Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what assessment his Department has made of the effect on the health service of the reduced capacity of junior doctors to undertake additional shifts or internal locums with their own organisations prior to the implementation of the junior doctors' contract in 2016.

The new Junior Doctor’s contract retains the same maximum requirement for working hours of an average of 48 hours a week or 56 if the doctor chooses to opt out of the working time regulations. The contract also includes a fidelity clause so that trainees wishing to work extra shifts offer them to the National Health Service first.

Further, the General Medical Council has recognised that some trainees that do not work full time may have the capacity to undertake additional shifts and have given their support for those working less than full time to do so. Previous advice was that Less Than Full Time trainees should not undertake additional shifts.

The previous contract allowed patterns of working that junior doctors' representatives told us were unsafe. The new contract is much safer and includes new, stronger limits on working hours and patterns. These include:

- the maximum number of hours worked in a week reduced from 91 to 72;

- the maximum number of consecutive nights reduced from seven to four; and

- the maximum number of consecutive long days reduced from seven to five.

The new contract puts patients first by requiring that these rules apply also to any additional shifts a trainee might choose to work, ensuring junior doctors are not required to work when tired and that their overall working hours, whether they work for their own or another employer remains within safe limits. These are overseen by a Guardian of Safe Working Hours in every trust. Doctors can therefore offer additional hours to the same overall limits as before but must work them within the new safe limits.