The junior doctor contract and fidelity clause explained

August 19, 2017

The new contract is set to greatly affect the way that junior doctors work extra shifts, primarily due to the introduction of the fidelity clause.


The clause was designed to reduce the number of doctors working locum shifts through agencies. This is because hiring agency doctors is much more expensive than hiring doctors from an internal staff bank. After all, agencies charge up to 25% commission.


The fidelity clause means that junior doctors looking to work extra shifts will first need to offer their services to an NHS staff bank before they can locum, whether through Swiftlocum or the traditional method of calling a bank and having to work through a busy and overworked rota coordinator. The ambiguity of the clause has opened up many different interpretations of how to implement it. Some trusts may specify that doctors work a certain number of bank hours or shifts. Other trusts may not allow their doctors to work for agencies at all. On the flip side, the British Medical Association's (BMA) stance is that if an NHS staff bank cannot offer extra shifts to doctors on days that they are available to work, they will have met the conditions of the clause. Notably, the rates paid for bank shifts are likely to be capped.


One thing to bear in mind is that doctors will have to keep a record of bank hours or shifts worked, or have some form of evidence confirming that they offered their services to an NHS bank but there were no shifts available.


Swiftlocum has you covered, whatever the situation. Let’s go through some possible scenarios:


Problem: Your trust wants you to work eight hours (or one shift) at capped bank rates before being released from the clause.

Solution: No problem. You can intelligently track the number of hours or shifts you have worked at capped rates. This will be intuitively illustrated on your homepage, and will be available to view by any trust that has accepted you onto their staff bank. You can turn this feature on or off.


Problem: You worked a capped bank shift at a trust that does not use Swiftlocum, and you want to update your capped hours on the app to reflect that.

Solution: You may upload any evidence of bank work within Swiftlocum. To do this, simply press the upload icon next to the capped hours chart on the homepage. Any evidence uploaded will be available to view by trusts that have accepted you onto their staff bank. Staffing admins can then review evidence and approve it, resulting in your capped hours being updated automatically.


Problem: You offered your services to an NHS staff bank but they were unable to provide you work on a day that you were available.

Solution: This is certainly a possibility and does mean that you will have met the terms of the clause. However, in order to be released, you will need to prove this. Again, we at Swiftlocum have you covered. You can upload any evidence (whether that’s an email or a letter from medical staffing) that confirms your initial offer of services to an NHS staff bank, in the same way that you upload evidence of bank work. Simply press the upload button, add a short note and submit.


Dr Samandip Dhesi

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