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Practices should not use GP trainees as substitute locums

Proposed junior doctor contract will also look at working hours

Louise Prime

Thursday, 20 June 2013

Practices should not use GP trainees to substitute for a locum in the practice, and nor should the practice’s effective running ever depend on the trainees’ attendance, agree the British Medical Association and NHS Employers.

The BMA and NHSE point out that a great deal has changed since the current junior doctors’ contract was agreed 13 years ago, and that it “is no longer working as well as it could for NHS employers, doctors and dentists in training and patients”. The two organisations have held exploratory talks about possible change to the contract in all parts of the UK, and this afternoon jointly published new draft heads of terms for possible renegotiation of the contract.

They say that the existing contract barely covers training-related issues, and that they propose to discuss how training for junior doctors can be better facilitated by any new contract. They say the contract should “facilitate high quality NHS patient care through sustainable service provision, delivered by suitably trained doctors and dentists, working in an approved training environment”.

The BMA and NHSE’s draft considers the particular needs of GP trainees. It says: “GP trainees work in an environment where work is split into sessions and this needs to be accommodated in the new contract. They are an integral part of the practice team but are additional, not intrinsic, to the practice workforce.

“At no point should the effective running of the practice be dependent on the GP trainee’s attendance and they will not be used as a substitute for a locum in the practice.”

The BMA and NHSE are also addressing the issue of long working hours for junior doctors. They say that although working time regulations set a weekly limit of 48 hours, this is currently calculated as a mean over a 26-week period, and point out: “This formula means that in some weeks, a junior doctor may work for far longer. Similarly, the rules governing time off (which stipulate two complete days away from work in any two-week period) could entail 12 consecutive days on duty.”

The bodies want to negotiate on determining how average working hours are defined, and the period over which they are referenced; they propose to investigate “limiting the number of actual working hours (as defined by statute) in a defined (in days) period”.

Dr Ben Molyneux, chair of the BMA’s Junior Doctors Committee said: “Since the current contract was drawn up we have seen radical changes to the way doctors in training work. We believe there is scope for producing a contract that works better for both junior doctors and their employers.”


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