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Independents' Day

Practices 'not legally bound' by GP trainee contract, says GPC

GP practices are not legally bound by the elements of the new contract for GP trainees that specifies how they should schedule their trainees' work, the GPC has advised.

The GPC's workforce lead, Dr Krishna Kasaraneni, told delegates at the LMCs Conference in Edinburgh that the BMA has taken legal advice, which found that there is no legal basis to enforce agreements on 'work scheduling'. 

It comes after GP practices have raised concerns that the guidelines will lead to trainees not having enough time with their trainers in front-line general practice. 

The controversy centres around Work Scheduling Guidance that was agreed by the BMA and NHS Employers. 

The guidance says that trainees should work seven clinical sessions and three educational sessions in an average week, with requirements for regular breaks and exception reporting where they are working longer.

However, delegates said this could cause trouble for practices. Northamptonshire LMC representative Dr Jamie Green said: ‘A lot of our trainers decided it was time to stop training because of this.

‘I want to see my [trainees] in practice. but this contract means trainees are either in the practice for very short periods every day, or three very long days.

But trainees said that the guidance provided 'safeguards'. BMA GP trainees committee chair Dr Samira Anane said: ‘As GP trainee we have heard about the workload crisis, and how there need to be safeguards for all trainees.

‘We have here a contract where there are safeguards in place to ensure rest periods. Or ensure if you finish a shift at two in the morning, you’re not expected to see patients at eight o’clock - which has been happening.

‘We want a consistent message that unsafe workload, over stretched GPs, unsafe working is not good for anyone.’

However, Dr Kasaraneni told delegates that practices are not compelled to enforce this contract. He said that where trainees are employed under a 'lead employer arrangement' - with several organisations training them - then it is unclear who has responsibility for enforcing the working schedules. 

He added: 'Where there is a non-lead employer arrangement, where training practices directly employ trainees, legally you cannot be forced into offering the new contract. The choice is yours.'

The motion in full:

COVENTRY: That conference believes that the new contract for GP trainees will have the following negative consequences:

(i) practices will drop out of GP training

(ii) trainees will be less well prepared to become career general practitioners

(iii) the increased intake to general practice will become more difficult to realise

(iv) there will be increasing reluctance of trainers to take LTFT trainees.

The motion was lost in all parts.

Readers' comments (6)

  • It is Health Education England who limit trainees to 40 hour weeks, not the new contract. The new contract would quite happily take 48 hours.

    They are trying to save a few pennies, but it will lead to practices leaving training and a lower pass mark for trainees.

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  • As the clinical encounter is significantly reduced due to this contract this will have impact on trainees passing CSA .
    Resulting in extension of training which costs taxpayer more money to train GP.

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  • pretty sure I did no more than 40 hours per week as a trainee 10 years ago. so whats new? In Canada I work barely 35 hours a week. All this bullshit about not preparing trainees for work as a GP is b@llox its only UK GPs who work so hard anyway its not part of the job its just we got bullied in to it. We should be fighting the cover to 6:30 rule for practices let alone just extended hours I finish 4 or 5 pm in Canada or I work 5 til 10 and theres no obligation to cover any particular hours.
    one minute we say were all overworked the next were saying 40 hours isn't enough for trainees. Its enough for anyone and including breaks. make ur minds up.

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  • I suspect an inconsistent approach as described about will spell disaster- trainees at different practices given different pay and potentially working wildly different hours?! And what about the trainees from different specialities who were protected in the past but not under the new contract? They could lose thousands dependent on which on which practice they are allocated to!
    Just expecting it to be reasonable for GP trainees to work more hours than their hospital counterparts without any hours monitoring or recognition this will just persuade even more doctors to choose other specialities.

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  • There is no substitute for spending hours with patients and reflecting on ways to improve. The more the better. This soft training was to avoid exploitation. That should be assessed from feedback for each practice.

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  • 3:31 spot on. Its all inconsistent even between training areas, so the red flag trainee is not different from a red flag trainer (see letters BMJ this week), except the red flag trainer (the exploiting ones) will get away with it. The trainees in GP are usually doing similar menial tasks e.g. other partners docmann/hospital letters filing, similar to writing the notes on a ward round. The RCGP have been particularly dopey about tackling trainer abuse. Remember though, in GP training, there are no routine weekend or nights, not supposed to be after 6pm, other than the required OOH experience chichis entirely reasonable- esp when the trainees have seen GP's working the OOH.

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