The Trainee’s Working Week

WHAT CAN YOU EXPECT FROM YOUR TRAINING PRACTICE?

Here is a graphical representation of what you can expect from your training practice.  Please remember that all GP training practices work differently.  This means that different practices will:

  • have varying numbers of partners, salaried doctors, nurses, admin and other staff.
  • operate different appointment systems – some may run at 2h, 2.5h or 3h surgeries.
  • differ in the average number of home visits they do.
  • vary in the types of patients they see and other demographics.

What this ultimately means is that GP trainees in different practices will be exposed to different types of work and varying amounts of workload.  In order to protect the trainee from being overworked, a good benchmark is that trainees should not be doing more than what the average doctor at that practice is doing.  The scheme expects the trainee to engage in whatever is normal for other doctors at that training practice – despite whatever might be happening at another practice.   Trainees should not be comparing themselves and complaining about a ‘lighter load’ in a different practice (unless they really think that the training practice is treating them unfairly).  If this is the case, one should discuss it with the GP trainer and the Practice Manager in the first instance before contacting the Programme Director.

THE GP TRAINEE WORKING WEEK & DEANERY GUIDANCE ON IMPLEMENTATION

The standard GP trainee working week consists of 10 sessions.  These will be divided into 7 clinical sessions, and 3 educational sessions (as depicted below).

  • This structure formalises protected educational time for the trainee and their trainer and thus provides a clear definition of the standard GP trainee working week.
  • It provides an excellent practical mix of clinical and educational sessions. A session is defined as 4 hours.
  • The structure is also a good basis from which part-time/flexible trainees can work out their weekly schedule.
  • The pattern of work will be different in each practice but the overall number of hours should be the same.
  • Flexibility is required when implementing this approach i.e. an extra educational session may be substituted for a clinical session to meet specific training needs or to help the struggling trainee with additional needs.
  • Educational Sessions are also 4 hours but they can be split up across the week e.g. half-hour debriefs can be added together to make up educational time and personal study can be split into smaller blocks across the week.
  • Structured educational time in practice can include tutorials, debriefs, clinical meetings, protected learning time sessions and joint surgeries but not OOH sessions. Joint surgeries are considered educational time if clinical workload is reduced by 50% e.g. 20 minute appointments instead of 10 minutes.
  • It is important to ensure the GP trainee undertakes at least one independent educational session per week due to the intensive training nature of the GP trainee year. This should be timetabled in as a ‘personal study’ session of 4 hours duration. However, this does not mean that there is an “automatic” right to a half day as this will depend on individual practices timetables. The independent educational session should be for personal study, ePortfolio work, audit, WPBA preparation and other admin work.
  • On days where there is no Half-Day Release (HDR) session, this does not become an automatic day off. Trainees are expected to inform their practices that there is no HDR session. If the practice requires the trainee to work, then that is what they should do.
  • Sessions can be spread across the period of the post e.g. a longer course involving a whole or several days will result in less clinical sessions that week which can be “paid back” on weeks when there is no VTS session. This does not apply to induction.

REST PROVISIONS (all from August 2004)

  • OOH is in addition to this 40 hour working week even at EWTD 2009 (48 hours/week) this will be compliant. However time off the following day may be required.
  • 11h continuous rest in every 24h
  • Minimum 20min break if shift > 6h
  • Minimum 24h rest every 7 days or minimum 48h rest every 14 days
  • Maximum 8h work in every 24h for night workers

 

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