No one has been trained for what is about to come – not even our most senior colleagues have experienced what lies ahead. The challenges are unprecedented and it is vital that we prepare ourselves as best we can and ensure that through good practice and following guidance that we remain safe and continue to provide the high standard of patient care that the public has come to expect.
BMA Scotland has now produced it’s guidance for junior doctors in response to covid-19. We know the next few months are going to be challenging and there will be significant disruption to your working patterns, conditions, the roles which you may be asked to carry out and of course the settings in which you are working. It’s been said often, but this is an unprecedented situation and it is normal to feel anxious and worried about expectations. On our part we’ve produced clear and concise guidance that we hope will ensure that you are safe, that you feel valued and that you are treated fairly while undertaking your duties during this difficult time, whatever those duties might be.
We have outlined some of the key points from this guidance on rota changes in response to the COVID-19 emergency below. More details on all these areas can be found in the full guidance which is available here. And as always, if you have any if you have any individual concerns or queries you should contact the BMA for further advice. We would also suggest that you email your LNC JDS (LNC junior doctor subcommittee) for advice on any group or specific local issues.
- Ensuring your health and wellbeing
As NHS boards understandably try to maximise their clinical capacity rotas will be temporarily reconfigured and you may well be asked to redeploy to a different team or department.
Regardless of whatever revised rota is introduced they must still provide you with sufficient rest to ensure both patient safety and maintain your own health and wellbeing. Our own physical and mental health has never been more of a priority, this is a marathon not a sprint and we must pace ourselves appropriately.
Some of you may have genuine difficulty in working your new temporary rota due to caring responsibilities, disability etc, and you will need to flag this up to your employer. If you are unable to agree an acceptable resolution, please contact the BMA as we may be able to help.
- Hours limits
All current New Deal contractual provisions and Working Time Regulations currently remain in force and there are further non-contractual rota agreements the BMA have made with the Scottish Government for junior doctors to address longstanding issues around fatigue. These are there to ensure your safety and your patients safety. Make sure you take your breaks, you will need them. Further details on WTR and New Deal contractual provision can be found in our guidance.
- Less than full-time trainees
If you are a LTFT then that status is protected on a temporary rota – unless you agree otherwise. You can voluntarily agree to increase your usual LTFT percentage temporarily or pickup additional shifts on an ad-hoc basis should you wish. Further details on Category 1 and category 2 LTFT trainees and additional pay can be found in the guidance.
- Rota banding
The Scottish Government has taken the decision to suspend rota monitoring for the remainder of the current 6 month monitoring period (i.e. up until the end of July). When your rota is temporarily redesigned, depending on the new working pattern, this may or may not result in a change to your rota banding and an associated increase in pay in line with the New Deal contractual provisions. You should check that your employer has run any redesigned rota through a compliance software tool called DRS, which all employers have access to. This will highlight any breaches of the hours and rest rules in the new rota, and will calculate the appropriate banding supplement. If you have any reason to believe that your new temporary rota has not been run through DRS, please contact the BMA and our employment advisers will take this up on your behalf.
- Additional hours
Although rota monitoring has temporarily been suspended, the Scottish Government have confirmed that all NHS staff should be paid at the appropriate rate for any hours worked during the emergency. The BMA has advised that if your actual working hours do not reflect your temporary rota, then you should make sure you claim for any additional hours through whatever local arrangements apply, which will generally be through the NHS staff bank at the prevailing staff bank rates. You can undertake additional shifts via the staff bank, and be paid at the prevailing NHS staff bank rate, in addition to your rota. But you need to make sure that you get enough rest to ensure patient safety and your own health and wellbeing, and that you are compliant with the Working Time Regulations.
When this is over, and it will be over, BMA Scotland will work with the Scottish Government to ensure that normal rotas, and arrangements for banding monitoring, are resumed. This guidance relates solely to the response to COVID-19. We will be continuously reviewing the rotation freezes and the temporary rotas to ensure that they are both proportionate to demand and sustainable for doctors.
Of course, all this is a balance. We know that these are extraordinary circumstances where normal rules may not always apply. Many of you will want to help out as much as possible but equally, your safety and wellbeing remain as important as ever. We hope this guidance helps you to set your limits and strike the right balance.
More detail on all the areas above can be found on our guidance pages. I am under no doubt that you will have more questions, there are more questions than answers. Further information on issues such as indemnity, annual leave, cancellation of study leave, ARCP progression etc can be found in our FAQs. Further COVID-19 related information for trainees and a set of FAQs can also be found on the Scotland Deanery section of the NES website.
Or contact us, let us know, that is what we are here for.
Dr Lewis Hughes and Dr Chris Sheridan are Scottish Junior Doctor Committee co-chairs
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