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European Working Time Directive. And its impact on GPStRs in practice. Overview. Several main features Compulsory mid shift break Essentially a lunch break Compulsory daily rest Compulsory weekly rest Maximum number hours worked per week. Maximum 48 hours per week.
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European Working Time Directive And its impact on GPStRs in practice Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Overview • Several main features • Compulsory mid shift break • Essentially a lunch break • Compulsory daily rest • Compulsory weekly rest • Maximum number hours worked per week Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Maximum 48 hours per week • Deal with this first as it is easiest • Maximum 48 hours is averaged • Either over the duration of the post • Or over six months whichever is shorter • This will not affect GPStRs (unless they do locums) • GPStR contract 40hrs +36 hours OOH (in 6 months) =41.5 hours per week averaged over six months Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Maximum 48 hours per week Exceeding this in any one week is OK As long as the compulsory rests periods are not lost Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
GPstR Contract • 40 hrs • 1 session protected teaching (Tutorial) • 1 session self directed • 1 session Half Day Release – when on Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
“Lunch Break” • They must be allowed 20min break for working days that exceed 6 hours • They must be free of duties completely • The test - can they do what they wish during this time without notifying anyone else – if not they are not free of duties • (See later for definition of work) Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Daily Compulsory Rest • A minimum of 11 continuous hours rest in every 24 hours • Please note not per day but for every (rolling) 24 hours • After every working day – max shift 13 hours • This usually means that time is required before and after an OOH shift Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Weekly Compulsory Rest Continuous 24 hours rest after every 6 days OR Continuous 48 hours rest after every 12 days Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
What Counts as work? • Practice Meetings • Personal Study Time (the half day) • Half day Release • Travel between sites (including HDR & OOH) • Oh…………and seeing patients! • NOT travel to work Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
BUT……. • Yes • I know its not what we did in our day • I know its not how we work even now • And • It IS the LAW • Breach of EWTD can incur a £5,000 fine Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Daily Compulsory Rest Some examples Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Normal Day 08:30 18:00 08:30 18:00 Normal Day 9.5 hrs Normal Day 9.5 hrs • 14.5hours rest Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Evening Shift 08:30 18:00 08:30 18:00 OOH 19:00 - 01:00 Normal Day 9.5 hrs Normal Day 9.5 hrs • 7.5hours rest Just get on with it – no longer an option Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Evening Shift – let them start late 12:00 18:00 08:30 18:00 OOH 19:00 - 01:00 Shortened Day Normal Day 9.5 hrs • 11hours rest 14 hours work – 7.5 hours rest (as a block) 08:30 Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Late Evening Shift 08:30 18:00 08:30 18:00 OOH 22:00 - 01:00 Normal Day Normal Day • 4 hours rest • 7.5hours rest More than 11 hours – But not continuous Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Evening Shift 12:00 18:00 12:00 18:00 OOH 19:00 - 01:00 Shortened Day Shortened Day • 11hours rest • 13 hours work Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Overnight Shift 08:30 18:00 08:30 18:00 Normal Day OOH 24:00 - 08:00 Rest Day 11hrs • 6 hours rest Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Overnight Shift 08:30 13:00 shortened Day OOH 24:00 - 08:00 Rest Day 11hrs min • 11hours rest Guidance suggests that overnight shifts should be no longer than 8 hours. Difficulty for our registrars is the mixture of OOH and normal day time duties Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
EWTD - FAQ • Questions from September 2011 workshop Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
What if trainee wants to work longer than the EWTD limit? • They can’t • They have a professional duty not to put themselves in breach of the EWTD • In the event of a complaint it is likely this would be counted as contributory negligence • If you collude and allow this you would be in breach of the EWTD Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Unpaid work : does this count? • Yes it does Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Locums? • They are contractually obliged to inform you • You must agree (also see longer hours) • I would advise recording any such discussion on the Educators Notes taking into account their current progress Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Running late?if trainee consistently runs over, is this still counted? • When calculating time spent on work, you should reasonably estimate the expected duration • Perhaps ask them to complete a time / motion diary if in doubt • Always taking one hour longer on clinics becomes a performance issue but still has to be taken into account when calculating time spent working Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Reasonable Adjustment with experience • The time allocated for registrar doing house calls should vary depending on experience Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Administration work • Staying behind to finish off letters, reports, do lists etc - time for administration should be identified on the timetable Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Can break be coffee time? • Yes • As long as this does not include any work or expectation of work • 20 minutes must be free from all duties – ie no phone calls, messages etc Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
What about the BMA model contract? • The BMA is working on a updated version • This will be released soon Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
On-call • A break of at least 20 minutes is required even when on call • The simplest solution would be to “pass the bleep” to the supervisor for this time Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme
Request • Trainers would find a sample timetable helpful • Earlier allocation of NDUC sessions would help planning • A consistent approach to working time lost from EWTD is required • Asking registrars to work a number of extra sessions pre-emptively which can be cancelled if not required, is easier to manage than seeking extra shifts later on Dr Andy Downs, LTPD, Durham & Tees Valley GP training Programme