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There has been in recent years a shift and a drive towards increased flexibility in the NHS and its workforce.
In contrast to the traditions of previous generations, an increasing number of both male and female doctors today are keen to work less than full time (LTFT) – almost 12 per cent of trainees were working LTFT in England in 2016. This was just under 11 per cent for Wales, whereas in Scotland and Northern Ireland, trainees were LTFT eight per cent and five per cent respectively.
LTFT working has clear appeal, as it can provide a better work-life balance and allows a more manageable workload for trainees, who will then be better able to juggle all the various plates up in the air at any given time.
We are very aware of this, as outside of the demands of our clinical work, we are both mothers to young children, responsible for co-chairing a BMA forum, and engaged in a variety of personal and voluntary activities.
However, this isn’t to say that LTFT working doesn’t present its own challenges.
Doctors can be left feeling professionally penalised at times by their choice of working arrangements, or face a postcode lottery in terms of the flexibility of their working arrangements, as well as facing the financial impact of working fewer hours.
Meanwhile, for the departments they work in – managing staff who don’t work a standard working week can be challenging, especially in these times of widespread rota gaps.
Today’s announcement by the GMC, that as the regulator for all doctors in the UK it takes no view over what doctors do outside of their training programme hours, is a hugely important step towards addressing the inequalities faced by LTFT staff. LTFT trainees must still get permission from their postgraduate deans to undertake any locum shifts, however with this clarification from the GMC we envisage that access to locum shifts should improve.
We don’t foresee that this will result in a rush of LTFT trainees to do lots of locum work. However, it gives us the option of doing a few more shifts, perhaps when children are old enough to go to school, or when a carer is around to look after sick relatives.
LTFT workers will now be able to better benefit their departments by helping fill unfilled shifts where appropriate, and enhancing continuity of care for patients; this will improve their sense of belonging to their team, as well as allowing LTFT trainees to better budget for things like the expensive exams that we have to sit as part of our postgraduate training.
Additionally, the lack of clarity around this important point has previously seen many doctors worry that receiving remuneration for their non-medical interests and hobbies may land them in an ethical grey area – the new GMC guidance resolves this issue, and is extremely welcome.
The GMC’s point of order will not undo all the hurdles that LTFT doctors face, but it is an important step towards achieving the equality that a flexible NHS workforce deserves.
Maddy Fogarty-Hover and Ruth-Anna Macqueen are co-chairs of the BMA LTFT forum
Read the updated guidance on flexible working and LTFT.
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