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Implications of the imposition of the junior doctor contract in England

In an article published in the Journal of the Royal Society of Medicine, Ailsa McKay, Ravi Parekh and I  discuss some of the implications of the imposition of the new junior doctor contract in England's NHS. For doctors, the contract's imposition is distressing for several reasons. First, the contract is incompletely developed, and there are errors in the associated ‘pay calculator’, and heavily criticised, unrealistic rotas have been published. Doctors are therefore unable to determine the hours they are likely to work under the new contract, how these will be distributed across the week, and the impact on their salaries. This uncertainty is compounded by lack of clarity around the government’s rationale for imposition: provision of a ‘seven-day National Health Service’. The government has not clearly defined what it means by this, and the proposed rotas do not redistribute services evenly across the week. Indeed it is unclear whether the new rotas will provide any enhancement of weekend cover. Nor is it known what impact the proposed new working patterns of junior doctors will have on clinical outcomes, mortality and National Health Service productivity.

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