Where can I find information regarding working compressed hours in a practice placement? (GPSTs only)


Compressed Hours Guidance – GPSTs based in Medical Practice

Background:

All GPSTs are employed by NHS Education for Scotland (NES). From August 2018 NES is their employer for the whole of their training programme, although they will be hosted by individual Health Boards (PLACEMENT BOARDS) during their hospital attachments.

GPSTs throughout Scotland have a single contract covering their work in the GP element of training.

The GPST contract states that the normal working week (excluding out-of-hours training) will comprise of 10 sessions which will be broken down as: 7 clinical, 2 structured educational (including day release) and 1 independent educational. The nominal length of a session is stated as 4 hours.

The contact also states that, although an integral part of the practice team, the GPST is supernumerary to the workforce of the practice.

Additionally, the European Working Time Directive (EWTD) states that employees should have:

    • 11 hours rest a day and a right to a day off each week
    • A right to a rest break if the working day is longer than six hours

It is recognised that this contract differs significantly from the normal working pattern of many self-employed GPs who can decide their own working pattern as independent contractors to the NHS taking into account their Practices contract with their Health Board.

All GPSTs have a right to request a change to less-than-full-time (LTFT) working. All requests will be considered fairly, with individual circumstances taken into consideration.

Implementing the Contract:

The NES GP Teams across Scotland (led by the 2 Directors and 5 Assistant Directors covering all the Regions) would take the view that a normal working day for a trainee comprises 2 sessions of approximately 4 hours.

Breaks for lunch are not included in the sessional hours, but would be deemed an essential part of the working day per EWTD.

The independent educational session may sometimes be taken out of the Practice, but should not be presumed to be a half-day. The format of the session may reasonably change during the course of a training programme in response to stage of training and individual trainee needs.

The working week timetable should be viewed as an average over a 6-week period. This allows for differences to accommodate e.g. day-release programmes which vary in their design across the Regions.

The GP trainee is not an employee of the practice but is there in a training capacity and therefore impact on clinical experience, workload, supervision and European Working Time Directive must be taken into account. NHS education has a duty of care to their employees and must protect them from working long hours that may impact on their safety and that of the patients.

Compressed Hours:

Compressed Hours would be deemed to be any variation in working pattern where the normal 40 hour working week is “compressed” into fewer than 5 days. For example, to allow a trainee to structure their week as 4 x 10-hour days.

Educational Supervisors have a unique one to one relationship with their trainee and they should not be involved in the decision making relating to the trainee’s request for compressed hours. A decision would be made by the NES Deanery in liaison with NES HR, taking into account legal guidance regarding requests for changes to normal working patterns.

Individual trainees may apply for Compressed Hours for specific personal reasons as an employee of NES. Although able to make an application, approval of a request lies solely with NES and is not guaranteed as it will depend on a range of considerations.

Key considerations in deciding whether to approve an application would be:

  • Will the proposed working pattern -
    • allow the trainee to receive all the necessary training including exposure to the various required areas of practice?
    • allow the trainee to be appropriately supervised at all times?
    • allow the trainee to function at the required level throughout the course of an extended day without affecting the trainee or patients?
  • Suitable rest periods will need to be factored in to the longer working day
  • Consideration will also need to be given to how the shorter days associated with Regional Teaching will be factored into the overall working week

Applying for Compressed Hours:

The trainee should complete the Flexible Working Application Form for GPSTs (LINK to be added) based in Medical Practice. The form should be passed to the regional Training Administrator for forwarding to relevant TPD for a decision.  The TPD will inform the trainee and the practice of the outcome of the request in writing, giving reasons for the decision.

Further information on flexible working is available in the NES Flexible Working Practices Policy (link here) .