2.2 Similarly to 2.1 above, where a junior doctor doesnot leave their workplace at the end of their shifttime, it should not be declared as time in workunless instructed to do so by an authorised andsenior member of the trust.2.3 Doctors working on an on call rota providing oncall duties Monday to Thursday nights are requiredto be on duty no more than 32 hours at a stretch.For this to be possible, finishing times on the dayfollowing on call must adhere to the followingprinciples:2.3.1 Any doctors presenting themselves earlierthan 9.00am at the commencement of theiron-call day, do so at their own volition andmust notify the Directorate Manager of theirreasons <strong>for</strong> doing so.2.3.2 Doctors providing on-call that day, who havecommenced duty at 9.00am, must completetheir duties at 3.00pm the following day.They are not required to be present afterthat time.2.3.3 If due to clinical commitments, it appearslikely that the shift will extend beyond therequired finishing time, the junior doctormust notify their consultant <strong>for</strong> advice nolater than an hour be<strong>for</strong>e the scheduledfinish time. The directorate manager shouldalso be notified who will record this fact (seeAppendix A – Hours Breach Report) and anyagreement made with the consultant onbehalf of the trust to extend the finish time.Any extension to the finishing time must besolely <strong>for</strong> emergency clinical work.2.4 Wherever possible, junior doctors shall not berostered <strong>for</strong> commitments such as clinics, post oncall.If they are, the trust must ensure that theycan leave that clinic early. For example if the endof shift time is 3pm, post on call, and the juniordoctor is required to attend clinic in the afternoon,they must leave clinic at 3pm. Failure to do so willresult in the post becoming non compliant andBand 3.2.5 In most circumstances, the junior doctor will berequired to finish at their designated time. Only inexceptional circumstances will they be required tocontinue working after this time.Natural Breaks3.1 Junior doctors must ensure that they take therequired half hour break <strong>for</strong> their working pattern.For example, <strong>for</strong> a standard working day of 9am –5pm, a natural break should be taken betweenmidday and 2.00pm Monday to Friday.3.2 It will be the junior doctors’ responsibility to take acontinuous suitable break of 30 minutes, notifyingtheir immediate clinical team that they are taking abreak and that they are not to be contactedexcept in an emergency.3.3 Junior doctors should notify the directoratemanager when it has not been possible to take asuitable break, citing the reasons <strong>for</strong> this. Thedirectorate manager will record each breach (seeAppendix B – Natural Break Breach Report). Theseincidents will then be taken up with the relevantconsultant team by the directorate manager toensure full compliance with this aspect of thejunior doctors’ hours regulations.3.4 Theatre and clinic overruns will become theresponsibility of the consultant where they arerequired to relieve junior doctors of their duties sothat they can take a natural break. The consultantmust make it explicit to the junior doctor that theyare required to take a break.3.5 If the junior doctor wishes to <strong>for</strong>feit their naturalbreak <strong>for</strong> their own reasons, they may do so butthis will not be at the behest of the trust, andcannot <strong>for</strong>m the basis of a failure by the trust tocomply with Working Time Directive (WTD) or NewDeal, nor can it result in posts being allocated payband 3. If a junior doctor <strong>for</strong>feits their naturalbreak of their own volition, they must also reportthis on every occasion to the directorate managerwhere it will be recorded accordingly.Responsibilities4.1 All directorate managers in conjunction with theirconsultant team should ensure mechanisms are inplace to support the taking of natural breaks. Aspart of this process, notices on wards and wardphones should in<strong>for</strong>m other ward staff of therequirement <strong>for</strong> junior doctors to take natural56
Appendicesbreaks and set out ‘bleep free’ periods when wardstaff should refrain from contacting junior medicalstaff (except in an emergency).4.2 It will be the junior doctors’ responsibility to take asuitable break, notifying their immediate clinicalteam that they are taking a break and that theyare not to be contacted <strong>for</strong> a period of 30minutes, except in an emergency.Communication5.1 The above requirements will be communicatedwidely to all consultant teams, nursing staff,directorate managers, divisional general managersand the wards. Explicit reference to thesearrangements will be made at junior doctorinduction with a hard copy handed out to all newappointments.5.2 Each directorate will feedback to junior doctorsregularly regarding overruns and incidents whichprecluded junior doctors from taking a naturalbreaks and complying with the working pattern.Agreement and Review Date6.1 This agreement has been reached with thedivisions and representatives of the (needs fullunabbreviated names first) SHO and SpR grade.6.2 This policy will be reviewed annually followingeach period of monitoring or earlier if the needarises.6.3 This policy has been approved by the capital andwork<strong>for</strong>ce planning meeting held on 6th July2007.Implementation date: 1st August 2007Review Date: Following annual monitoring of juniordoctor hours or earlier if required57