Is your practice creating safe working patterns for trainees?

In order to create safe working patterns – and avoid burnout – practices must make sure their staff are taking compensatory rest 

The most recent GMS national training survey found that 63% of trainees, and 52% of doctors working as trainers, are a moderate or high risk of burnout. Following on from COVID-19, and the dire impact it had on GP wellbeing, practices must ensure that safe working patterns are observed to create a healthy work environment to help trainees entering the workplace avoid burnout. 

As a starting point, practices can make sure that their staff are taking compensatory rest. This refers to the time taken to recover after undertaking work which otherwise interrupts periods when they would ordinarily spend resting; getting enough rest is essential for patient safety and staff wellbeing. The key elements of compensatory rest specify that:

• If staff are unable to take 11 hours of continuous rest per day, they are entitled to compensatory rest.
• Staff should not have to ‘pay back’ an activity they may have missed during a period of compensatory rest.
• If the rest period is interrupted, the clock must be reset.

To meet the specifications of compensatory rest, practice managers can implement any of the following measures across the practice. 

• Local systems – put a local system in place for healthcare professionals to inform their managers when they are too tired to work due to unpredictable activity whilst on call and so will be taking compensatory rest. 
• Create a culture – which encourages healthcare professionals to take compensatory rest when necessary. 
• Accommodate for disturbances – prepare for sleep disturbances when staff are on call on a supernumerary basis so staff that are not disturbed and will be able to attend, and assist with, on-call duties the following day, whilst staff who were disturbed will be able to take compensatory rest.
• Schedule – avoid scheduling single point access time with patients wishing to access adult community services for staff following a night on-call.
• Academic considerations – give consideration to trainees undertaking academic research activities. 
• Have a policy to cover absence – agree and implement an appropriate policy to cover for absent trainees. There is no contractual requirement for consultants to provide this cover so the employers should agree such arrangement. 

Services such as the NHS and social care will have instances where a continuous emergency service must be maintained; in these instances, if it is not possible to grant compensatory rest, employers should provide appropriate protection to safeguard the health and safety of staff. 

Arrangements for compensatory rest will be determined locally and must take individual circumstances into consideration. Compensatory rest should be taken as soon as possible to ensure staff have adequate time to recover and can, therefore, provide the best quality care for patients.