cannot work safely, not asking for the time off from their shift. 

  • Further information

    If you have any concerns about on-call working or have any issues with declaration of fatigue, BMA members can get in touch for employment advice and support.

    Call 0300 123 1233 or email us.