On-call services are an ever-present aspect of working life of a physiotherapist, especially in the NHS. However, there is often confusion about members rights when it comes to on-call arrangements.
This section will inform you of the rights of individuals undertaking on-call but also will act as a guide for stewards and reps when negotiating on-call at a trust and service level.
On this page:
- How to negotiate around on-call working
- Pay rates and agreements in the four nations
- Compensatory rest
Is it on-call, overtime or unsocial hours?
To start negotiating around on-call it is important to consider how the provision of respiratory services are currently provided.
Respiratory service may be run on different models in different organisations. They could be run by a seven-day service, extended service or a respiratory on-call service. This guidance is for any service, or part of service that is run in line with the NHS Terms and Conditions Handbook definition of on-call/emergency working.
The below definition outline the contractual differences between overtime, unsocial and on-call forms of working.
Overtime working
- Classified as hours worked beyond 37.5 hours. Only staff in bands 1-7 are eligible for overtime payments (except in Scotland) and pay is set at a rate of time-and-a-half or double time on public holidays. Working overtime is voluntary.
Unsocial hours working
- Hours worked after 8pm and before 6am which are part of your normal contracted working hours. For part-time workers working additional hours, unsocial hours are also attracted for hours between their contracted hours and full time hours.
On-call / emergency duty working
Where staff are available outside of normal working hours to work as part of an on call rota, as and when required. Staff who are required to "sleep in" the workplace during the on call period are described as on "standby".
This type of working is paid in addition to standard rates of pay, and in cases where a worker has had their legal entitlement to a rest period or holiday disrupted, may result in the need for them to be given "compensatory rest" or Time Off in Lieu (TOIL).
The Working Time Regulations (WTR) state that staff "on-call" will only be regarded as working from the time at which they are required to undertake any work-related activity. Therefore, working time begins when a referral is made, often over the telephone and ends when the member arrives home again. Staff on standby duty, who remain in the workplace, will be regarded as working for the whole duration of the period. Staff who are available for an on-call session are entitled to the availability fee.
- For information on overtime and enhanced rates of pay. See Section 2 - Maintaining round the clock services and Section 3 - Overtime payments of the NHS Terms and Conditions handbook
How to negotiate around on-call working
There is UK wide agreement on the definition of on-call, travel expenses and the principles for harmonised on call arrangements. However, you may have to negotiate locally with employers around elements such as pay, time off in lieu (TOIL) and compensatory rest.
Frequency, rota allocation and backup systems are also likely to be subject to physiotherapy service-specific negotiation and agreements.
Negotiating on-call policies requires consideration of:
- pay rates,
- compensatory rest,
- on-call system arrangements,
- and how these integrate with extended working hours.
By focusing on these key areas, you can negotiate on-call policies that are fair, transparent, and aligned with both national guidelines and local needs. Always refer to relevant NHS handbooks and CSP resources for detailed guidance and support.
What is agreed across the UK
Annex 29 - Principles for harmonised on-call arrangements of the NHS Terms and Conditions handbook sets out the following which has been agreed on a UK wide basis:
- The definition of on-call - ‘A member of staff is on-call when, as part of an established arrangement with their employer, they are available outside his/her normal working hours – either at the workplace, at home or elsewhere – to work as and when required.’
- The 12 Principles for harmonised on call arrangements. These can be used as a test to ensure that your local policy complies.
- That the reserve rate of mileage should be paid for those working overtime. The CSP would argue that this should also be the case for on call despite it not being explicitly covered in the handbook.
Pay rates and agreements in the four nations
There are agreements covering on-call pay and allowances in the devolved nations, however on-call conditions in England, including rates of pay, are negotiated locally.
Important things to consider when negotiating pay
- Equal pay for jobs of equal value
- Including a review date
- Increase in pay rates in line with any agreed national pay rise or inflation
- Consider what the members would be willing to accept prior to negotiation. Consider three scenarios: best case, acceptable and worst case.
England: Pay rates and availability fees can vary widely and are likely to be negotiated on an organisation-wide basis. It is important that reps are part of the mechanism such as the Joint Negotiating Consultative Committee (JNCC) that negotiates these rates.
Northern Ireland: A nationally agreed on-call policy includes a specific availability allowance and minimum payment for call-outs (time and a half), with higher rates for work done during public holidays (double time).
Staff who are called into work during a period of on-call will receive a minimum payment of 2 hours, including travel time, for the first call out. Subsequent calls will be paid at actual call out time rounded up to the nearest 15 minutes.
Scotland: The nationally agreed policy limits on-call sessions to nine per week, with set allowances and enhanced rates for work on public holidays. https://www.publications.scot.nhs.uk/files/pcs2012-afc-04.pdf
Wales: The nationally-agreed policy limits on-call sessions to nine per week. Availability fees rise in line with nationally agreed pay rises. Pay for work completed is at time and a half or double time on a public holiday. Updated allowances for on-call are included in Welsh Pay circulars.
Is your organisation trying to implement spot-rates for on-call payment?
- Some Trusts propose paying a flat rate (spot rate) for on-call work, (often band 6) to all staff regardless of their banding. The CSP opposes this as it results in payments for work done that are lower than the contractual pay rate. Reps are strongly advised to not sign off on any proposals to pay spot rates without consulting your Senior Negotiating Officer (SNO).
- If your trust is proposing a detrimental spot rate you should continue to be fully involved in local on-call negotiations while making the CSP’s position clear to both staff side colleagues and management
What is compensatory rest?
Compensatory rest should be given to any workers who have their entitlement to rest between working periods under the Working Time Regulations disrupted due to being 'called out'.
