NHSE sets out immediate actions to improve working lives of resident doctors

NHS England has published a 10-point plan for ‘getting the basics right’ for resident doctors, which trusts must act on ‘without delay’. 

The plan instructs NHS organisations to conduct a ‘self-assessment’ of workspaces, to commit to issuing work schedules at least eight weeks in advance, and prevent unnecessary repetition of statutory and mandatory training. 

While the plan’s actions wait to be formally incorporated into the NHS Oversight Framework, trusts ‘should proceed on the basis that it is already in effect’, the plan states. 

In a letter to trusts published alongside the plan, NHS England chief executive Sir Jim Mackey and national medical director Professor Meghana Pandit said preventable issues like payroll errors, poor rota management, and lack of access to facilities persisted for resident doctors. 

‘These concerns are within our collective gift to fix, and continued failure to do so risks further erosion of trust between resident doctors and their employers and undermining morale – which inevitably has an impact on patient care and the effective running of the NHS’, they said. 

The plan states that, from now, NHS England itself must provide at least 90% of trainee information to trusts 12 weeks prior to rotations commencing. 

Trusts must subsequently use this information to ensure resident doctors receive work schedules eight weeks in advance and detailed rotas six weeks before they begin. 

By March 2026, all trusts are also expected to have reduced rotation-related payroll errors by at least 90%. 

Elsewhere, the plan says every trust must ‘review their current processes’ to ensure resident doctors receive reimbursement for course-related expenses within four to six weeks of submitting claims. 

From this autumn, NHS England said it will publish new data and information to measure aspects of the 10-point plan including: 

• Trusts delivering access to the basics – lockers, rest facilities, hot meals, on-call parking spaces; 

• Delivery of eight-week work schedules and six-week rota notice on rotations;

• Number of payroll errors;

• Self/preferential e-rostering;

• Percentage of trusts delivering board level reporting of issues;

• Changes to the way in which annual leave can be taken.

The joint letter to trusts alludes to the ongoing dispute between the BMA’s Resident Doctors’ Committee (RDC) and the Government, saying that while talks are ‘constructive’, ‘the NHS must not wait for those to make the improvements to working conditions that residents doctors have been promised by their NHS employers and repeatedly let down on’. 

Responding to the 10-point plan, Dr Melissa Ryan and Dr Ross Nieuwoudt, BMA resident doctors committee co-chairs, agreed resident doctors had been ‘failed on the basics’ but said the new plan ‘will feel like too little, too late’ for many.

‘Alongside these issues, resident doctors have endured a real-terms pay cut of more than 21% over the last 15 years, continue to face insecure and disruptive employment arrangements, and are held back by severe bottlenecks in specialty training that block career progression.

‘Words must now translate into real, consistent improvements in every trust, not just more empty promises.

‘We remain in active talks with Government about the wider reforms and investment needed to improve doctors’ working lives and safeguard the future of the NHS workforce’, they said.

Resident doctors in England, including GP registrars, took industrial action in July in an effort to restore pay to pre-2008 levels.   

During the strike action, the RDC announced it was launching an additional linked dispute with the Government to ‘solve the looming unemployment crisis’ faced by trainee doctors. 

A survey by the union found more than half of doctors finishing foundation training had no substantive employment or regular locum work secured. 

Last month, BMA GP Committee chair Dr Katie Bramall told Pulse there were ‘opportunities to work together and be collaborative’ with the Government to avoid a further dispute, but that it is going to be a ‘fragile’ time.