The Limits on Hours
Since December 1994 no doctor or dentist in training should work on average more than 56 hours per week. No doctor or dentist in training should be contracted to be on duty for more than 72 hours per week on average.
The English Clause is a provision of the New Deal that applies only to Specialist Registrars. It allows them to continue to be contracted for duty up to a maximum of 83 hours per week on average, when it would benefit their training and they wish to do so. The 56-hour limit for actual work still applies.
On-Call Rotas
This is the traditional pattern of out of hours cover. Trainees working on-call rotas should have a reasonable expectation of 8 hours rest during a period of 32 hours on duty, principally within the on call period. 5 must be continuous and undisturbed and between the hours of 10pm-8am.
Partial Shift
This is appropriate to acute specialities where there is a significant commitment to daytime work and high intensity out-of-hours work. Trainees working partial shifts must achieve the equivalent of one quarter of the out of hour’s element as rest. In some instances hybrid arrangements between on call rotas and partial shifts have been developed to suit local circumstances.
24hr Partial Shift
This is an alternative arrangement when a partial shift pattern is appropriate, for example in some acute specialities. Trainees must have 6 hours total rest in the 24 with 4 hours continuous rest during the period 10.00pm and 08.00am. The maximum total shift length must not exceed 24hours. The trainees must then rest until the next day, in practice usually for 24hours, but for at least 20hours.
Full Shift
This is considered appropriate where the work is intensive and potentially continuous throughout a 24-hour period, traditionally A&E and SCBU but is now necessary in acute specialities such as Paediatrics and O&G, and to meet the requirements of the European Working Time Directive. Trainees working on a full shift system will effectively work for the whole time they are on duty but shall be allowed reasonable time for natural breaks during the working period.
THE HOURS REQUIREMENTS
|
Working Pattern |
Maximum Contracted average Hrs/Wk |
Maximum Ave Hours worked/wk |
Minimum rest during duty periods |
Maximum Continuous duty period |
Minimum Period off duty |
Maximum consec. Duty days |
Minimum Continuous off duty |
|
Full Shift |
56 |
56 |
Natural breaks |
14 |
8 |
13 |
48+62
|
|
Partial Shift |
64 |
56 |
4 |
16 |
8 |
13 |
48+62
|
|
24 hour Partial shift |
64 |
56 |
6 |
24 |
20 |
13 |
48+62
|
|
On Call Rota |
72 |
56 |
8
|
32
|
12 |
13 |
48+62 |
Health Service Circular 1998/240