Average hours worked

You should expect to work, on average, a pro-rata % of the total number of hours full-time resident doctors on your rota work. This 'average' is defined as the average number of hours worked per week over a 26 week period (or the length of the rotation if shorter). The total number of average hours full time resident doctors work will be calculated by the compliance team (they use the Riddel formula for this calculation) - it is often around 47 or 48 hours but can be less.

Doctor A who is 80% LTFT working in a department where her full time colleagues work 48hrs/wk (on average), should expect to work approximately 38.4hrs/wk. Doctor B who is 80% LTFT works in a department where full time colleagues work 44hrs/wk, should expect to work 35hrs/wk.

Please note that although both these doctors are working at 80%, because their average hours are different, their 'basic salary' pay bands are different (see 'pay' section).

Fixed non-working day

Your employer is not under any legal obligation to give you a fixed non-working day (e.g. every Monday), although many LTFT resident doctors prefer this pattern and most departments will accommodate this. If you have moved from England, this will be different to what you are used to, as fixed days can be guaranteed under an English contract

It is important to realise these days off are not set in stone and there may well be occasions where on-call commitments or rest post on-call encroach on this day off. Unless agreed, a normal day, long day, twilight shift should not be rostered on a non-working day - although be aware Friday evenings may be an expectation (see 'Fridays' below). Night shifts and post on-call rest shifts may be rostered on your usual fixed day off. A day in lieu will not usually be necessary unless you exceed your average weekly hours (over 26 weeks) and your average weekly hours exceed your F bracket (see 'pay' section).

Uneven percentages

Resident doctors working at uneven percentages (50/70/90%) may agree with their department to vary their working pattern to alternate weeks (e.g. if at 70% to work alternate 3 and 4 day weeks). This may be preferable in some cases if you anticipate it will be difficult to leave on time on a half day.

On-call committments

LTFT resident doctors should undertake a pro-rata % of daytime working and they should undertake a pro-rata % of on-calls. NES advise that on-calls should be "pro-rata on-call" unless there is an exceptional training need e.g. opportunities for achieving competency/experience which can only be achieved through on-call work. The difficulty is that working anything greater than a pro-rate% of on-calls means your daytime hours and educational experience is reduced.

When your hours are agreed to be pro-rata daytime and OOH, you should expect to cover (approximately) the relevant % (e.g. 80%) of all types of shifts across the rota. This means you should expect to work approximately 80% of normal days, 80% of night shifts and 80% of weekend shifts, as your full time colleagues do. Weekends and nights are usually worked in full blocks because it would make life very difficult to work only 80% on Friday/Saturday/Sunday block (you would have to go home at Sunday lunchtime), but the overall frequency will drop.

Unfortunately, some departments within NHS Lothian are not currently able to cope with a reduction in contribution to the OOH workload, and one of the conditions of working LTFT in such departments (with your prior agreement) may be that you undertake 100% (and not pro-rata) of on-calls. Alternatively, you may choose (or be advised) to undertake 100% OOH for educational purposes. This will be taken into account when calculating your banding supplement (see 'pay' section). You have the opportunity to discuss the OOH contribution with your TPD when you meet to complete your Form A, but a pro-rata % should be considered the norm.

Please ensure you communicate your expected OOH% to your rota master (if this is not the usual pro-rata%) as it is very difficult for them to get this information any other way.

Fridays

Remember in many departments, Friday evenings will be treated as part of the weekend working pattern. This may mean you are rostered on a Friday evening even if you do not normally work this day. You may wish to take this into account when choosing a regular non-working day.

Rotations

LTFT resident doctors are normally expected to move between placements and rotations at the same time as their full time colleagues in the same programme. This allows LTFT doctors to attend inductions with the rest of their cohort. Some training programmes will extend the duration of each placement on a pro-rata basis. Whilst potentially beneficial from an educational perspective, this may lead to a doctor rotating "out of sync". When this occurs, employers should ensure appropriate and timely induction takes place.

Choosing which day to work LTFT

Many resident doctors value a fixed non-working day(s) each week. You should be aware your LTFT day cannot be guaranteed from rotation to rotation, although in practice, many resident doctors are able to maintain fixed non-working days for prolonged periods of time by giving their new department plenty of notice. It is advisable to get in touch with your next rotation's rota master as soon as you know your next block, to request your fixed non-working day - at least 6 months in advance if possible.

Some resident doctors may not require a fixed day off each week. This allows more flexibility to access educational opportunities such as certain clinics or departmental teaching. Rotas should distribute non-working days evenly throughout the duration of the rota.

When considering which day to request off for a particular rotation, you may wish to consider when departmental teaching takes place or a clinic which may be useful for your training. If you are choosing LTFT to reduce burnout, you may find it helpful to have a Wednesday off to break up the number of days in a row you work.

If you are choosing LTFT around childcare, you may wish to consider how you will cover childcare on days which you will occasionally need to work or be on post-nights. E.g. if you do not work on a Monday, you will find you are sometimes post-nights on Monday morning or going into nights that night and may need to arrange additional childcare. You may find that having a midweek (Tues-Thurs) day means there are fewer days where you need additional childcare to cover. You may, however, find if you have children at nursery it is easier to arrange additional childcare on Mondays or particularly Fridays as these tend to be days where nurseries may not be a full capacity. If you have a non-working day on a Friday, remember some departments may ask you to work Friday evening.