Junior doctors leave (2002 terms and conditions)

A guide to annual leave and sick leave for junior doctors on the 2002 terms and conditions of service.

Location: Northern Ireland Scotland Wales
Audience: Junior doctors
Updated: Wednesday 1 May 2024
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Annual leave entitlement

All employees in the NHS have the right to take annual leave. The amount of leave is determined by your grade and, in the case of specialty trainees, your incremental pay point. These grades are entitled to five weeks of annual leave (+ 3 days in Wales):

  • Foundation year 1
  • Foundation year 2
  • StRs, StR(FT)s and SpRs on the minimum, first or second incremental points of the payscale.

These are entitled to six weeks of annual leave (+ 3 days in Wales):

  • StRs, StR(FT)s and SpRs on the third or higher incremental points of the payscale.

The leave entitlement in Scotland is 8 public holidays and an enhanced annual leave entitlement of 6.6 weeks or 5.6 weeks (for those who previously received 6 and 5 weeks respectively).

Less than full-time trainees

Annual leave for LTFT (less than full-time) trainees should be calculated on a pro-rated basis.

For example, an LTFT trainee working 60% of a full-time rota should receive 60% of the annual leave entitlement, and 60% of the entitlement to public holidays.


Calculating and requesting annual leave

Because junior doctors do not generally have a conventional working week, there can be confusion as to what constitutes ‘a week’s leave’, in terms of the number of days off. There are a number of different approaches to calculating it, explained in the Junior doctors handbook (PDF), page 121.

Doctors are required to notify their employer when they wish to take leave, and the granting of such leave is subject to approved arrangements having been made for cover. It is usual for employers to ask for a minimum of six weeks’ notice of intention to take leave.

Employers often restrict leave such that only one doctor per rota can be on leave at any one time. If junior doctors wait until the end of the post to take leave, they may not be able to take it. In general it is more beneficial to take leave than to be paid in lieu, since payment in lieu for a day’s leave is normally made at only 1/31 of a month’s salary.


Working on a public holiday

Your terms and conditions entitle you to eight public holidays a year, in addition to your annual leave. This is pro-rated for LTFT trainees.

If you work on a public holiday, you should get a day off in lieu, including if you only work between midnight and 9am that day (ie a night shift or on-call that runs into a public holiday).


If you have a ‘zero hour’ or ‘off’ day on a public holiday

Increasingly, some rotas are designed with additional days off (sometimes called ‘zero-hour days’) to ensure they comply with New Deal and EWTD limits on working hours.

If your rota has you doing a ‘zero-hour day’ on a public holiday, the day should be counted as only one of these and you may still receive the other as a day off in lieu. A single day cannot count as both a day of holiday and a ‘zero-hour day’ at the same time – ie a public holiday can’t be treated as a zero-hour day, or vice versa.

A zero-hour day is not a day of leave from duty, because you will be working your full hours, just on other days of the rota – so a zero-hour day cannot be counted as holiday. Your colleagues who work on a public holiday will get a day off in lieu as well as their zero-hour day at another time, so it is logical to expect a day off in lieu too.

We recommend checking your rota in advance. Speak to your employer or rota manager if you have any doubts about whether you’ve received your contracted number of public holidays. If you continue to have concerns, contact a BMA employment adviser. 


Fixed annual leave

Most rotas are designed with ‘leave weeks’ built in – that is, weeks where the junior doctor is on a week of normal day shifts, with no out-of-hours commitments. These weeks allow flexibility in planning annual leave as they can be swapped with other junior doctors on the rota, with their agreement. You can still take leave in other weeks, but this requires swapping out of the on-call/out-of-hours commitments.

Another approach used by employers is to design a rota template with periods of annual leave factored in. Junior doctors are then either allocated to a slot or given the choice of a slot which suits their leave needs. This is often referred to as fixed leave, and is much less flexible for the doctors.

