Returning to work after parental leave

Having responsibility over another’s life (not to mention experience of sleep deprivation) is hardly a new experience for a doctor. That being said there is no career in the world that can fully prepare you for parenthood and the impact that it will have on every aspect of your life. Balancing the demands of a new born with working life is a work in progress where some days it can feels your infant is taking more steps forward than you. Parental leave is therefore more than an opportunity to bond with your new born, it’s also a time for you to adjust to your new identity as a parent and build your confidence in this new walk of life. Under no circumstances should this time be given up or rushed. It is your statutory right to take it in its entirety; any pressure for a premature return should be reported.

Timing when to return to work can be a challenge in and of itself; false starts and delays are par for the course in this. Returning to the adult world is a seismic shift from childcare, no more so than when returning to the hospital environment. As a parent and a doctor, you will be used to putting others first but in a transition as difficult as this it’s essential to prioritise your own needs and fully utilise the support that is available to you.

Just as no child is alike, you must also tailor your return to work without comparing yourself to colleagues. Though anecdotal advice can be helpful it can also be completely unsuitable to your own set of circumstances. Returning to training, and the time it takes to do so fully, hinges upon so much more than willpower. This transition hinges upon so many variables: your own maternity or paternity, access to childcare, time of shifts, consistency of shifts and speciality of training to name a few. Similarly, it’s essential you know exactly what leave you are entitled to at the earliest point possible as this is also dependent on the parent. Though often not possible, planning your parental leave in advance can be key to success in return.

Guidelines for maternity leave

You must alert your employer of your pregnancy, your expected week of childbirth (EWC) and your desired start date of ordinary maternal leave (OML) by the 15th week before the expected delivery week.
Compulsory maternity leave begins two weeks prior to your expected delivery date.
You are entitled to 26 weeks of OML, beginning no earlier than the 11th week prior to your EWC and a further 26 weeks of additional maternity leave (AML). The 11th week is classed as starting the Sunday beginning of that week.
Occupational Maternity Pay (OMP) depends on length of NHS service specifically (at least 12 months continuous service with one or more NHS employers), whereas Statutory Maternity Pay (SMP) depends both on length of service and its continuity (employed by same the employer for at least 26th weeks consecutively into the 15th week prior to EWC).
OMP is based on average weekly earnings. This currently stands at 8 weeks full pay and 18 weeks at half pay.
SMP is paid at 90% of full pay for 6 weeks, then at £140.90 for the following 33 weeks. This is as liable for tax and national insurance payments as if you were working.
Those who are not eligible for SMP may be eligible for Maternal Allowance – you must provide an SMP1 form for this claim (obtainable via Jobcentre Plus). This is paid out at the smaller of £140.90 or 90% of weekly pay for the entire 39 weeks.
Pension payments will continue as though you were working.
When returning to work, your employer should carry out a risk assessment including the fact you may be continuing to breastfeed. It is up to your employer to take responsibility for mitigating any risks you may encounter when returning to work. If you feel unable to perform your on-call duties due to pregnancy or when phasing back into work, discuss this with your own GP.
When returning to work your Trust can offer alternative work (you would still receive same pay even if this work would ordinarily attract a lower rate).
Any employee is legally protected from incurring any detriment as a result of taking leave and are guaranteed the right to return to the same job performed prior.
Do not hesitate to call the BMA at 0300 123 1233 if you encounter any issues in pay or require any further clarification on what you’re entitled during a maternal leave.

Guidelines for paternity leave

Leave may only begin after a baby’s birth.
All employees, regardless of hours spent working, are entitled to paternity leave if responsible for a baby’s upbringing regardless of whether they are the biological father.
Same-sex partners are entitled to exactly the same leave.
All paternity leave should be completed by the time the infant is 56 days old.
Trainees are required to complete a SC3 form and a copy of their partner’s (if applicable) MAT B1 form to request paternity leave.
Though likely to wish to be present for the birth itself, it is your responsibility to locate suitable coverage for your patients. You may wish to book annual leave to guarantee this. However, if labour is completely unexpected, you must tell your clinical lead immediately and must remain at work until cover can be obtained.
Two weeks of paternity leave are available and these must be taken consecutively (not as two odd days or weeks).
You must alert your employer by the 25th week of pregnancy that you are expecting with your partner.
You must provide your employer with 28 days-notice to qualify for Statutory Paternity Pay (SPP).
SPP is at the standard rate of maternity pay (either 90% of average weekly earnings or £140.90 per week – whichever is lower).
Pension payments will continue as though you were working.
You are legally protected from incurring any detriment as a result of taking leave and are guaranteed the right to return to the same job performed prior.
You may be eligible to additional paternity leave but this will be unpaid.

