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NHS Employers Clarifies Guidance on Junior Doctor Guardian Fines

Following the complaints from the British Medical Association (BMA), NHS Employers has made some changes in the guardian fines for overworking junior doctors.

If junior doctors are required to work beyond the upper limits of their rostered hours then the Guidance encourage junior doctors to make an exception report, allowing their employer to respond to rota issues in real time. The exception reporting is designed to flag up bigger problems or weaknesses in the system and ensure safe working limits.

The previous guidance for junior doctors had raised concerns to the BMA that the junior doctors who exception described owing to being overworked could have ‘failed’, implying the system would judge junior doctors’ work.

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

The chairs of the BMA junior doctors’ committee, Dr Jeeves Wijesuriya and Dr Pete Campbell welcomed the response made by the NHS Employers in BMA requests to clarify the original wording of their guidance.

They said the response of NHS Employers makes it clear that it is employers who are responsible for managing a system in which juniors are never required to work unsafely. The junior doctors can and should exception report all breaches of their work rota with total confidence and no implication of their individual failure.

They further added that the rota gaps, unpredictable service pressures and staffing shortages are outside the control of any individual doctor, whether that is a junior, their guardian of safe working or their supervisor.

After a bitter industrial dispute with the BMA, the Department of Health introduced a new contract under which junior doctors are required to work longer hours. A study by the Royal College of Physicians has found that most of the junior doctors believe the rota gaps and staff morale are having a negative impact on patient safety and four-fifths of junior doctors are suffering from excess stress.

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