Junior Doctor Monitoring Guidance For Administration Processes 1
This guidance seeks to ensure a monitoring framework within Blackpool Teaching Hospitals NHS Foundation Trust (the Trust) consistent with the 8 principles set out in national guidance on monitoring, requiring: Agreed national set of standards and guidance Simple to use and easy to understand Targeted and comprehensive Accurate and transparent Clear performance management lines of accountability within the trust Audit trail Properly resourced process Monitoring system capable of adaptation to future changes in contractual or legal requirements Junior Doctor monitoring is a contractual obligation and must be completed at least once every 6 months. 1.1 Provision of information and working hours 1.1.1 At the commencement of each post, every trainee will receive a rota template and monitoring timetable from the Monitoring Team. This information details the working pattern of that post and when monitoring will take place through the year. 1.1.2 The rota template will provide trainees with the expected duty and working hours, the pay banding supplement. 1.1.3 No trainee is expected to attend work or teaching outside their rostered hours and trainees should achieve natural breaks (20 minutes per 6 hours worked). Handover systems exist at the Trust to prevent additional hours of work and should be utilised by trainees. Where these systems are not providing adequate support or trainees feel an expectation to stay beyond rostered hours or attend work prior to rostered start times, trainees should contact Trainee Doctor Support Team Manager immediately. 1.2 Monitoring methods 1.2.1 Monitoring of all junior doctor rotas will occur approximately every 6 months as outlines on the rota template. 1.2.2 Monitoring will only be carried out for doctors appointed to Deanery recognised training posts. 1.2.3 A suitable 2 week time period for monitoring will be chosen, unless otherwise stated. Doctors involved in monitoring will be notified of these dates 2 weeks prior to the onset of monitoring. This allows trainees to notify the Trainee Doctor Support Team of any typical working arrangements during this period not previously recognised. 2
1.2.4 This monitoring period will provide representation of a typical continuous 14-day period of work. This should therefore not include bank holidays, change of house or additional locum work. Care should be taken to avoid changeover periods. 1.2.5 Monitoring will occur via the Doctors Rostering System (DRS3) online monitoring to enable computerised analysis of monitoring returns in accordance with the statistical methods of hours and rest calculations agreed with the BMA. 1.2.6 Monitored doctors will be informed of the monitoring period via e-mail, to personal e- mail addresses (where provided), and will receive e-mails throughout and immediately following the period reminding them to participate in the process. 1.2.7 Less than full time trainees will be monitored separately on their own rota, in order to ensure that the hours of these trainees do not artificially lower the monitoring result. This will require individual arrangements and extension of the monitoring period to cover the entire rota period for these trainees. 1.2.8 Doctors in training take full responsibility for entry of their individual data. Data can be entered by the administrative team, but will only be done where annual leave, study leave or absence have been confirmed and the doctor is unable to enter the leave themselves. No post-hoc amendments to individual data will be made without either express permission. Any amendments will be accompanied by a note on the online system of the change(s). 1.2.9 The monitoring timeline will follow the monitoring process in section 1.3 below. 1.2.10 If monitoring of a rota returns at a poor rate (<75% of participation by trainees on the rota or <75% of overall duty periods returned), no conclusions can be validly drawn from the data provided; the monitoring return is invalid. If the rota being monitored is new or the banding of the rota has changed since the previous monitoring episode, a repeat round of monitoring will be organised. If the rota has monitored validly in a previous monitoring episode, no repeat round will be held. The Trust must have a compliant result at least twice per year. 1.2.11 In addition to the receipt of a summary of the monitoring data by participants of the monitoring episode, a full copy of the monitoring data may be shared with the BMA on request. If any trainee does not want their data shared in this way with the BMA, they should notify the Trainee Doctor Support Manager prior to the start of the monitoring episode 3
1.3 Monitoring Process (to be completed by member of staff responsible for monitoring process) Action 1 Action 2 Action 3 Action 4 Action 5 Action 6 Action 7 Action 8 Action 9 Divisional notification 4 weeks before monitoring is due to commence sent to Directorate Manager, Workforce Business Partner, Rota Coordinator, Assistant Directorate Manager (Documentation included: Monitoring Timetable, Rota Template, DRS Guidance and Trust Guidance for Trainees) Trainee Notification of monitoring 2 weeks before monitoring is due to commence, sent to Trainee and Rota Coordinator (Documentation includes: Monitoring Timetable, Rota Template, DRS guidance and Trust Guidance for Trainees) Trainee notification of monitoring 1 week before monitoring is due to commence, this is the same as Action 2 but includes a link for DRS3 to enable the completion of the diary card Trainee is notified on the day of monitoring that this exercise has commenced (DRS3 link included) Trainee notification at the end of week 1 of the diary cared exercise; this informs the trainee of the percentage completed to date. The Head of Department will be notified of any trainees who are not engaging with the diary card exercise. Trainee notification at the end week 2 of the diary care exercise; this informs the trainee of the percentage completed to date. The Head of Department will be notified of any trainees who are have not engaged with the diary card exercise. Trainee notification that the diary card is now closed; the percentage completed and colleagues who have not completed the diary card will be asked to ensure this is done. Head of Department and Rota Coordinators are updated. Investigate entries within the diary card, i.e. reasons for working extra hours or outside the rota template. Narrative is requested from the trainee to ensure the data is correct. The Trainee Doctor Support Team will only modify a diary card with express permission from the Trainee in writing. Email notification of outcome of the exercise; provided to the Trainees, Rota Coordinator, Head of Department, Directorate Manager, Workforce Business Partner, Trainee Doctor Support Team Manager and Clinical Lead. The outcome of monitoring will be provided within 15 working days of the closure of the monitoring exercise. 4
1.4 Monitoring feedback form Hospital:- Specialty:- Grade:- Date Monitored:- Please find below an anonymised summary of the results of the recent monitoring episode: Number of trainee doctors on rota Percentage duty return rate (%) Banding Rota Template Monitoring Result New Deal Average weekly hours of duty Average weekly hours of work Longest duty period Natural Breaks achieved (%) EWTD Average weekly hours of work EWTD 59hrs in 14 days rest achieved (Y/N) EWTD 11hrs rest achieved (Y/N) Comments from doctors within analysis: Insert any salient comments from monitoring e.g. not able to get to clinic Comments from medical staffing/directorate manager on analysis (including reason for nonvalidity): Insert comments regarding the monitoring result: - Valid return but dispute result see JDAT guidance e.g. The trust disputes the representation of this monitoring episode and wishes to discuss the results further with trainees at a mutually acceptable date. - Valid though appears not getting natural breaks overnight will review policy e.g. 80% of natural breaks achieved. 20% of breaks not achieved primarily result of over-running of respiratory and cardiology clinics. Directorates informed and to review clinic hours for trainees If you require a full redacted report of the monitoring data or for any other queries please contact: Trainee Doctor Support Team: TraineeDoctorSupportTeam@bfwhospitals.nhs.uk For further details on the Junior Doctor contract, pay or banding structure, feel free to contact the Junior Doctor Advisory Team. E-mail: nwd.jdat@nw.hee.nhs.uk For more information, please 5
Contacts For more information, please contact the Junior Doctor Monitoring Team Telephone: 01253 953646/955028 Email: TraineeDoctorSupportTeam@bfwhospitals.nhs.uk Nicola Di-Vito, Trainee Doctor Support Team Manager Telephone: 01253 957256 Email: Nicola.Di-Vito@bfwhospitals.nhs.uk 6