Generational Shift Win:Win
Whitepaper
Introduction
While technology can’t change every aspect of a resident doctor’s experience of training and work, it can make a material difference.
How rota, rostering and patient safety technology is set up and applied can mean the difference between a poor experience at work or a great one.
Everyone has heard the stories. From residents that report safety incidents and never get feedback, to rotas and work schedules that are shared too late, or overly restrictive rules on annual leave, slow approval and no flexibility or access to self-rostering.
These experiences can make the difference between a trainee that thrives and stays in the NHS or one that struggles and opts to work elsewhere. We believe it is incumbent on all of us to help support the next generation of doctors, by shaping how they experience work today.
The good news is that across the NHS in all nations and across professional bodies there is an increasing consensus about how some of these poor experiences can be prevented. In England that has resulted in the 10 Point Plan to improve resident doctors’ working lives.
RLD believe that we have a part to play.
Our plan is to help resident doctors, medical staffing, rostering teams, patient safety teams, bank offices and their respective leaders to fully understand how workforce and patient safety software can be used for good, and of course how to spot when it might be set up and applied to deliver a less then desirable experience. Through our Generational Shift Win:Win Programme we aim to support and train our customers, across all the professions and disciplines above, so they can meet the standards so clearly articulated in recent guidance.
The training and support include a full curriculum, a clear assessment against the standards, a community of practice to help shape the future, and supporting tools and events. We encourage our customers and the resident doctors using our solutions to select the elements of the programme that are most meaningful to them.
This short guide is one of the supporting tools. It gives a high-level indication of how the technology can be configured and applied to make a difference, it signposts to deeper supporting resources and highlighted where certain elements help meet the requirements set out in NHS England’s10 Point Plan.
We hope you find it helpful.
Document What Good Looks Like:
Set Your Intention
Top Actions
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- Consciously design the experience you want
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- Revisit policy documents
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- Assess your current position versus your ambition and the guidance in your country
Myths
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- That you need to reimplement technology if it is set up based on the needs of the past
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- That you must apply the same rules across specialities
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- That fixing rotas is enough. Rotas, Rosters, Locum and HR records need to be aligned with a single aim
Workplace Wellbeing:
Start with Culture
A culture that prioritises a supportive environment and fosters psychological safety is central to workplace wellbeing.
By enabling resident doctors to speak up about safety incidents, to raise concerns about workload or about rotas without fear of blame creates the conditions for learning and trust.
While thoughtful rotas, flexible rosters and payroll accuracy are vital, wellbeing and patient safety remain deeply linked, and both come from a culture where people are respected, listened to, and empowered to raise issues early. A culture where caring for staff is seen as inseparable from caring for patients or service users.
Top Actions
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- Ensure all resident doctors have training on incident reporting
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- Create feedback loop in DCIQ to ensure residents that raise incidents are acknowledged and see how their action influences change where needed
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- Ensure Residents have access to exception reporting and that these are responded to in a timely manner
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- Keep rotas up to date in eRota to facilitate a seamless exception reporting process
Myths
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- Exception reports are a form of complaining to management/supervisors
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- You need pre-authorisation to submit an exception report
How does this support the 10 Point Plan?
- Point 7: Resident doctors should be enabled and encouraged to Exception Report to better support doctors working beyond their contracted hours
Workplace Wellbeing: Follow with Flexibility and Control
Resident Doctors need greater influence over how, when, and where they work. This helps them have fulfilling lives, but it also helps care delivery. The outdated view was that flexibility and control negatively impact the availability of staff to deliver a safe service to patients and service users. However, when technology is set up properly this is untrue. In fact, the opposite can be said, flexibility isn’t just about personal needs, it’s about team working and shared responsibility. Often doctors and teams who have control over their working patterns are more motivated, more resilient, and better able to deliver safe, continuous care.
Top Actions
- Ensure all Resident Doctors have Loop set up so they can see where they are working, when and with who
- Consider self-rostering or a team-based rostering approach, remove limits on requests, enable direct booking and swaps on Loop
- Auto enrol in bank and enable direct booking
- Give Residents the visibility they need to see where their supervisor is working and contact them via Loop
- Use eRota to generate work schedules, ensure they are interfaced into our rostering solution
- Enable ‘Detailed rotas’ to be published to Loop for resident doctors to view 6 weeks prior
Myths
- That a singular rostering approach must be applied to everyone on a given roster
- If I opt in to a self-rostering approach, then I’m not permitted to raise exceptions
How does this support the 10 Point Plan?
- Point 1: Improve workplace wellbeing for our resident doctors
- Point 2: Resident doctors should receive work schedules and rota information as per the requirements of the Rota Code of Practice
How does this support the 10 Point Plan?
