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Guide to working a successful NHS on-call shift

  • November 19, 2018

What is an on-call shift?

When you are on-call you are expected to be available outside of your normal working hours to work as and when required, the number of hours will have been previously established within your contract. Your location during your on-call shift will also have been stated in your contract. Typically, junior doctors remain on-site and then consultants off-site to allow flexibility of work.

In this post, we provide you with some fundamental tips on how to successfully work an NHS on-call shift and some advice from an SHO General Medicine working within the NHS.  

On-call shift patterns

Weekday on-calls

Weeknight on-calls

Weekend day on-calls

Weekend night on-calls

There are also different forms of on-call shifts. This can include on-take shifts, where you will perform examinations or history-taking. You could also cover ward-rounds, which is crucial for reviewing and planning patients care. Please note, the type of shift you will be undertaking will be determined by the specialty you work in.

As a doctor-on-call, you must…

  • Ensure you are available at all times of the required-on call period, and that members of the Trust and switchboard are informed of your contact details whilst on-call
  • Ensure that you are in the right state to attend work and you must remain in a fit state whilst on duty i.e. not drunk
  • Be aware of and follow the local standard operating procedures relating to on-call
  • Be familiar with the local arrangements for reporting any unavailability

BDI Resourcing’s top tips before going on-call

1. Preparation is key

Before you start your first NHS on-call, you will need to prepare in order to have a successful shift. The first task is to bring food with you. Often, when doctors first start working on-call they decide to order pizza and drink cans of coke to increase their energy levels. However, fast-food will only make you crash later on in your shift and will also result in weight gain.

Secondly, it would also be useful for you to organise your personal life prior to working on-call. This could include doing a food shop, paying bills, organising childcare etc. This will reduce stress and worry when you are working on-call, allowing you to focus on your job.

Thirdly, when on shift, you should carry a list of common medications with their dose to save time. This will help you speed up routine tasks. 

2. Maintain a healthy and balanced lifestyle

By eating well and regularly exercising this will reduce the negative effects of working nights, such as fatigue, performance levels and your mental well-being.

Tips on working a night on-call shift

1. Eat and drink properly as this will help you maintain your energy levels.

2. If you are unsure of the appropriate action – ask for help. Your responses will not be as reliable as they are during the day and nothing beats a second opinion.

3. Try and take naps when you have the opportunity

Tips for after you have finished an on-call shift

Once you have finished your on-call shift and you are making your way home, try and stay vigilant. Whether you are driving or taking public transport, your responses will be low so take extra caution to help you stay safe. Once you reach home and you get into bed, reduce all possibilities of waking you up to ensure you get a good-quality sleep and you wake up feeling rest. This includes, earplugs, blackout blinds and put your phone on aeroplane mode.

Advice from an SHO General Medicine working within the NHS

“Although everything will be taught and demonstrated within your induction, there is such an influx of information that some of it is often forgotten. In addition, as an IMG you will be used to practicing within a different system with different processes. Therefore, requesting a blood test or an x-ray can often lead to you feeling slightly confused or overwhelmed. However, it is important to remember to ask for help. This includes nurses, pharmacists and therapists as well as doctors– they would have previously been in the same position and so everyone will be happy to help you. And over time you will feel a lot more confident.”

Although working an on-call shift can feel overwhelming and leave you feeling tired, the advantage is that you are essentially your own boss for the shift without too much pressure from senior staff.

If you have any questions about relocating to the UK and working within the NHS email [email protected] and we will be happy to guide you.

Join our Facebook Group IMG Advisor – here, you will have access to frequent relocation blog posts, the opportunity to ask questions and receive professional guidance and the chance to meet other IMGs!

References (2018). Surviving on call. [online] Available at: [Accessed 16 Nov. 2018].


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