Junior doctors’ forums (JDFs)
The 2016 junior doctors terms and conditions of service (TCS) include a non-negotiable requirement for each NHS trust in England to appoint a guardian of safe working hours (GSWH). The guardian, in partnership with the director of medical education (DME), is required to establish a JDF to advise them. The JDF reports to the Board, the postgraduate training committee, medical staff committee, and LNC (local negotiating committee) at their quarterly meetings.
Responsibilities of this forum include:
- the discussion of contractual issues raised by employed junior doctors
- the review of exception reports, work schedules and rota compliance
- the review, discussion, approval and distribution of income raised through fines levied as a result of exception reports
- involvement in the performance management of the guardian to ensure this role is undertaken to a high standard.
JDF core members must include the local negotiating committee (LNC) Chair and relevant LNC junior doctor representatives. They should be accompanied by doctors elected from the employed trainees. Employers are required to make necessary arrangements to facilitate these forums, including allowing elected representatives to arrange time off for their JDF activities and duties, and integrating forum meetings into their work schedules.
JDFs can also benefit from the attendance of other individuals (or their deputies) including:
- directors of medical education
- HR directors
- Trust rota co-ordinators
- Trust executive directors
Attendance of other members should be negotiated at a trust level. This usually includes representatives from each sub group of the junior doctor population, elected on an annual basis.
In addition to overseeing contractual responsibilities, the Keogh Report (2013) outlined that JDFs will “provide a forum for the trust to engage with and harness the energy and vision of junior doctors in developing and improving services, working conditions, education and training.”
Many NHS trusts already have a network or meeting of junior doctor representatives. Some have similar roles to JDFs but are less formal, with a junior doctor as chair and with only the DME in attendance on behalf of the trust. Others are more closely related to a junior doctor representative group and community of practice model.
New JDFs were not necessarily intended to replace existing forums, particularly if the existing structure can fulfil the remit and responsibilities of a JDF. Similarly, if an existing forum has traditionally had a different focus, there is no imperative to replace or merge it, and the two forums can co-exist. There are two case studies described in this which toolkit demonstrate this point. Both Nottingham University Hospital (NUH) and Oxford University Hospitals (OUH) have JDRGs with distributed leadership structures - NUH has chosen to integrate the requirements of new JDFs, while OUH has opted to have two co-existing forums.
Prior to the implementation of the 2016 TCS, most forums for junior doctors had a similar format to JDFs, but without formal recognition in NHS trust targets and without the role of the guardian. The introduction of the contract has seen JDFs become compulsory and has introduced the guardian.