Compensatory rest is the same length as the rest, or part of a period of rest, which a worker has missed due to having been 'called-out' to work. The CSP supports the development of local compensatory rest policies, which allow staff to claim back compensatory rest either at the beginning or the end of their next shift, or as soon as possible after the rest disruption.
This is particularly important where overnight rest periods are interrupted, as this ensures that workers are not fatigued and minimises the scope for any fatigue-related incidents. The CSP believes this should be paid.
Section 27 of the Agenda for Change agreement and the Working Time Regulations provide the framework for compensatory rest.
According to the Working Time Regulations, compensatory rest can only be denied in "exceptional cases in which it is not possible, for objective reasons, to grant such a period".
Is your compensatory rest unpaid? Make the case for it to be paid:
- Currently, whether compensatory rest is paid or not is a matter to be agreed locally. It is still the case that many NHS Trusts assume compensatory rest is unpaid. The CSP have always advocated for paid compensatory rest and legal advice has supported this approach.
- According to this advice, the term "compensatory rest" means something over and above the rest to which a worker is otherwise entitled between shifts. Therefore compensatory rest involves giving more rights to the worker than previously enjoyed.
- The Employment Appeal Tribunal also indicated that they would generally expect compensatory leave to be paid, because otherwise it would be difficult to see what meaning should be attributed to the words "compensatory" or "protection" as written in the Working Time Regulations (link to previous section (The Corps of Commissionaires Management Ltd v Hughes Employment Appeal Tribunal 2009).
The on-call rota
A requirement to undertake on-call is commonly an obligation set out in the contract of employment. If included in a contract of employment it is a contractual obligation to undertake on-call duties.
In some cases, participation in the on-call rota can also be covered by a locally negotiated agreement which will specify the staff who fall within the scope of the agreement and as a result are expected to participate on the on-call rota as part of their core duties.
Ensuring an individual’s participation on the on-call rota is 'fair or equitable' is one of the most difficult aspects of on-call rotas. All rotas need to balance the frequency of rostering full-time, part-time staff and those who may for certain reasons not be able to fully participate on the on-call rota.
There is no national guidance or legal frameworks which set out clearly the frequency of participation that should be expected of individuals on an on-call rota. This will need to be negotiated at local level. Negotiating on frequency and cover of on-call rotas will usually occur at service level and will undoubtedly be considered in light of the service needs. It is worthwhile also considering the 'Redesigning On-Call Service' sections of this hub.
Bank Holidays
There should also be a fair system for deciding who covers bank holidays. Most commonly this is done by a voluntary system first and staff should ideally not be rostered onto more than one bank holiday a year.
Exemption from or limiting participation on the rota
All staff should be able to request either long term or limited term exemption from the on-call rota or for a reduction in obligations/frequency on the rota. Examples of where this may apply are those:
- Who fall under the equality act or ,
- Who have a risk assessment identifying exception from on-call duties, or:
- Who have been deemed as exempt from Occupational Health or it has been deemed as a reasonable adjustment
- Who have a flexible working request approved
Where individuals feel the response from management is unfair or they have not had their concerns addressed they can raise this through the appropriate local policy i.e. grievance or flexible working policy.
Sickness / unplanned absence
If a member of staff is unable to fulfil their rota slot because they are off sick, they should not be forced to do an extra slot on the rota to make this up. The local policy should have clear guidelines for reporting sickness when you are due to be on call and the cover arrangements should be clear. See the below paragraph for further information on covering vacant on-call shifts.
Covering on-call shifts at short-notice
Due to sickness or vacancies, there maybe times where managers expect members to fill a vacant on-call shift. Even though it may be part of a contract of employment, employers still need to give reasonable notice to work a shift.
There is no legal definition of reasonable notice, but the CSP advocates for as much notice as possible when managers request members to work but also that anything less than 7 to 10 days would be unreasonable. Organisations may also operate systems such as a "back-up rota" or a "hit list" that requires members to be available when there is an unplanned absence on the rota or if there is need to call in an extra member of staff due to demand.
If these are in your organisation or are proposed to be introduced, consider the following in discussions with management:
Does your organisation have or are they proposing to introduce a "back up rota", a "hit list" or something similar? If so:
- There should be a fair allocation of expectation to be on the back up rota and it should be set in the on-call agreement.
- An availability payment should paid as the member is making themselves available to work, especially if they will be expected to remain available for that rota period.
- What the expectations will be of the person on the back up rota i.e. will they be available to give advice to junior members of staff
- If there is no availability fee paid for being on a back up rota, then staff are not obliged to cover shifts at short notice. The notice for an individual to work should be reasonable. Thus members would not be contractually obliged to work the on-call shift if requested to do so at short notice. In these cases, it is always worth consulting your local workplace steward.
- If a shift cannot be covered, then the organisation should have a protocol in place to manage this situation.
A checklist for negotiators
- Know what is negotiated nationally, organisation-wide or within local physiotherapy services
- Aim to achieve enhanced pay rates for all staff
- Aim to achieve a bank holiday premium
- Ensure a review date is set for reviewing rates of pay in line with newly agreed pay rates
- Any change or update to the on call systems, frequency and back-up systems should be consulted on with members
- Competency training should be carried our regularly for all staff on on-call rotas
- Individual members should have regular reviews of the number of rotas they are on
- On-call rotas and working hours should be compliant with the European Working Time Directive
- Does the locally negotiated on-call arrangements meet the Principles for Harmonised on-call Arrangements (set out in Table 22 of Annex 29 of the NHS Terms and Conditions handbook)
- Is there a clear policy in place for the administration of 'on-call' arrangements that has been developed in partnership?
There is a lot to be considered when you to negotiate around on-call. It is important you gather members views and represent these in order to have the best chance of gaining a successful improvement in the conditions of on-call working for members. Take a look at the Organising around on-call page for further information on mobilising the local members.
