Managing rotas and duty rosters for junior doctors in England

Guidance for non-resident on-call rotas

Location: England
Audience: Junior doctors
Updated: Tuesday 8 February 2022
Topics: Working hours

Definition of non-resident on-call (NROC)

NROC is when you are required by the employer to be available to return to work or to give advice by telephone but are not normally expected to be working on site for the whole period.

Non-resident on-call working patterns are required when employers do not need on-site cover, but require the doctor to be available to provide advice over the phone and/or to return to the site as needed.

Carrying an ‘on-call’ bleep whilst already present at their place of work as part of your scheduled duties does not meet the definition of NROC working.

On-call rules

An NROC ‘availability allowance’ of 8% of basic pay is paid to any doctor who undertakes NROC work irrespective of the amount, and all hours worked while on-call are paid at the prevailing rate.

The average number of hours work expected to be done during the duty are calculated prospectively, and the doctor is paid for these hours. Exception reports should be used to claim payment for extra hours of work done on top of the prospective average, and also to ensure a doctor is sufficiently rested if they end up having to work more hours than was expected.

Sufficient rest and declaration of fatigue

Sufficient’ rest during an on-call period is defined in the TCS as eight hours rest per 24- hour period, of which at least five should be continuous rest (between 10pm and 7am).

It is vital that you are able to self-declare as too tired to work safely if this on-call period rest requirement has not been met.

If you have not received the required rest, and you feel unable to work you should inform your employer that you cannot attend work as rostered. Your employer does not need to assess your ability to work safely or the level of rest you received.

Arrangements for dealing with this must be agreed locally. See guidance for negotiating local arrangements.

Guidance for managing NROC rotas

The good rostering guidance includes principles for assessing work during on-call periods. It addresses key areas for developing appropriate NROC rotas and for addressing issues that arise with the rotas. These include:

  • How to prospectively calculate hours for work done
  • Determining predictable and unpredictable work
  • NROC rota design process
  • Exception reporting for on-call periods
  • Effective management of the rota after the design and implementation process

Many of the guidance points included within the good rostering guidance are now incorporated into the 2016 TCS following the 2018 Review.