2 April 2026

Dear colleagues,

I am writing to update you on progress made in delivering the 10 Point Plan for improving resident doctors’ working lives, our next steps, and to thank you for your work to date.

Tackling long-standing systemic issues which have affected resident doctors for years does not happen overnight, however a great deal has been achieved in a short period because of your commitment.

As well as establishing a new network of resident doctor peer leads across the country, the new arrangements mean payroll errors for resident doctors have halved; 9 in 10 trusts are now reimbursing course expenses within 6 weeks; and we have published annual leave guidance to ensure resident doctors have the same fair access to annual leave as their colleagues in other professions.

This is real, tangible progress that will make a difference for us to build on.

Embedding resident doctor peer leads (RDPLs)

Having an RDPL in every trust is key to delivering this agenda. Supporting them to carry out their role, both locally and as part of the broader RDPL network, is a priority.

Over Phase 2 of the 10 Point Plan, we have worked closely with our RDPL network to refine the RDPL role to complement other resident doctor leadership roles, such as chief registrar. In light of this we will reframe the job description for RDPLs.

Our RDPL community has defined a comprehensive leadership development offer which includes a new guide for the induction and succession of RDPLs, that will support smooth transitions when they rotate to a new trust.

We have heard that RDPLs want to connect more with others in their region, so I ask you to support this as it is an important part of sustaining momentum.

Annual leave

One of the most longstanding frustrations for resident doctors has been difficulty in taking and booking annual leave; so I am especially pleased to publish Minimum standards in annual leave for resident doctors alongside this email.

This represents a tangible, practical improvement on an issue that has needed addressing for a very long time.

I request that you review your trust’s annual leave policy against this guidance as soon as it is published and identify a named individual to support implementation and oversee any appeals.

Course expenses

Our second survey in December showed 75% of trusts were now reimbursing course expenses within 6 weeks (up from 53% originally).

Our ambition was 100% by April; this now stands at 93%, and we are working on targeted, supportive interventions to ensure the last few remaining trusts meet this standard as quickly as possible.

Payroll errors

When I wrote to you last August, I asked you to establish a board-level governance framework on payroll accuracy. The latest figures show trusts with resident doctors have seen a 51.5% reduction in payroll errors, saving an average of £1.5 million per trust.

To maintain momentum please submit your National Payroll Improvement Data each month and ensure boards continue to maintain high levels of scrutiny in this area.

Next steps

During Phase 3 of the 10 Point Plan, we want to embed this work as business as usual.

From October, the 10 Point Plan will be in the Education quality framework and the Provider self-assessment report (PSAR).

I also attach a Board assurance framework for trusts to use to provide assurance to boards.

We will continue to work with RDPLs to strengthen the role and highlight the benefit they bring through stronger engagement with the resident doctor community.

One area where we need more progress is the limited response to nominating non-executive directors (NEDs) to lead on resident doctor issues, with only 42% of trusts responding.

This role will enhance the support to RDPLs and signifies the seriousness with which boards cover their responsibilities to resident doctors. Many trusts have achieved this by widening the remit of an existing workforce NED.

We are keen to showcase the great work which has been undertaken at trust level, such as comprehensive improvement plans, innovative approaches to annual leave management, or effective cultural transformations. Your insights would be highly valuable and can be shared with your regional lead.

Thank you for all your work on this programme so far. There is more to do, but we have strong foundations.

We will write to you again with a further update in due course.

Yours sincerely,

Professor Meghana Pandit
National Medical Director
NHS England