From a GP Trainer:
Please can I have some advice. One of our Trainees is objecting to participating in extended hours because he has spoken to other trainees in the region and none of them are doing it. So, question 1 – can we make our trainees do Extended Hours? Should we be asking them?
The trainee said he might be willing to engage if time was given back in lieu for the hours done during Extended Hours. Is this acceptable? Have they a right to request this?
In the Yorkshire-Humber Deanery it is NOT a requirement for trainees to participate in Extended Hours. Therefore in response to Question 1, the short answer is no, you cannot make your trainee do Extended Hours. However, some educators believe that trainees should be encouraged to do whatever their trainers do – that they are preparing for a career in General Practice and as such need experience in all aspects of the job, included Extended Hours and Saturday mornings. There is some argument that Extended Hours/Saturday mornings might provide a different perspective of General Practice that is not experienced elsewhere like in routine surgeries or Out of Hours. Personally, I remain unconvinced and I the operative word at that time was ‘encouraged’. And, in answer to your question about whether we should be asking them, I wonder whether an alternative approach would be to rouse their natural curiosity to want to take a peek.
In Bradford, most trainees do not do Extended Hours. My own trainees have occasionally ‘opted in’ to see what it is like. If they do opt in, you have to make sure you don’t break the European Working Time Directive (EWTD) guidelines on hours of working. There’s more about the EWTD here… Therefore, in summary to Question 2, if they do engage, you have to make sure you give time back the following day – not so much as giving time back in leiu but because you must not break the European Working Time Directive (which states that trainees must not work more than 48h in any one week).
So, to recap (and a few additional interesting points)…
- You cannot make a GP trainee do Extended Hours or Saturday morning surgeries.
- If they do engage voluntarily, then Extended hours/Saturday mornings should only be ‘instead of’, rather than ‘as well as’. You will soon go well over the nominal 48 hour a week that is in most contracts and you will then be in breach of the European Working Time Directive. Many GP trainees will do more than 48 hours a week anyway – don’t believe me, add it up, particularly if including admin time etc.
- Extended Hours/Saturday mornings CAN form part of the contract with the GP trainee providing you include it on the Form B which approves the GP post in your practice for training. If you did that, then you can ‘make them’, otherwise not. But remember, you have to give time back so as not to break the European Working Time Directive. The only practice in Bradford that has done it regularly and successfully was done mostly for space issues. The GP trainee and trainer worked late on Monday instead of Monday morning. They worked together, had debrief time etc etc. It was in the Form B, and probably in the contract of employment. No trainees have complained about it so far.
- So, in practice, it is something that could be ‘offered as a different experience’ or an ‘opportunity to help out the team’. So, might appeal to a sense of professionalism, but if one is seeking to ‘make them’, that is hardly a way to facilitate promoting that.
(Written 24th December 2013)