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Foundation programme review

One of the biggest challenges facing the NHS is recruitment and retention. Working with partners, this review seeks to address some of these issues by improving transition periods, addressing geographical issues and widening access to undergraduate study in medicine.

The transition from medical school to foundation training is a particularly difficult time for trainees. Supported from the start; ready for the future; The Postgraduate Medical Foundation Programme Review makes recommendations about improving that transition period and highlights the importance of making the NHS an appropriate environment for individuals to learn and work - echoing a key theme in the Interim NHS People Plan.

Undertaken in collaboration with Royal Colleges, the Medical Schools Council the General Medical Council (GMC), the British Medical Association (BMA) and trainees, it re-enforces the commitment to enhancing the experience of doctors in training and in turn their health and wellbeing.

The review contains 16 draft recommendations across the following themes;

  • Improving transition from medical school to foundation and from foundation to core/specialty training
  • Addressing geographical and specialty distribution issues
  • Enhancing the Working Lives of Foundation Doctors
  • Improving Supervision and Educational Support
  • Improving Faculty Support

Since publishing this report HEE, with the help of our key stakeholders, are taking forward each of the 16 recommendations within the report. Please find below further information on each of these;


Health Education England (HEE) rolled out self -development time for foundation doctors in August 2020 in order to further support health and wellbeing.

Over the course of the Foundation Programme Review, we heard that foundation doctors are often unable to find time within the working week for essential non-clinical activities such as working on their ePortfolio, meeting with supervisors and developing skills in teaching and QI.

Recommendation #14 of the review is to ensure all foundation doctors have time formally included in their work schedules for non-clinical professional activities and that this would be called ‘self-development time’.

In August 2020, all English trusts with foundation doctors were required to include self-development time in the work schedules of foundation year two (FY2) and then if possible for foundation year one (FY1) doctors. FY2 doctors were required to have a minimum of two hours per week self-development time. FY1 doctors were to have a minimum of one hour although not mandatory. After evaluating the first year of this scheme listening to feedback from trainees themselves and the system it has been determined that from August 2021 all FY1 and FY2 doctors will have a minimum of 2 hours on average per week of SDT time. The implementation of this has been planned with the wellbeing of doctors in mind, but also with the demands that are being placed upon service provision in mind.

The attached documents explain the intended uses of self-development time in more detail and also cover many of the questions frequently asked by foundation trainees and their supervisors about this time.

We would like to thank NHS Employers for working closely with HEE on implementing this recommendation.

 - Self-development time - FAQs for trainees and supervisors
 - Intended uses of self-development time
 - Self-development time background information

Self-development time case studies: 

 - The Royal Surrey NHS Trust
 - Brighton and Sussex University Hospitals NHS Trust


If you have any further questions or comments regarding self-development time, please get in touch with us at merp@hee.nhs.uk

In 2018–2019 the HEE Foundation Programme Review heard evidence from a wide range of stakeholders, including foundation doctors, about the difficulties faced by those entering foundation training from medical school. A number of recommendations were made and this pack outlines progress and contains practical information to assist with implementation.

Supporting Trainers, Supporting Doctors, Supporting Patients: progress since the postgraduate medical foundation programme review. This document also contains information regarding the Foundation Quality Charter.