On-calls
Increasingly across the UK, staffing shortages have been used to drive the introduction of new forms of on-call. This is not the intended purpose of on-calls, which have traditionally been worked by community teams to cover intrapartum care for the women in their care.
You are on-call when you are available outside of your normal working hours to work as and when required.
For midwives and MSWs generally on-call is undertaken from home, but on-call can also mean being required to stay or sleep at the workplace, or nearby.
For all NHS staff employed under Agenda for Change, the Agenda for Change Handbook sets out principles for harmonised on-call arrangements.
The terms and conditions of on-call for RCM members vary by nation, with:
- Local on-call arrangements in England, through an organisation’s partnership forum or joint negotiating committee.
- National on-call agreements for NHS staff in both Scotland and Wales
- A regional policy in Northern Ireland.
The RCM’s position is that:
- Proposed changes to working patterns should be subject to organisation’s management of change policy
- On-calls should not be rostered immediately before a day off or a period of annual leave, and compensatory rest should be taken immediately or ASAP after being called out. On-calls should only be rostered before a working shift to allow for a period of leave to begin immediately after an on-call.
The RCM will challenge the imposition and abuse of on-call at local level and raise it at national forums.
Payment
- On-call arrangements should be consistent with the principles of equal pay for work of equal value
- Staff must be paid from the time of call out, including:
- work done at home
- time spent travelling to work
- Payment must reflect the availability for being called (for example, at home vs. already at work)
- When you are on call, but otherwise free to use the time as your own, this won’t count towards working time
Arrangements
- Frequency of on-call availability should be calculated appropriately
- As with all working patterns, employers should ensure that staff are given at least four weeks notice of on-call duties
Rest and TOIL
- Staff should have the option to take TOIL rather than payment
- Covering a public holiday will attract a day in lieu in addition to any work done – even if you don’t get called in
- Staff will receive compensatory rest for work done
Alongside Agenda for Change, there are a number of other arrangements, terms and conditions that apply to on-call provision, such as the Working Time Regulations which set limits on the number of hours that workers can work each week, the NMC code and specific organisational, local and national arrangements.
Additional Hours
Any imposition of on-call systems is particularly concerning considering the extra hours worked by RCM members in England. In the 2022 NHS Staff Survey (England), 81% of midwives reported working additional unpaid hours for their organisation and an RCM survey in March 2023 which asked RCM members in England of their experience of one week in March found 88% of respondents worked additional unpaid hours with 26% working more than five additional unpaid hours that week. Additional hours worked by staff should be rewarded fairly, with overtime paid at time-and-a-half for staff in bands 1 to 7 for hours worked above standard hours (37.5 hours a week). There may also be local agreements which extend overtime payments to some Band 8 staff.
Work/Life Balance
Work/life balance is fundamental to the health, safety and wellbeing of midwives and MSWs and importantly to staff retention. Burnout and work-related stress are common amongst RCM members, the survey carried out in March 2023 also found that 74% of respondents often or always faced unrealistic time pressures and workloads and 64% felt burnt out or exhausted at the end of most or all of their working shifts. To retain staff in maternity services NHS organisations should be looking to offer a wide variety of different shift lengths and patterns and supporting self and team rostering to enable teams to decide how to organise their working time, arrange schedules and roles while ensuring that intra-partum care is covered, not imposing on-call systems which have a detrimental impact on midwives and MSWs working lives.
RCM Guidance
The RCM has produced guidance to support RCM workplace representatives who may be faced with proposals for new on-call systems – or for existing systems to be adapted and widened beyond their intended use. RCM reps can use our on-call negotiating guide to stop the imposition of new on-call systems that have not been agreed with staff and negotiate any proposals on behalf of RCM members.