Guidelines for shared parental leave

Shared parental leave is a statutory right allowing more flexibility in how you choose to manage initial caregiving between yourself and your partner.
A maximum of 50 weeks is available to be shared.
It is your choice as to whether this time is taken off together or in turns.
Ensure your employers are aware of how you intend to separate childcare during this period. Any changes to hours require written justification as this will affect your on-call availability.
Due to the flexibility of this arrangement, seek personal guidance from the BMA or feel free to call dedicated advisers at 0300 123 1233 between 08.30 to 18.00.

Case Study: Catriona

‘[Before coming back into work] I worried if my practical clinical skills and theory knowledge would be ‘accessible’. I left at quite a junior time in my career, so I didn’t have a lot of experience to fall back on or that could reinforce time out. I was worried about making mistakes those first few weeks in particular.

We couldn’t afford paid childcare, so my husband and I both have to work 70%, though in reality we need to keep him as close to 100% as he is self-employed. We are very fortunate to have my mother-in-law come from Wales to help us most weeks. [With being on call] I found other people trusted me more than I trusted myself! Confidence takes a beating during time out. [At the time], my daughter (being 9/10 months old when I returned) started having her first baby illnesses – nothing serious, but bad timing!

Supportive colleagues, studying and asking for advice helped me settle and get my confidence back. I was very open if I felt I needed more assistance or supervision. Though I missed the Giving Anesthesia Safely Again session run by the Royal College Of Anesthetists, the 5 KIT days at Hammersmith were invaluable. The WhatsApp group for Less Than Full Time trainees has also been incredibly helpful.

As a new mother, I think I became even more aware of risk. With the doctor’s strike during my first maternity leave leaving me with a feeling of concern over the general future of medicine. I do worry about what could happen if I make a mistake.

[To others about to return to training I would say] start planning! You can’t really plan exactly, but everyone has the same questions: how long can I stay off, how do I do KIT days (timing is important due to maternity leave/annual leave pay), how to calculate % of rotas, how to balance childcare etc. All this can be discussed and considered before your brain becomes complete mush!’

Resources available to returning parents

Keep In Touch Days (KIT)

KIT days, were introduced to ensure junior doctors felt prepared to return to the workplace after time spent away. These provide opportunities to learn of any potential changes in relevant clinical protocols and handle new equipment in a controlled setting. KIT days also involve supervised clinical work at facilitate attendance of courses, teaching days and departmental induction days as the return to work date approaches. Junior Doctors have access to 10 such KIT days during their leave; these are paid at the daily rate for the hours worked.

Clinical Attachments

Enquire with your educational supervisor as to whether a Clinical Attachment may be available for you before attempting to formally transfer back into training. This usually involves shadowing a doctor within your specialism for between 2-4 weeks. This can be a useful way of both refreshing your skills and identifying any areas for improvement prior to fully immersing yourself back into the working world. In addition to improving personal and clinical confidence, such Attachments are fantastic opportunities to make contacts within a specific department.

Contact your Trust’s childcare coordinator

Your Trust’s Child-Care Coordinator will be most knowledgeable as to what childcare is available within your area and most appropriate for your specialism and on-call rota. Alternatively contact your Deanery Career Lead for similar information. These figures can help you decide whether full-time or phased return will be most suitable for both you, your partner and your child. However, bear in mind that ordinarily 8 weeks-notice is required to arrange this. Also, make sure to refer to Less Than Full Time Training guides to make the best decision for you (https://www.healthcareers.nhs.uk/explore-roles/doctors/career-opportunities-doctors/less-full-time-training-doctors).

Peer to Peer mentorship and support

Enquire with your Deanery as to whether any social support networks exist within your area. In addition to many Facebook sites offering support and practical advice on returning, some Trusts hold informal social events for returning parents to meet, discuss their experiences and concerns in relation to both their absence and return to work.

Though Junior Doctors take time away from training for a variety of reasons, parental leave is a unique (and ongoing!) experience. It’s important to remember that learning to balance patient demand with parental is not a linear process – make the most of the support and advice that’s available to you whenever you need it. Knowing when to ask for help is an asset, particularly when you’re caring for those who cannot help themselves.