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 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.
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 has replaced paper cards. Most employers use DRS or Zircadian. Here is a step-by-step guide on how to use these two systems.
Before the monitoring begins, you should receive an email from your HR department with your login details.
- Log in and on th card select the correct Day Type for the shift as per your rota.
- Amend the Start and End Time if they differ from the actual hours you worked.
- Enter any time spent as Rest.
- Leave the Rest box ticked if you were onsite/resident for the shift.
- The Natural Break (NB) box is automatically ticked as the software assumes that you achieved all of your natural breaks for the shift. Untick the box if you did not get adequate natural breaks or if you were unable to take all your natural breaks.
- Click Save after completing the entry for each day.
- If you had to work extra hours or were unable to get your natural breaks, you can add a reason in the Notes section. Remember to Save the notes before closing the window.
If you have swapped a shift, then it would help if you stated who you swapped with (make sure that you swap any zero hour/ rest days that come with any exchanged on-call shifts).
All hours worked during monitoring should be recorded if the doctor is not able to leave on time due to care of a patient/ compulsory teaching. If you choose to remain at work, perhaps to gain extra training, then this time should not be recorded on the monitoring diary.
Before the monitoring period begins, you should receive an email from your HR department with your login details for the Zircadian monitoring website www.juniordrportal.co.uk.
- Your day is represented as a series of squares representing 15 minutes. Green blocks indicate work. Uncoloured blocks do not count towards your hours worked and are counted as rest (compulsory teaching counts as work and is green).
- Recording natural breaks: The Natural Break box is automatically ticked below the Work Episode as the software assumes that you achieved all of your natural breaks for the shift. Untick this box if you did not get adequate natural breaks, or were unable to take all of your natural breaks in a shift. You will need to record the periods in which you took your natural breaks using the Work Activity labelled Natural Breaks. Where this is not available, colour the boxes as green to record the time as 'Work'. Only additional rest taken over and above natural breaks should be uncoloured.
- Start and finish times: If you need to change your hours of work beyond that shown on your rota, use the drop down menu to the right of the diary squares (click to shade it green if you worked during that time). Whenever you enter a Start or Finish Time that extends your shift, you will be prompted to enter a reason.We wo ld advise you to enter a reason to justify the extra time spent at work. All hours worked during monitoring should be recorded if the doctor is not able to leave on time due to care of a patient/ compulsory teaching. If you choose to remain at work, perhaps to gain extra training, then this time should not be recorded on the monitoring diary.
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.
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.