The BMA continues to resist the imposition of the new contract. Previous communications to LNCs on the junior doctors dispute have requested that they do not facilitate implementation of the new contract, and we understand that some members may have taken that to relate to the guardian role too.
However, we do not see this as facilitating part of the imposition, but as part of our ongoing efforts to get the best possible deal for junior doctors, and would therefore encourage junior doctors to engage with the guardian of safe working hours.
The role of the guardian
The role and responsibilities of the guardian are set out in detail in schedule 6 of the final Terms and Conditions of Service:
Guardian role and responsibilities (NHS Employers)
A sample job description for the guardian role is also available online:
Guardian job description (NHS Employers)
We strongly encourage you to read this in detail before taking part in the appointment of your guardian.
Contact us at [email protected] if you have any questions.
As a junior doctor, you understand the issues that can have a negative impact on the safety of your and your colleagues' working patterns in your trust.
As a starting point, we would suggest the following skills and characteristics when considering whether the candidates are suitable - these are desirable, but are not all essential:
- Senior doctor who can command the respect of both junior doctors and management
- Experience of high-quality rota design
- Track record of understanding and supporting junior doctors
- Familiarity with the relevant IT systems
- No other management responsibilities at the trust (this one is essential and required by the contract)
- Familiarity with the doctors in question - for example, GP trainees or hospice doctors
- Experience in medical education
- Interest in patient safety and quality improvement
The appointment process
The terms governing the guardian's role include a requirement for two junior doctor representatives on the panel appointing the guardian, and for the panel to reach consensus before any appointment.
The guardian will be appointed by a panel of four, made up of the trust medical director, HR director and
two junior doctor representatives. The panel must reach consensus on its appointment – so if you don't share the decision taken by others on the panel, they cannot proceed without your agreement. It is a contractual requirement that 50% of the panel be made up of junior doctors and that consensus be reached.
Despite the seniority of others on the panel, as a junior doctor you have an equal right to be on the panel and your opinion counts equally. If the junior doctors on the panel are unhappy with the candidates, they should not feel pressurised to appoint, and the position should be re-advertised.
We would advise junior doctors to identify the director within the trust that the guardian will be reporting to, and meet with them to discuss the role and their expectations.
We encourage you to discuss your approach with the other members of the panel before the interview, to ensure you have planned interview questions covering all the issues you feel are most important.
We suggest the following questions as a starting point:
- Do you think you have enough SPAs allocated? If they prove insufficient, how will you deal with this?
- What experience do you have of the work of junior doctors/GP trainees/palliative care trainees?
- How would you approach an exception report you feel is unjustified?
- How would you stop doctors being pressured to under-report their hours?
- What is your experience in facilitating less than full time (LTFT) training?
- What challenges does LTFT training have? How could they be overcome at this trust?
- Will you be attending the LNC regularly to go over exception reports?
- What would you suggest the fine money be spent on at the trust?
- How do you imagine a work schedule review working?
- Tell me about an occasion when you challenged a senior colleague over a disagreement, and how you resolved this
- How have you contributed to the wellbeing of junior doctors in your career?
- Do you work well with the Director of Medical Education? Have you done any joint work?
Support from the BMA
Please contact the BMA if you require any support throughout the guardian appointment process.
You can contact a dedicated employment advisor by calling 0300 123 1233 or emailing bma.org.uk/support