The Working Week and The New Junior Doctor Contract (NJDC)

 

NOTE – NJDC applies to all trainees who commenced GP training since Aug 2016, so all ST1s and most ST2s. ST3s and those LTFT trainees or other trainee who started training before Aug 2016 remain on the old contract. If in doubt please check with HR in Gloucester.

 

The basic working week requirements for trainees on the NJDC and the old contract are the same with regard to proportion of clinical and educational activity. Trainees on the NJDC are entitled to paid breaks and so these have to be included. OOH are part of the 40 working week not in addition to it for trainees on the NJDC, see below for more details on NJDC and OOH.

 

The 40 hour working week is divided into 10 x 4 hour nominal sessions (7 clinical and 3 educational) but this does not fit well with most GP working days so it is easier to think about it in terms of hours. So on average trainees should do the following per week:

  • 28 hours clinical activity - with 1 hour of clinical admin time for every 3 hours of patient contact (booked appointment, unscheduled care (duty doctor), visits) = 21 hours direct patient contact and 7 hours clinical admin.
  • 12 hrs educational activity - 4 hours external structured education; 4 hours practice based structured teaching and 4 hours independent educational activity.

 

External structured education includes:

  • Teaching Programme Induction days
  • Half Day Release Course (HDRC)
  • Timetabled Education Provider Organisation (EPOs such as BGPERT, SGPET, GGPET)
  • Topic Teaching
  • AKT and CSA courses provided by local RCGP Faculty
  • Careers Faire
  • Attending ST3 practice for ST2 trainees

Study leave is used for these sessions.

 

Practice based structured teaching includes:

  • Tutorials
  • Joint surgeries
  • Practice based learning events
  • Some induction activities

 

Independent learning activity could include:

  • Primary care team meetings e.g. practice meetings, CCG meetings, Federation meetings.
  • Audit and research in general practice.
  • Independent study/revision for AKT and CSA. Tutorial and teaching preparation.
  • Commissioning services.
  • Sitting in with other HCP eg nurse practitioner chronic disease management clinic
  • Attending speciality clinics eg dermatology
  • Time spent with other professionals who deliver services that are not considered part of general medical services, such alternative and complementary therapists.
  • Time spent with professionals who have expertise in other matters that relate to aspect of healthcare and death administration, social workers and undertakers.
  • Getting to know local healthcare professionals and helping the practice maintain links with the local community (COGPED, 2012).
  • Planning and delivering medical student teaching in your GP training practice, up to 8 sessions maximum per year.
  • Some of these will be induction activities.

 

These sessions should be planned and agreed with the educational / clinical supervisor to meet individual trainee’s learning needs and should be recorded in appropriate learning log entries to demonstrate learning achieved. It may sometimes be appropriate for this time to be used in gaining more clinical experience by seeing patients in surgery. It is anticipated that a significant amount of this time will be used to undertake quality improvement project(s) within the practice.

Study leave is NOT used for these sessions.

 

 

Every week will not be the same given study leave, annual leave and public holidays etc so over a 12 month ST3 year there should be approximately:

  • 44 x 4 hour External Structured Teaching Sessions - comes out of study leave.
  • 44 x 4 hour Practice based structured education (2 of 4 hours protected)
  • 44 x 4 hour Independent education activity sessions

 

For ST2 trainees in a 6 month post the numbers would be halved.

The exact number and type of external structured teaching sessions offered by each program and different EPOs will vary.

 

Study Leave

ST3 trainees are entitled to up to 30 days or 60 sessions (60 x 4 hours) of study leave so there will be approximately 16 sessions left to use once the external teaching sessions are accounted for. ST2 trainees are entitled to up to 15 days (15 x 4 hours) study leave in a 6 month post so will have about 8 sessions left to use after external teaching accounted for. Trainees need to apply to use these additional days/sessions.