There is no provision for challenging this under your contract, but the BMA does not support the practice – we do not believe it represents good practice and we encourage employers to move away from it.

In Scotland, fixed leave becomes the exception. Where fixed leave is in use, local systems should exist to allow junior doctors to take leave when they wish. Where possible, junior doctors will be notified six weeks before the commencement of any confirmed period of leave. BMA SJDC (Scottish junior doctors committee) have reached agreement with the Scottish Government that by August 2020 this will be a requirement for all rotas where fixed leave remains in use.


Get involved in your rota design

Most employers are glad to get junior doctors’ input into rota design as it generally makes for a better working relationship. For example, you may find that fixed leave was only inserted for convenience when the rota was first designed and there is little resistance to changing it.

If you want to challenge the use of fixed leave on your rota, you’ll need to redesign the rota in conjunction with your medical staffing department. We recommend following these steps:

  1. set up a meeting to discuss the rota with your colleagues and get a consensus on how you would prefer it to be arranged
  2. come up with a rota that allows you to take your leave more flexibly. Don’t forget there could be an impact on your banding – make sure to consider this before any meeting. Read our guidance on rota design
  3. once you have your ideas on paper, contact the person/department in charge of your rota and request a meeting to discuss your proposal.

You may also find it useful to contact your local BMA representative or your LNC representative for advice and support.


Carrying over annual leave

Sick leave entitlement

If you are unable to attend work due to illness, injury or other disability, you are entitled to a sick leave allowance based on your length of service:

  • During your first year: One month’s full pay and, if you’ve completed four months’ service, two months’ half pay.
  • During your second year: Two months’ full pay and two months’ half pay.
  • During your third year: Four months’ full pay and four months’ half pay.
  • During your fourth and fifth years: Five months’ full pay and five months’ half pay.
  • After completing five years of service: Six months’ full pay and six months’ half pay.

In exceptional cases, these times can be extended by the employer at their discretion.

While on half pay you can receive statutory sick pay as well, as long as the total amount does not exceed your normal full pay. Continuous service is defined as working in the NHS (or other bodies such as the civil service, defined in TCS paragraph 228a), including as a locum, with no break longer than 12 months.

If you work outside the NHS for more than 12 months, you have to start building up your sick pay allowances again from the beginning.


Sick leave and your responsibility

You are contractually obliged to notify your employer immediately of your absence, its nature and, if possible, how long you expect to be absent. Beyond the third day, you must submit a statement regarding the nature of the illness. You can do this with a self-certificate from your employer upon your return to work.

The self-certificate is to cover days four to six of the absence. After seven calendar days, medical certificates completed by a doctor other than you should be submitted, ie a fit note.

Having advised the employer of the absence, it is the employer’s responsibility to arrange appropriate cover. The employer has no right to request a doctor who is absent due to ill health to make the necessary cover arrangements.

Nor should the doctor be put under any pressure when absent to repay the cover at a later date. If you are unfit for work, under health and safety legislation you should not be at work.

It is vitally important to give your employer as much information as possible about your reason for absence at the earliest opportunity, to enable them to arrange cover.

For example: a doctor advises on day one that they are unwell and unable to work, stating a probable return on day three. However, by the afternoon of day two, the doctor does not feel they will be fit to return to work on day three.

The doctor should contact the employer to give an update and an indication of a potential return date. Failure to update the employer could impact on your colleagues as they are expected to cover for the occasional short-term absence (NB: a colleague is another doctor participating in the same rota or shift).


If you are asked to complete a shift when you are unwell

If a junior doctor falls sick during annual leave and produces a statement to that effect at the time, (eg a self-certificate), they should be regarded as being on sick leave.

If the first statement is a self-certificate, it should cover the first and any subsequent days up to and including the seventh day of sickness.

Medical statements should be submitted to cover the eighth and subsequent calendar days of sickness. Annual leave should be suspended from the date of the first statement.