Junior Doctors Committee Junior doctor England

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Enhancing junior doctors' working lives - A progress report 2018

Watch the video of our JDC chair and deputy chair, announce the launch of the latest Enhancing Junior Doctors' Working Lives - progress report 2018. 



In May 2018, Health Education England published the second annual Enhancing Junior Doctors' Working Lives progress report. This document details a great deal of work that is of crucial importance to junior doctors, and much is a direct result of lobbying by the BMA, who have been involved in this work from the start. So, with the publication of this report, what does the progress detailed in the latest version of this report mean to trainees?

So, what does the progress detailed in the latest report mean to trainees?

During the junior doctor contract dispute in England two years ago, the BMA identified a substantial number of issues that sat outwith the contract itself, and therefore were not able to be resolved through discussions with NHS Employers alone. These varied from a lack of flexibility in training, to late notification of rotas, to problems with study budgets.

These issues were taken forwards through a tripartite working group, chaired by HEE with the BMA and NHS Employers; this committee became the Enhancing Junior Doctors' Working Lives group, and also includes input from the Royal College and GMC.

An initial report was published in 2017, but this year the progress that has been achieved in the first full year since this report is the true test of meaningful changes for trainees.

Read the latest progress report from Health Education England


Progress report 2018

The latest report contains a significant number of improvements for trainees that the BMA has been fighting for since 2016. 

Many initiatives that have been taken forward over previous months have come from this group, the highlights of which are covered below in the tabs.

See the progress report details


What the BMA thinks

As the review of the 2016 contract approaches, non-contract issues will continue to arise and will be taken forward through the Enhancing Junior Doctor's Working Lives group.

The latest Enhancing Junior Doctor's Working Lives report is a welcome step in the right direction, with many improvements that should make a real difference to trainees. There remains work to do however; many issues still exist, including with educational supervision, diminishing mentorship, and the ever greater demands of a system under pressure.

This is not the last version of the report – the BMA and the JDC will continue to lobby HEE and NHS Employers for improvements to conditions to build on those already secured through this work.

As the review of the 2016 terms and conditions of service approaches, issues outside the contract will continue to arise and will be taken forward through the Enhancing Junior Doctor's Working Lives group.


What you can do

If you are finding your experience is not matching what is described in the article above, make sure to contact your regional JDC for local support, or send an email to [email protected]

We can lobby for the change that juniors need to have better working and educational conditions to support their work now, and their careers in the long term.


Progress report 2018 details

  • Study budgets

    Having come into effect from 1 April 2018, the intent of this new system is to ensure that all courses relevant to a junior doctor's training programme curriculum are covered by their study budget, as well as increased transparency and equity of access throughout the country, including for LTFT trainees who may have previously paid proportionately more from their own pockets.

    The BMA pushed hard for this to include funding for clinical interests and trainee's future career ambitions that may lie outside the main curriculum. While this is on the proviso of trainees proceeding in line with what is expected from them for their core curriculum, it is nonetheless vital funding for trainees to be able to access, alongside no single limit on spend for core curriculum content.

    What does this mean for me?

    This is a change that affects all specialty trainees in hospital placements in England. It does not affect GP trainees in GP placements, public health trainees, or anyone else not currently covered by the Education and Training Tariff.

    Find out more

    Read the study budgets guidance

    Read the blog

    Read the news story


  • Supported Return to Training

    Trainees who returned to training from time out have told the BMA that they would often return to work after months or even years out of the clinical environment, only to be expected to pick up where they left off, with no induction or clinical skills refreshment.

    Now, as decided during the ACAS agreement, a new annual and recurring £10m fund will be used to provide bespoke return to work packages, and innovative courses, to support junior doctors across England back into the clinical environment after an extended period of time out, for whatever reason. Funding will be used by local offices to provide a greater range of clinical support, pastoral care, refresher courses, and other support that trainees need to resume their training.

    What does this mean for me?

    If you are a trainee returning to practice after time out of the clinical environment for any reason (such as maternity, time out for research, career break, health or any other reason), HEE local offices will now have a bespoke set of courses and enhanced support for trainees that need it. Further detail will be available via your HEE local office for your region.

