It can hardly have escaped anyone’s attention that on 1 August, 11 years after it first became law, the European Working Time Directive was fully applied to junior doctors.
The government’s has said the NHS is 97% compliant with the new hour limits. This may be true on paper, but the reality is very different. The recent PMETB/deanery survey demonstrated that in hospitals across the UK, junior doctors are under pressure to lie about their hours to create the illusion of compliance.
Whilst I understand why some might do this to protect training opportunities, lying about your hours and working for free is not the solution. The Royal College of Surgeons in particular has been clear that juniors need to be honest about the hours that they are working.
Of course all junior doctors can, if they wish, opt out of the working time directive. This is not something I would encourage as most of us are not in control of our working hours. If getting better training opportunities is the motivation behind considering using the opt-out, think again, because opting out does not guarantee that work done in additional hours will be of educational benefit. It is much more likely that you will end up being used as fodder to fill rota gaps.
Junior doctors who opt out for training reasons run the risk of not being appropriately paid for the additional training hours as service delivery is the real priority for most trusts. Working additional hours for free, even if it does provide good training, could risk our long-term pay and conditions. Why would employers pay doctors to train if they can get us to do it for free in our own time? It is also important that we maintain the pressure on employers to improve training within 48 hours.
I am also concerned that junior doctors who choose not to opt out could be bullied especially if some of their colleagues decide to use the opt-out. We can’t have a situation where educational opportunities are used as a carrot to tempt people into working longer hours. All junior doctors are entitled to high quality training within 48 hours.
The BMA believes that doctors who are not in control of their own hours should not opt out of the directive however we have a responsibility to provide our members with information and guidance to allow them to make the choices that are right for them.
The opt-out allows doctors, on a strictly voluntary basis, to sign a waiver with their employer agreeing that they are happy to work additional hours. It is not possible to opt out of the rest requirements, so doctors will still need to ensure they take the necessary breaks, and their employer will still need to monitor the hours they work. The WTD is not the only thing that limits working hours. Even if you have opted out of the WTD, the junior doctor’s contract still limits junior doctors’ hours to 56 hours per week.
Doctors who want to opt out should look at the BMA guidance which contains a sample letter which can be sent to your trust. It is a good idea to keep a record of your opt-out letter. You should also renew your opt-out every year if you wish to continue working extra hours.
Once someone has opted out of the WTD it is important that they come to an agreement with their employer about how they are going to be paid. If there is a predictable increase in hours, extra hours can be addressed using the pay banding system. If the extra hours are unpredictable, for example, to cover additional shifts then payment using internal locum rates could be an alternative.
It is possible for us to train in 48 hours and the BMA is determined to pressurise trusts to ensure that junior doctors’ training does not suffer because of the reduction in working hours. All juniors considering using the opt-out should ensure they are fully informed of their rights before they make any decision.
