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Enhancing working lives

The junior doctors’ contract dispute highlighted a number of issues involving doctors’ training and working environment. To address this, working with partners, we have been looking at how we can enhance the working lives of doctors in training.

We have committed to improving the quality of education and training for doctors. We believe that safe, high quality patient care is best delivered by a highly motivated workforce, that also feels valued.

The junior doctors’ contract dispute highlighted a number of issues involving doctors’ training and working environment.  We heard of longstanding structural and cultural issues within the training environment that were having a significant negative impact on doctors’ quality of life.

In recognition and in response to this feedback, we established The Enhancing Junior Doctors’ Working Lives programme. The programme works with partners such as the British Medical Association Junior Doctors’ Committee, General Medical Council, NHS Employers, Academy of Medical Royal Colleges and trainee representatives, to discuss and address these issues.

We committed to publishing an update on the programme’s work every year.

Progress report – 2017

Progress report – 2018

Infographics to support the 2018 progress report

Highlights from our latest report include:


We ran 2 pilots allowing higher specialty trainees in emergency medicine the ability to train at 50%, 60% or 80% of a full time rota for 12 months, without having to meet the criteria set out in the Gold Guide. Evaluation that follows the pilot will also provide evidence determining whether to expand this pilot to other specialties.

Our Supported Return to Training strategy and investment plan outlines our 10 commitments for supporting returning doctors in training. We’ve also enabled the development of new simulation training packages to support returners.  An evaluation of the strategy will commence this year.  We will undertake further work with employers, Directors of Medical Education and Educational Supervisors to embed necessary cultural changes for delivering the Supported Return to Training strategy.

We envisage that this work will enable the medical career to be more tailored to the individual clinician, reducing some of the current causes of dissatisfaction with the training system and its’ process and allow a better work life balance. We will continue to make improvements as we move through the next year.

We completed and published ‘Enhancing training and the support for learners’, a review of the ARCP process and the wider appraisal, assessment and support to doctors in training in this process.  

A major finding in the report was the key role of the Educational and Clinical Supervisors and that they need much greater support, information and ongoing training. We are working with other organisations to ensure that this happens.  Work is planned to ensure that all involved are clear about their responsibilities, what they can expect from the process and that they are appropriately trained. We are exploring how what was learned through the review can be of benefit to other healthcare professions.

Over the next year, we will provide leadership in co-ordinating activities across the system and in identifying and promoting initiatives and innovation to support doctors in training.  We will continue to work with system partners to engage with doctors in training and their representative bodies.

Among the important themes that we will be examining over the coming year are:

- the provision of Educational and Clinical Supervision

- empowering doctors in training to ensure they have time for both clinical work and educational opportunities, for example, with work scheduling

- the provision of pastoral support or mentorship

- effective, supportive, multi-disciplinary team working

- what more can be done to tackle bullying and harassment

- guidance on safe reflective practice.

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