Helping Junior Doctors

Package of measures to ease pressures.

The Scottish Government has announced steps to reduce the pressures and long working hours experienced by junior doctors.

Health Secretary Alex Neil said that, while progress has been made, more had to be done to ensure the right work life balance was in place in NHS Scotland.

In a letter to health boards the Chief Executive of NHS Scotland outlined that the following new initiatives are being taken forward:

• NHS boards will end the practice of rostering junior doctors for seven full night shifts in a row by February 2015. Currently only one per cent of rotas in Scotland schedule junior doctors to work seven full night shifts in a row.
• NHS boards will simplify the working hours monitoring process. Best practice guidance on this exists and NHS Boards will ensure that they meet these requirements.
• NHS boards will review rotas with a view to reducing long stretches of days on duty. We expect that by 2016 no junior doctor will work more than seven day shifts in a row.
• NHS boards will ensure that all staff have access to appropriate rest facilities.

Mr Neil said: 

"Scotland's NHS must continue to attract world class staff so that it can provide truly world class services for patients. 

"We have already increased the number of staff working within NHS Scotland and are now focusing on ensuring that they have the best possible working practices.

"I am quite clear that no junior doctors in Scotland should have to work seven nights in a row and I am committed to ending this practice where, on occasion, it does exist by February next year. 

"While 99% of rotas in NHS Scotland do not include a junior doctor working more than four nights in a row, we are committed to ensuring full, one hundred per cent compliance from health boards. We expect boards to observe not simply the letter, but also the spirit of the law.

"This is one of many measures we've been working on to support junior doctors and relieve some of the pressure they face. Since 2007, there are over 2000 more doctors working in Scotland's NHS and junior doctors have been supported through the introduction of advanced nurse practitioners and additional support staff.

"However, we are committed to doing more and we'll continue to work with NHS boards and professional bodies to review best practice and consider how this can be used to improve the work life balance of junior doctors.

"We will also be implementing an external assessment to ensure that these actions are being taken forward by NHS boards and that junior doctors see the improvements in their work-life balance that we all desire."

These improvement actions were agreed following a meeting between the Health Secretary and BMA Scottish Junior Doctors Committee representatives.

Dr David Reid, Chair of the BMA's Scottish Junior Doctors Committee, said:

"There is a growing body of evidence to demonstrate the dangers of shift working patterns on individual doctors' performance and more importantly on patient safety. I am therefore pleased that the Scottish Government has set a deadline to end the practice of junior doctors working seven full night shifts in a row by February next year. This has been the result of successful collaboration between NHS Boards, Scottish Government and the BMA. It proves that when politicians and management listen to those at the frontline of NHS services, we can work together to make a dramatic difference to the working lives of doctors and improve patient care.

"Although this is welcome progress, many junior doctors still work a combination of both day and night shifts which, for some means they can be working up to 90 hours a week. These rotas may be compliant to the letter of the European Working Time Directive, which aimed to reduce working hours, but they are not in the spirit of the legislation.

"It will be a challenge for NHS Employers and the Scottish Government to achieve the target to end long stretches of day shifts. I hope they will continue to work with us to address arduous shift working which can leave junior doctors exhausted whilst at the same time providing a high quality learning environment for doctors in training. If we achieve this, we will be closer to addressing the current problems attracting and retaining junior doctors in Scotland."

Dr Reid added:

"It is a positive step that the Scottish Government wants to work with us to produce best practice guidance on the monitoring process of junior doctors' hours. By streamlining and simplifying the process, junior doctors can be assured that wherever they are working, the same practices will apply across Scotland, offering consistency and removing any barriers to participating in the monitoring process."