Night workers in the UK have a right to a free health assessment before starting nights and at regular intervals. If fatigue affects your concentration at work or your drive home, raise fatigue with your manager as a patient and staff safety issue. See your GP if poor sleep lasts more than a few weeks.
Key facts
- Night time
- 11pm to 6am, unless your contract sets a different seven-hour period which includes midnight to 5am.
- Night worker
- Someone who regularly works at least 3 hours during night time.
- Night work limit
- An average of 8 hours in each 24 hours. Jobs needing round-the-clock cover, such as hospital work, can be exempt, and you should then get compensatory rest.
- Health assessment
- Your employer must offer a free health assessment before you start night work and at regular intervals after.
- Rest
- 11 hours between working days and 24 hours off each week, or 48 hours each fortnight.
How night work affects sleep and safety
Your body clock pushes you to sleep at night and wake in daylight. Night shifts work against this. Sleep after a night shift is usually shorter and lighter, and the effect builds over a block of nights. The risk of errors and of falling asleep at the wheel rises in the early hours and on the drive home.
In healthcare, fatigue is a safety issue for patients as well as for you. A tired pharmacist checking a controlled drug, or a nurse calculating an infusion at 4am, needs the same accuracy as on a day shift.
Rota features which help
HSE guidance on shift work and NHS Employers advice on shift work point to the same features. Ask your rota coordinator about:
- Forward-rotating shifts, moving from days to lates to nights, which are easier to adjust to than backward rotation.
- A limit on consecutive nights, and at least two full nights of sleep after a block.
- Protected breaks on nights, with a quiet rest area. Some employers allow short naps on a break. Check your local policy.
- No long day straight before a first night shift.
- Fair notice of rota changes, so you can plan sleep and childcare.
Resident doctors in England on the 2016 contract have rota rules on consecutive nights and rest. The BMA can check a rota against the contract.
Sleep habits for night workers
- Sleep in a dark, quiet, cool room. Blackout blinds and earplugs help.
- Try a nap of up to 90 minutes before your first night.
- Take caffeine early in the shift and stop several hours before you plan to sleep.
- Eat light meals on nights and keep to regular times where you can.
- Wear sunglasses on the way home if morning light keeps you awake.
- Tell your household when you need to sleep.
If you are too tired to drive
Do not drive if you feel drowsy. Ask your employer what the arrangements are for a rest room or taxi after a night shift, and raise the issue if none exist. A near miss on the way home is worth reporting as a fatigue incident.
Health conditions, pregnancy and requests to change shifts
Some health conditions make nights harder, such as diabetes, epilepsy, sleep disorders and menopause symptoms. Ask for an occupational health referral. If a disability is involved, your employer must consider reasonable adjustments, which can include fewer or no night shifts.
If you are pregnant or breastfeeding and a doctor or midwife certifies night work as a risk to your health, your employer must offer suitable day work. If no day work exists, your employer must suspend you on full pay. Any employee can make a flexible working request from the first day of employment.
See your GP if poor sleep lasts more than a few weeks. The NHS recommends cognitive behavioural therapy for insomnia as a first treatment. Our burnout guide covers what to do when fatigue turns into longer-term exhaustion.
Support organisations
Pharmacist Support
Profession-specific support for pharmacy people, including wellbeing and practical help.
Check the provider's current criteria for pharmacists, trainees, students and family support.
BMA wellbeing services
Counselling and peer support for doctors and medical students.
The main wellbeing services have their own access rules. Additional member services may require membership.
Doctors' Support Network
Peer support for doctors and medical students with mental-health concerns.
Check membership, group arrangements and confidentiality guidance. Peer support does not replace treatment.
Doctors in Distress
Group-based support and wellbeing programmes for healthcare workers.
Programme audiences, dates and availability vary. Confirm a current programme includes your profession.
Related guides
- Workload and understaffing
- Caring responsibilities and work
- Pressure on locums
- Workplace rights and wellbeing
Common questions
Do night workers get a free health check?
Yes. Your employer must offer a free health assessment before you start night work and at regular intervals afterwards. You can decline the assessment.
How many night shifts in a row is safe?
Most UK workers have no single legal limit on consecutive nights. HSE guidance advises limiting consecutive nights and allowing at least two full nights of sleep after a block. Resident doctors in England have specific contract rules.
Can I ask to stop working nights?
Yes. Any employee can make a flexible working request from day one. If a health condition or disability is involved, ask for an occupational health referral and reasonable adjustments.
Can pregnant staff be asked to work nights?
If a doctor or midwife certifies night work as a risk to the health of a pregnant or breastfeeding employee, the employer must offer suitable day work or suspend the employee on full pay.