Unravelling the Complexities of NHS Junior Doctors’ Rostering, Pay & Working Conditions

The current frustrations and concerns among Junior Doctors regarding their pay and working conditions are multi-faceted. One issue that stands out is the way their working schedules are created. Typically, a department will establish a standard pattern of work, consisting of shifts over a specific number of weeks, which every doctor is expected to follow. For instance, if there are nine doctors in the department, a nine-week pattern may be established, with each doctor starting the pattern on a different week.

Contractual rules and regulations

The challenge arises when trying to accommodate the contractual rules and regulations that govern doctors’ working hours. For instance, doctors are not allowed to work more than 72 hours in a span of seven days and should receive 48 hours of rest after working night shifts. Balancing these regulations while ensuring adequate coverage for the department becomes incredibly difficult. As a result, many doctors find it challenging to secure the annual leave they desire, face difficulties in obtaining promised study leave, and often have to miss important events like friends’ weddings.

To address this issue, doctors must resort to swapping shifts with their colleagues in order to secure the leave they need. However, this further complicates matters, as some doctors may be reluctant or unable to accommodate these shift swaps due to their own schedules and commitments. Additionally, Junior Doctors rotate placement every 26 weeks and department more, which often requires them to move locations to different hospitals. This reshuffling of the entire workforce adds another layer of complexity and reduces flexibility in scheduling.

Fair pay and remuneration

Due to the complexities around rostering, Junior Doctors often find themselves not being paid for the exact number of hours they work. Instead, they receive an average payment because the rolling nine-week rota pattern over 26 weeks does not align perfectly with a round number of hours. Consequently, there is an imbalance in the distribution of night shifts among doctors, with some individuals inevitably working more nights and out of hours than others.

2 ways HealthRota facilitates building a Junior Doctors work schedules

To address these challenges, HealthRota offers two methods through which work schedules for Junior Doctors can be facilitated: 

  1. The traditional approach involves providing Junior Doctors with tools that allow them to self-preference their leave, enabling them to indicate their desired time off. This method aims to honour their leave requests as much as possible within the constraints of the department’s needs.
  2. Some NHS trusts that we support have implemented a system where doctors are allowed to self-roster into the number of shifts they would need to accomplish according to the established template. This approach grants doctors more control over their schedules, allowing them to align their working hours with their personal commitments. However, this method still requires careful management but better aligns the available resource to the coverage needs of the department.

In conclusion, the frustrations surrounding the creation of Junior Doctors’ work schedules are rooted in the difficulty of balancing contractual regulations, departmental needs, and individual preferences. These challenges often result in Junior Doctors struggling to secure desired leave and facing difficulties in maintaining a healthy work-life balance. Implementing self-preferencing or self-rostering systems can provide some flexibility, but careful consideration and effective management are necessary to ensure the smooth functioning of the department while meeting the needs of the doctors. That’s where HealthRota can help. 

Want to learn more about how we can support Junior Doctors in your NHS trust? Get in touch.