BMA/COGPED Guidance on GPR Working Week
The BMA and COGPED nationally have agreed what should be a GPStRs normal hours of work and guidance was issued in July 2012 - see COGPED Guide to a Session in the Downloads section below.
Also available in the Downloads section are sample weekly timetables for full time and LTFT (50% and 60%) GP posts. More specific timetables for each training practice are available in the individual practice profiles at Training Practices.
Extended Hours Working
The School of Primary Care view is that trainees should be exposed to the full range of services offered in GP during their training period, including extended hours. Extended hours are not considered as OOH and if these are worked, the trainee's weekly timetable should be adjusted accordingly to remain EWTD compliant.
EWTD and OOH
In the past trainees, trainers and practice managers may not have been clear about the impact of European Working Time Directive (EWTD) on GP registrars' working hours on days following OOH sessions.
The EWTD Rest provisions are:
11 hours continuous rest in 24 hours
24 hours continuous rest in 7 days (or 48 hours in 14 days)
20 minute break in work periods of over 6 hours
This a legal requirement and cannot be foregone, even if the employee wishes to. As employers, practices are bound to stick to these requirements and may wish to note that these rules apply to employees (including salaried doctors) but not GP partners who are self-employed.
This leads to the following interpretation as to how this should be applied to GP registrars.
After an OOH shift to 2400 or 0100, the trainee needs 11 hours rest so should not start work in practice until 1100 or 1200 the following day.
After a 2400 to 0800 OOH shift, the trainee needs rest time until 1900, so no clinical work that day likely.
But trainees also need to do a 40 hour COGPED/GPC agreed week "in hours". How this is managed may vary depending on the practice arrangements and the registrar's weekly timetable. Here are some suggestions - others may be possible as long as they fit with the COGPED/GPC working week and EWTD.
If the trainee starts the "normal" working day at 1100 or 1200 and therefore misses a morning surgery, they could be reasonably be expected to do a surgery at another time when not normally done, eg on "half day" or a day they finish earlier, or do an extended hours surgery that evening or another evening, or
early morning or Saturday morning (as long as the trainee agrees or it has already been agreed in the contract they have signed). Private study time could be "made up" later on one day, eg after 1700/1800.
Likewise after overnight 2400-0800 for example, the trainee could have a private study session after 1700 for 2 hours and, as previously, "make up" the clinical time missed by doing a surgery at a time in the week when not done in a "regular" week (or an extended hours surgery).
All this should meet the contractual requirements and be compliant with EWTD as long as trainees work a COGPED week of 40 hours (28 clinical, 12 educational) with no more than 8 hours OOH/week (EWTD 2009 introduced a maximum 48 hour week).
Note that EWTD rules mean that hours can be averaged out over a 6 week period although in GP posts it may be rarely necessary to do this over more than a 2 week period.
Refer to COGPED Guidance to a Session in the Downloads section below.
There is information on EWTD on the BMA website at: