Junior doctors are not allowed to work more than 56 hours a week

At present, junior doctors are not allowed to work more than 56 hours a week under their terms and conditions of employment - known as the New Deal.

And now, NHS employers in Scotland who breach those limits could be stripped of junior posts as punishment.

The sanctions have been agreed by the Scottish Executive, Scottish Junior Doctors Committee (SJDC) and NHS.

The penalty system comes after a year of talks between the three sides but will only be used as a last resort.

Last resort

The sanctions are designed to protect young medics working as senior house officers (SHOs) and specialist registrars (SpRs), and will be available from August.

Penalties already exist to prevent trusts breaking the New Deal rules for pre-registration house officers with each employer facing fines of up to �5,000 per breach.

Under the new scheme, SHO and SpR rotas will be monitored by a body set up to oversee the New Deal in Scotland - the Implementation Support Group (ISG).

Junior doctors have approved the sanctions

However, the ISG, which is a partnership between the British Medical Association (BMA), health department and NHS employers, will only begin action against an NHS employer if they have been found in serious breach of the rules on three occasions.

The withdrawal of posts from a hospital will only be used as a last resort and before any such decision is taken, hospitals will be given a chance to improve their performance.

SJDC joint chairman Graeme Eunson said: "We are pleased that 18 months after the contractual deadline to implement the new deal for SHOs and SpRs the system of sanctions has finally been agreed."

The latest ISG figures for compliance for all junior doctors stand at 95% in the west of Scotland, 80% in the south east and 85% in the north.

'Fresher staff'

The executive said patient safety was at the forefront of the changes as it did not want doctors, or any other NHS staff, working when they were over-tired.

A spokesman said: "We are pleased that the New Deal for junior doctors, now in place for many years, is delivering shorter working hours and delivering fresher staff and better service for patients.

"Latest figures show that 85% of rotas are meeting the maximum 56-hour week target.

"Sanctions have existed for some junior doctor posts since 2003, and are simply being extended here to cover other grades."