 

Professional Leave

GPSTs are also entitled to up to 5 days professional leave a year. Professional leave can be used for attending committee meetings, the PESC or EESC to help trainers, practice visits and similar activities that are not primarily educational but are of benefit to the medical community.

After these educational and professional activities have been scheduled the rest of the trainee’s time should be spent on clinical activity. In practice there is regularly an overlap between clinical and educational activity with debriefing and clinical supervision taking place at the same time as clinical activity.

 

LTFT Trainees

Same principles as for full time trainees so all of the above pro-rata per year or count the total for however long they are ST2 or ST3 eg 20 months at 60% to complete 12 months FTE.

 

Working Week in Practice

Many GP days start with booked surgeries before 9am and go on until 6.30pm or beyond with extended hours and clinical administration. Unless trainees are going to be scheduled strictly 9-5 and not be exposed to the full GP day they are going to need at least one shorter day to compensate for the longer days. Pragmatically many practices schedule in an afternoon off and for some this works well on a Wednesday after teaching particularly if local geography means a significant travel time between the location of teaching and the practice.

 


Split of hours for FT and LTFT trainees – Old and New Contracts

ST3 old contract

40 hours plus ooh

Education

Clinical Admin

Direct Patient Contact

100%    

12 hours

7 hours

21 hours

80% (32 hours total)

9 hours 30 minutes

5 hours 30 minutes

17 hours

60% (24 hours total)

7 hours 15 minutes

4 hrs 15 minutes

12 hours 30 minutes

ST1/2 new contract

36.5 hours*

Education

Clinical Admin

Direct Patient Contact

100%

11 hours

6 hours 15 minutes

19 hours 15 minutes

80% (29 hours 15 minutes)

8 hours 45 minutes

5 hours

15 hours 30 minutes

60% (22 hours)

6 hours

3 hours 45 minutes

12 hours 15 minutes

* 40 hours includes 2 hours for breaks and 1.5 hours for OOH

 

New Contract with paid breaks and OOH

This can be calculated in different ways. The 40 hour working week can be averaged out over 26 weeks and so could be considered over the whole 6 month time period, including annual leave and study leave.

For every period of work over 5 hours trainees have to have a 30 minute paid break so if they work on a usual work schedule of four 9 hour days in practice (tutorial and independent learning time timetabled into these days) and one 4 hour day when attending teaching at day release then need to factor in 2 hours for breaks. Then there is 36 hours of OOHs to consider – could either pay back some time each week and therefore reduce each week by 1.5 hours but this does not take account of weeks when on annual leave or study leave. It could be suggested that it is probably easier to give the 36 hours for OOHs back by giving four clinical days off (4 x 9 hour days making 36 hours) or other time back as agreed with the trainee. So if taking off breaks only and working on a four x 9 hour day plus one x 4 hour day gives the following proportions.

 

ST1/2 new contract

38 hours plus 2 hours breaks

Education

Clinical Admin

Direct Patient Contact

100%

11 hours 30 minutes

6 hours 30 minutes

20 hours

80% 30 hours + 2 hour breaks

9 hours

5 hours

16 hours

60% 22.5 hours + 1.5 hours breaks

6 hours 30 minutes

4 hours

12 hours

 

The exact amounts for the 80% and 60% depend on how their week is structured for periods of work and therefore how much paid break time they have and would have to be calculated for each individual. For example if they were working 4 days a week for 80% that would be 32 hours total which could be one 10 hour day, two 9 hour days and one 4 hour day (going to teaching), in which case you would still need 2 hours of breaks because any day over 9 hours needs 2 x 30 minute breaks.

 

NHS Employers TCS - http://www.nhsemployers.org/case-studies-and-resources/2017/03/junior-doctors-terms-and-conditions-of-service-march-2017

 

Work Schedule guidance and Templates - http://www.nhsemployers.org/your-workforce/pay-and-reward/medical-staff/doctors-and-dentists-in-training/terms-and-conditions-contracts/work-scheduling-templates-and-guidance

 

 

This page was last updated November 9th 2022 (2 years ago)