- Point 1: Improve workplace wellbeing for our resident doctors
- Point 2: Resident doctors should receive work schedules and rota information as per the requirements of the Rota Code of Practice
Great Annual Leave Practices Make a Huge Difference
Getting annual leave and study leave practice set up perfectly in our technology is a great example of a win:win. It’s understandable that residents want to be able to book leave easily and well in advance, and that they want to be sure it will be approved quickly and honored. At the same time, poor annual leave practice often accounts for gaps in rostering, increase in sickness rates and unbudgeted overspend. Getting it right improves experience for resident doctors and helps organisations deliver the right care at the right cost too.
Top Actions
- MOD & Loop facilitates a systemised approach to leave from the comfort of your phone
- Trust agreed rules in MOD enable fair and equitable practices
- Being able to see the duties that have been booked is important – I need to know when I’m working to decide when I need to book leave
- Everyone has the same opportunity to book leave
- Remaining balance is clearly visible in loop – transparency
- Leave balance can be set proportionally for rotational placement though the year (with the ability to agree carry over between specialties)
Myths
- If I don’t use all my leave within a placement, it will be lost when I rotate.
How does this support the 10 Point Plan?
- Point 3: Resident doctors should be able to take annual leave in a fair and equitable way which enables wellbeing
Use the Software to be Respectful of Resident Doctors Time
There is another dimension of resident doctor’s time that we can take much more care with through thoughtful use of the technology. All too often we ask for repeated information or create complex multi-step processes. We believe our solutions should and can reduce admin and help free up time to care. Here are just a few actions that anyone can employ to make this a reality in their organisation
Top Actions
- Introduce single sign on
- Accept prior training and ensure ESR is kept updated. Interface ESR data into Optima and use this data to validate mandatory training when rostering
How does this support the 10 Point Plan?
- Point 6: No resident doctor will unnecessarily repeat statutory and mandatory training when rotating
Own the Experience of Resident Doctors at a Board Level
The 10-point plan demands that all boards appoint two named leads for resident doctor issues. We think the tech helps take board assurance a step further. Committees of the board and key executives need visibility of lead indicators and outcome measures that help to identify potential issues ahead of them emerging, and that help them get assurance that the right things are happening to support workplace wellbeing. No board wants to find out through a staff survey, or worse.
Top Actions
- Create an Insight dashboard of input measures for example, number of exceptions, number of incidents by resident doctors, number of rota gaps, unused annual leave, refused annual leave, % temporary staff
How does this support the 10 Point Plan?
- Point 4: All NHS trust boards must appoint 2 named leads: one senior leader responsible for resident doctor issues, and one peer representative who is a resident doctor. Both should report to the board
Ensure Resident Doctors are Never Out of Pocket
While contracts are often complex, pay accuracy should not be. Whether it is ensuring accurate salary or payment for extra duties, or whether it is getting timely and accurate pay from locum work or even getting timely payment of expenses the software can be configured to help.
Top Actions
- eRota generates resident doctor pay accurately in line with the contract
- Exception reporting payment outcomes, WLIs and bank duties managed through MOD enables automated processes to payroll, preventing errors to rate of pay or in transference
- Managing study leave in MOD enables reporting on recently approved study leave
- Upload of supporting documents to leave requests feature in testing which will support the study leave approval process
How does this support the 10 Point Plan?
- Point 5: Resident doctors should never experience payroll errors due to rotations
- Point 8: Resident doctors should receive reimbursement for course-related expenses within 4 to 6 weeks of submitting their claims - Supported by rostering
Make it Easier to Connect Than Not
Connection takes us back to culture. Making it easier for resident doctors to connect rather than not connect is vital. That connection might be to one another, to supervisors, to leadership, to an organisation. It might be to their own information, their own salary when they need it, or to their own career.
Top Actions
- Open up messages and groups in Loop
- DCIQ
Let’s Work Together to Make a Difference
Join the community of practice
Online webinars, face to face meeting and ongoing online resources. A chance to work with peers and other stakeholders.
Read the Generational Shift Whitepaper Win:Win
A deep dive into NHS England’s 10-Point Plan, exploring what it means for trusts, and how digital workforce tools can help deliver on each commitment.
Medics Rostering Maturity Index
Do you know how close you are to the 10-point plan or other standards? Let us assess how you use the technology today and provide a clear personalised action plan to help drive improvement.
Let’s create a generational shift together.
From rota design to exception reporting, every action matters. Together, we can make working in the NHS sustainable for resident doctors, and safer for patients.