    Find out more

    HEE - In your area


  • ARCP review

    ARCPs have been a persistent issue raised by our members, and represent very stressful time of year for all doctors. Not only is the process of evidence gathering and submission time-consuming and challenging, the process was also often suggested to be inconsistent, intimidating and felt by many to offer no greater benefit than being a tick-box exercise.

    The BMA made very clear these issues to HEE and others, and in light of this, a review of the ARCP process took place during 2017. HEE published its report earlier in 2018, with a commitment to implement a number of recommendations, which included further support for trainers, and increased ease of access to "stepping off" training programmes. HEE have also made a greater commitment to meeting the needs of LTFT trainees and maintenance of face-to-face feedback.

    What does this mean for me?

    Watch this space – the report was only recently completed and the BMA is awaiting further detail on how this will be implemented. It is likely take place over the next year or so. While this was an England-led review, the effects may be seen across the UK, given that ARCP requirements are often similar as based on UK curriculum requirements.

    Find out more

    ARCP - junior doctor appraisals


  • Code of Practice

    While the Code of Practice had existed for a number of years, the JDC had heard from members that the quality of the information that they received prior to starting in a new post, and timeliness of it, was not simply good enough.

    JDC met with HEE and NHS Employers to hold both organisations to account for Code of Practice performance, and worked with both to set new rules both in terms of time limits for confirming information regarding posts, and for how the Code of Practice should be adhered to. This has led to the establishment of new rules for ensuring that this information is provided on time and with the right detail, both to trainees and employers, to ease the burden associated with moving placement.

    What does this mean for me?

    These changes have been made to ensure that the vast majority of trainees will receive information about their next employer at 12-weeks before rotation, generic rota at 8 weeks, and a personalised rota at 6 weeks prior to start date. For the first time, the 12 week deadline is a Key Performance Indicator for HEE and each of its regions, and it is hoped that these changes mean that more trainees will receive timely notification of their placements.

    Find out more

    Read the Code of Practice guidance


  • Enhanced Preferencing

    During the selection process, doctors who are in relationships with other doctors were often separated when they did not get offers to train in the same region. Such was the inflexibility of the system, once these offers were made, trainees were locked into these regions, and could not alter their choices to ensure they stayed together.

    Trainees in a committed relationship are now able to reorder their preferences for regions where they have received offers to ensure they are both able to train in a region where they have both met the required score. Much more detail can be found in this blog from the JDC Chair for Education and Training, Sarah Hallett.

    What does this mean for me?

    Should your preferences for where you wish to train change during the course of your specialty application – whether due to a partner getting a job in a particular location, or for any other reason or change in circumstances – this new system means that this can be reflected during the offer process, to make the possibility of swapping to a different region much more straightforward, and therefore giving you extra flexibility.

    Find out more

    Read the blog


  • Special Circumstances panels

    In 2017, as a result of lobbying by JDC, for the first time, applicants with a disability, or caring responsibilities for someone with a disability, which means that they need to train in a particular part of the country can be pre-allocated to that region during the recruitment process.

    The panels are organised on a UK-wide basis, and meet shortly after applications are submitted. The process also includes an appeals panel.

    What does this mean for me?

    If you are a trainee that meets the criteria for pre-allocation owing to special circumstances (either disability or caring responsibilities for someone with a disability), then make sure you complete the relevant paperwork to notify the recruitment teams that you wish to be considered for pre-allocation. It is worth noting that evidence is required for this, therefore it is worth gathering this evidence in a timely fashion, to give your application the best chance of being approved on the first round.

    Find out more

    Applying for training


  • Emergency Medicine LTFT pilot

    In 2017, for the first time, all higher EM trainees were able to apply for LTFT training, without the requirement to give a reason. Evaluation of this pilot still continues, however, it has been confirmed that the pilot will continue into 2018/19.

    Preliminary reports suggest that the junior doctors in the pilot have felt that they were less burnt out, and able to provide better care, as demonstrated in the case studies in the report.

    What does this mean for me?

    The BMA will continue to lobby for this to continue beyond the pilot, and for it to be rolled out to a wider cohort of individuals in Emergency Medicine and other specialties.