Trusts are offering middle grade doctors jobs with additional paid hours and generous study leave to keep their accident and emergency departments running.

Some jobs come close to breaking the European working time directive on junior doctors’ hours, as they are advertised at up to 15 sessions a week. A session is normally four hours but out of hours sessions are three.

There is a national shortage of middle grade doctors with suitable A&E experience.

College of Emergency Medicine vice president Don MacKechnie said: “There are just not enough appropriately trained middle grades around at the moment - most have signed up as locums.”

“It will be challenging come August for departments to maintain middle grade rotas round the clock. What you cannot do is leave juniors unsupported - the bottom line is that you may have to close to be safe.”

Locum staff grade jobs are advertised at up to £2,500 a week or £80 an hour. Many hospitals are now advertising permanent jobs at 12 sessions a week or more, and stressing the generous study leave and time for professional development.

East Sussex Hospitals trust is to offer middle grade posts at 15 sessions, but says it does not routinely expect those doctors to work more than 48 hours a week. The extra sessions will boost middle grade pay to £78,000 a year and the 15-session week includes study leave and professional development.

“We are in a competitive market to recruit and retain staff,” said a spokesman. “Some of our neighbouring trusts have already offered a similar package.”

It should have eight full time equivalent middle grade doctors in A&E at Eastbourne district general hospital but from August will have only 2.7. At the Conquest Hospital in Hastings it has only two but is funded for six.

The trust has made repeated attempts to recruit in the UK and abroad, but cannot even find enough agency doctors to fill the gaps temporarily.

A board report said: “In order to maintain clinical safety… a minimum of four middle grades are required at each site.”

If the trust cannot recruit in time, it will use other middle grade specialty staff to cover.

Many middle grades have come from overseas in the past but employers now have to show that they can’t get sufficient interest from UK or European economic area applicants before overseas doctors can obtain a work permit.