Your contract rota and pay Objectives How your

Your contract, rota and pay

Objectives • • How your rota and shift patterns work Understand the junior doctors contract and pay Exception Reporting Support (BMA, payroll)

Rota • • • Typically on a rolling Rota with other junior doctors • • Variety of duration and start/finish times Fixed shift pattern, different doctors. Ideally you should all work the same number of shifts (not always the case-check!) Night shifts/on-calls at the discretion of your employer-check this!

Teams • • Ward Teams (e. g. Cardiology, Colorectal Surgery etc) – Ongoing care of admitted patients (in hours) – Responsible for designated ward/patients on their list (e. g Cardiology ward and outliers) – Often consultant lead On-call Team (e. g Medical, Surgical, Pediatrics) – Care of newly admitted patients (in hours and out of hours) – Clerking Team (Take) – Ward Cover team (out of hours) – Medical Emergency/Crash Team – Post-Take Ward Round (PTWR)- Always consultant lead

Shift Patterns • • Vary by hospital • Late shifts: approx 10 -12 hours (e. g 09002100, can be a mix of ward and on-call duties) • Early shifts: approx 9 hours (e. g. 09001700, 0800 -1700) Night Shifts: approx 12 hours, overnight cover (e. g. 2100 -0900)

Typical Medical F 1 Early shift • 0845 -0900: Preparing the patient list • 0900 -0930: Handover/Board Round from the night team • 0930 -1330: Ward round • 1330 -1400: Lunch/teaching • 1300 -1700: Jobs • 1700 -handover to on-call team, go home! • Free time-Clinics, Theatre, quality improvement projects, Mess

On-call duties • • Clerking: Hx, physical examination, ordering urgent scans, initial diagnosis and treatment. Ward Cover: Chasing outstanding jobs from parent team, answering bleeps PTWR: Support the consultant, document, carry out jobs. MET bleep: to attend all MET calls/Arrest calls

Contractual Agreements • • • New contract in 2016 Opt in/out of European Working Time Directives Contracts are sent to you and should be signed ASAP Escalate to your rota-coordinator first if any concerns BMA members have access to a Rota checker

Pay (BMA) • Additional supplement for: • Weekends • Nights • Unsocial Hours • On-calls APPROX TAKE HOME (after tax, NI, pension) = £ 1800 - £ 2100

• Further Reading • https: //www. bma. org. uk/media/1 933/bma-junior-doctor-payslipdecember-2019. pdf https: //www. bma. org. uk/pay-and -contracts/pay/junior-doctorspay-scales/pay-scales-for-juniordoctors-in-england

Locum • • Extra money for extra time worked Hourly rate dependant on your level/urgency Consider once confident in your department Ensure this does not compromise your ability to work on your contracted rota safely

Annual Leave • Request ASAP (ideally 6 weeks) • Fill in request form (signed off by rota coordinator and consultant) • Contingent on minimal staffing • Unlikely on nights/weekends/on-calls • Swaps possible • Typically 9 -10 days per 4 month block

Pearls and Pitfalls Pearls • • Lieu days if you work on a bank holiday (e. g Christmas) You can swap shifts to maximize annual leave (requires approval by rota -coordinator) Gain confidence in decision making (less people on nights) Great learning opportunities (e. g. theatre, bedside teaching) Pitfalls • • • Only 9 -10 days annual leave per rotation Can’t take leave on on-calls/nights/less than minimal staffing Commonly requires 6 weeks of notice

Exception Report • Centralised system to report any excessive hours worked that compromise patient/staff safety. • Ensure you find out how! • Remuneration through time off/money • Be sensible e. g leaving late 5 minutes late occasionally vs repeatedly staying until 7 pm due to lack of staffing/senior support