Redesigning junior doctor working patterns
Junior doctor rotas should be reviewed and re-worked to allow maximum training time and adequate service delivery. Junior doctors must always be involved in the redesign of working patterns to ensure they enable a good work-life balance and provide the necessary opportunities for training.
Clinical tutors, educational supervisor and college tutors must also take responsibility for ensuring that new rotas are good for training.
There are contractual mechanisms to ensure junior doctors and clinical tutors are involved in redesigning a rota.
Read our essential advice: rota design made easy
Junior doctors must not be pressurised into filling rota gaps, especially where there is a risk of New Deal or EWTD breaches and or exhaustion.
It is also unacceptable for cover to be provided without additional remuneration. Many junior doctors will be happy to cover gaps, but they must not be coerced and they must be paid properly for additional shifts.
We support our members to achieve this.
If problems with the working pattern raise clinical governance and patient safety issues, the clinical director should be informed straight away.
Read the GMC's Good Medical Practice guidance
It is often the case that junior and other grades of doctors carry out tasks that are not necessarily an appropriate use of their time. The Departments of Health and the BMA encourage the transfer of such tasks to other NHS staff groups, provided this is clinically appropriate, to enable doctors' time to be freed up for other things. This approach has been a feature of many of the successful EWTD compliance pilot projects that have been run across the country.
Employers may choose to engage additional staff in order to achieve compliance, but their employment must be sustainable and affordable, and should not provide a 'quick fix' only. Working patterns will need to be compliant for longer than a single financial year.
Increasing the number of junior doctors on the rota, or employing additional non-clinical staff to undertake appropriate tasks will both ease junior doctor workload and enable junior rotas to achieve compliance. Ideally, expansion of the consultant workforce should be a priority. This will enhance the quality of service delivery, ease pressure on junior doctor rotas and enable more opportunities for junior doctor training.