latest health care news

10.01.17

Employers clarify guidance on junior doctor guardian fines

NHS Employers has clarified that guardian fines for overworking junior doctors should be penalties for trusts in response to complaints from the BMA.

Guidance encourages junior doctors to make an exception report if they are required to work beyond the upper limits of their rostered hours, allowing their employer to respond to rota issues in real time.

The employer is also required to pay a guardian fine, which is divided between the doctor and the guardian they reported to.

The BMA expressed concern that the guidance suggested that junior doctors who exception reported had ‘failed’, implying it was the fault of the doctor instead of the trust. NHS Employers has now amended the guidance at the BMA’s request.

Dr Jeeves Wijesuriya and Dr Pete Campbell, chairs of the BMA junior doctors’ committee, said: “This makes it clear that it is employers who are responsible for overseeing a system in which juniors are never required to work unsafely, and that junior doctors can and should exception report all breaches of their work schedule with total confidence and no implication of their individual failure.

“The exception reporting system has the potential to be an effective tool for doctors to be open about the pressures the system is under and seek immediate solutions to ensure their safety, with no concept of individual failure or blame on anyone’s part.”

Junior doctors are required to work longer hours under a new contract, which the DH introduced last year after a bitter industrial dispute with the BMA.

A survey by the Royal College of Physicians has found that four-fifths of junior doctors are suffering from excess stress and half believe rota gaps and staff morale are having a negative impact on patient safety.

The BMA added that ideally, guardian fines should never be used, since they are intended to penalise trusts for encouraging doctors to work beyond limits designed to protect their safety legally.

However, it warned that some employers may plan to overwork junior doctors and pay the fine to try to cope with the unprecedented pressure on the NHS at a time of widespread rota gaps.

At the weekend, the Red Cross declared a humanitarian crisis in NHS hospitals, warning that they are near breaking point as they struggle to cope with winter pressures on reduced resources.

In an emergency statement, health secretary Jeremy Hunt suggested the four-hour target for treating A&E patients should no longer apply to non-emergency cases.

11 January UPDATE

An NHS Employers spokesperson said: “Our aim is to be as clear and straightforward as possible in guidance. We agreed a change with the BMA to improve the wording as soon as it was suggested by a trust.”

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