As a junior doctors, your employer must ensure that you can work safely and in compliance with the New Deal and the European Working Time Directive.

The hours you work and the unsocial nature of a rota determine your pay banding.

Accurate monitoring of your hours and working patterns is compulsory and should take place twice a year for two weeks. However, you may wish to request rota monitoring at any other time if you feel that your rota doesn't reflect the hours you work.

Who should be monitored

Doctors in the training grades, including flexible trainees and locum doctors in training employed during the whole monitoring period, should be monitored. 

In order for a monitoring exercise to be valid, 75% of eligible doctors need to fully participate and 75% of duty periods worked need to be monitored. 

Monitoring is not a contractual obligation for non-training grade doctors and they should not be compelled to complete it, nor they should be included as part of the 75% returns that are required. 

Breaks, late hours and leave

Natural breaks and rest

A natural break is at least 30 minutes continuous break after approximately every 4 hours on duty, without any interruption.

A single one-hour break cannot count as two natural breaks and two 15-minute breaks cannot count as one natural break. 

In Scotland only, a junior doctor should not work more than 5 hours without a break:

• any work after that up to 9 hours attracts one natural break
• work beyond 9 hours up to 13 hours requires a second natural break
• work between 13 and 14 hours necessitate a third natural break
• any work beyond 14 continuous hours makes the rota non-compliant with your contract. 

Rest is different from natural breaks. You don't usually get rest on a full-shift rota, as it only applies to on-call and partial shift rotas. On a full-shift rota, if you are not working, in a meeting nor teaching then you may fill in that time as rest.

Compulsory teaching should be recorded as work and not rest, or part of a natural break.

Working late

Working late is often unavoidable and a consultant is not always around to provide approval, where the employer policy requires it. In such circumstances, you are still required to record the late finish.

You may be asked to provide a reason for working beyond your hours or being unable to take a natural break. Although it is not a requirement of monitoring, this information can help your employer when analysing your diary cards.

Leave

You are required to take part in monitoring even if you are on annual, study or sick leave and on days when you are not on site.

Recommendations for ensuring effective monitoring

• Don't be pressured to change your normal working pattern or to document incorrect hours of work during a monitoring period as that constitutes harassment and bullying. The GMC has clear policy against such actions. 
• Diary cards don't need to be signed by a consultant to be validated. 
• If a consultant refuses or is unavailable to sign the form, then you should submit the form unsigned with the correct hours and an explanation as to why the form is unsigned. This will make it easier to challenge the monitoring results should this prove necessary. In Scotland only, a consultant signature or approval code is not needed so no justification is not needed.

If you feel affected by any of these circumstances, contact one of our advisers on 0300 123 1233 or via email. 

Online monitoring

Online monitoring has replaced paper cards. Most employers use DRS or Zircadian. Here is a step-by-step guide on how to use these two systems. 

What happens after monitoring

Check your return date

Employer are required to chase up any doctors who have not returned their forms, and you should check whether your return rate has been calculated correctly. Sometimes employers are not aware that staff are on leave when monitoring takes place and count such staff as non returns.

If forms are still outstanding, your employer must begin monitoring again. Without a valid return, rotas can sometimes go unmonitored for very long periods of time.

Report results

Employers must provide a report of the outcome of monitoring within 15 working days of the monitoring period.

If this has not happened:

• write formally to your medical staffing department using the template letter available, quoting this guidance and requesting the report
• you can also contact your Local Negotiating Committee chairman for their support
• if neither of these actions have any effect, contact the BMA on 0300 123 1233 for further advice.

Upon receipt of the report, compare with your own results and consider if your employer has analysed rest and breaks achievement correctly, has taken account of prospective cover, and has included all monitored duties.

Report any inconsistencies to your medical staffing department and request a meeting with a representative.

Pay banding discrepancies

If the monitoring report shows a lower pay band than the one included on your contract, your pay within the post you are monitoring is protected. However, if you are receiving a band 3 multiplier before the monitoring, then it is a 2A banding that is protected.

If monitoring has shown that your actual working hours are in a higher pay band than your rota is on paper, you are entitled to back pay as long as you were in post at the time of the monitoring or requested the monitoring.

When an agreement over the banding of a rota cannot be reached then appeal mechanisms exist to resolve this.