Health Education England (HEE) recognises and values the significant contribution of all healthcare learners, including doctors in training, to patient care. Learners are dedicated and committed professionals. In exceptional circumstances, they may need to work in different clinical areas or even for a different provider within their local healthcare system. It is important that these circumstances are exceptional and that any diversion of doctors, or others, from their training and normal professional responsibilities, does not become normalised and is managed appropriately.
Final year medical students
HEE has been working with the Medical Schools Council and the General Medical Council (GMC) to enable those who wish to make a contribution to the NHS as part of the COVID-19 response.
Following the joint UK statement on provision registration from health departments, regulators and education coordinators, the GMC has confirmed that early registered doctors can work in short term posts up until August when doctors will start their accepted 2 year foundation programme posts.
HEE and UK Medical Schools will directly link graduates who have expressed an interest with employers. Employers should work with HEE to determine how best to support these doctors.
These doctors should be employed under the 2016 terms and conditions for doctors and dentists in training as if they were foundation year 1 doctors. However, there should be a separation in roles and responsibilities between these new doctors and FY1 doctors already established in post. As such the new doctors will be referred to as FiY1 doctors (foundation interim year one doctors).
As this is likely to be the first time these doctors will have worked in the NHS, particular support and focus should be provided regarding the safety and support of these staff. Guidance will be provided by HEE, but as a minimum HEE has stated they should receive:
- an induction
- full supervision, ideally FiY1s should only work between 0700 - 2100
- recognition of their contribution at this time
- remuneration, as per the requirements of the 2016 TCS for FY1 doctors
- access to other resources provided to foundation doctors, such as support from the local professional support unit if necessary and access to e-Learning for Healthcare and recommended SCRIPT modules.
Further guidance on the support that should be provided to graduates in FiY1 roles has also been produced by the UK Foundation Programme Office.
HEE has also set expectations that during the COVID-19 pandemic, graduates in FiY1 roles should not be placed within emergency medicine, intensive care units or in anaesthetics and respiratory.
Information about funding, costs and payment support has also been provided by HEE and can be found on the HEE website.
Non-final year medical students
Medical students who are not in the final year may also want to make a contribution to the NHS at this time. If employers wish to employ these students to provide support to the NHS during the COVID-19 response, we would recommend that they are employed on Agenda for Change terms and conditions within an appropriate role within bands 2-4, such as an healthcare assistant or clinical support worker.
Read the joint-statement about the option for planned placements in England, issued on May 7 by the Nursing and Midwifery Council (NMC), Health and Care Professions Council (HCPC), Health Education England (HEE) and the Council of Deans of Health.
Doctors in training
HEE wrote to all trusts and GP practices in mid-March, reiterating guidance and providing information about the plans and contingency for management of medical and dental training programmes during emergent phases of the COVID-19 outbreak.
HEE notified employers that doctors in training who were due to rotate to a new placement in April, will instead remain in their existing work environments unless local arrangements allow otherwise, or wider clinical circumstances require it. Rotations may only occur where departmental inductions, appropriate supervision and support can be guaranteed.
Where doctors remain in their existing work environments rather than rotating, employers will be issuing new work schedules and will want to check that safe working hours are maintained across the transitional date. Doctors should be supported as much as possible with any existing plans that are affected by the change of rota, such as caring responsibilities.
HEE announced on 15 May that medical training rotations will restart again in August. Planned rotations were cancelled for May, June and July as a result of COVID-19. However, not all specialties will rotate in August there will be some programmes with start dates later than August.
HEE will provide trainees and employers with notice of the August and other summer placements as soon as possible but no later than eight weeks before the intended start date. Training placements will need to take into account requirements of local healthcare services and specific COVID-19 pressures and therefore placements within a programme area may change as a result of changes to service models.
We are aware that ALS courses have been cancelled due to social distancing requirements. Whilst this remains the case, doctors who would normally be required to have ALS as a condition of starting in post, should be able to take up their jobs. However, organisations will need to assess the skills required and any certification held by individuals and ensure that sufficient training is provided where necessary, so that they can carry out their role safely.
Terms and conditions
NHS Employers has agreed a joint statement with the British Medical Association on the application of the 2016 terms and conditions of service contract limits for the duration of the COVID-19 pandemic for NHS doctors and dentists in training in England.
Clarification on issues that have been raised by employers in relation to the medical and dental workforce can be found in our medical and dental workforce FAQs.
Doctors in training related information
HEE is committed to doing everything it can to reduce the impact on learning and training of any placement move or change in service provision. The exceptional nature of such circumstances will be taken into account when assessing progress against curricula. HEE postgraduate deans and regional teams will monitor any exceptional circumstances and liaise with education providers and employers.
HEE has a full set of resources (regularly updated) on COVID-19 which includes:
- coronavirus (COVID-19) information for trainees, as well as for allied health professions (AHPs) and nurses and midwives
- HEE coronavirus plans for management of medical and dental training programmes – this notes employment and training management issues and also addresses exceptional circumstances where trainees may have to be moved to other clinical areas or different locations.
The Academy of Medical Royal Colleges (AoMRC), the General Medical Council (GMC) and Conference of Postgraduate Medical Deans (CoPMED) have published a statement on exams. Following the government’s most recent advice, colleges have cancelled all exams. Trainees in programmes will not be disadvantaged by missing exams because of circumstances beyond their control related to COVID-19.
The four nation statutory education bodies have published a statement on contingency planning for the Annual Review of Competence Progression (ARCPs).