1. Workplace Wellbeing: In a range of areas including access to hot food 24/7, locker access, and access to rest spaces 167 of 189 trusts reported improvements over the 12 weeks. We asked Resident Doctor Peer Leads (RDPLs) to validate these returns and 89% fully agreed the assessments.

2. Rota and Schedule Transparency: We now have our first ever comprehensive end-to-end picture which shows 12-week notifications are at 92%; 8-week schedules at 82%; and 6-week rotas at 76%. This shows that a vast majority of resident doctors get the information they need with enough time to plan their lives and we ask you to continue to share rotas in a timely manner.

3. Annual Leave Reform: We committed to reviewing how resident doctors’ annual leave is currently agreed and managed recognising it would take longer than 12 weeks to solve the issues across the country. Our new Task and Finish Group has four priorities: national best practice guidance, local templates, rota coordinator training, and self-rostering options and we expect rapid delivery in this financial year.

4. Board-Level Leadership: Local ownership is critical to embedding the improvements long term. Now all 189 trusts have a Board Lead and 98% of Trusts have a Resident Doctor Peer Lead, with the remaining in active recruitment.

5. Payroll Accuracy: To improve payroll accuracy, we have informed and trained over 300 colleagues from 200 NHS trusts and other NHS organisations since September. We have set a target for a 90% reduction in errors over the next two months as a result.

6. Mandatory Training: Every trust has now committed, via a Memorandum of Understanding, to recognise training completed at a previous employer and our audit shows this is being delivered across the country.

7. Exception Reporting Reforms: We ensured this was in contracts in September and will be launching the national programme on 4 February having completed training for 365 employers and issued the guidance last year.

8. Course-Related Expenses: 75% of trusts are now reimbursing course expenses within 6 weeks of submitting expenses, up from 53%. Our ambition is to reach 100% compliance by April.

9. Rotation Reform: We worked with the BMA, Postgraduate Deans and Training Programme Directors to agree 18 pilot programmes to test real world options starting in August to coincide with rotations. When we get the results, we will implement what works best.

10. Lead Employer Model: This is a fundamental NHS wide change, and we are on target for approving a business case and publishing a delivery road map as soon as possible as this remains a system-wide priority.

We know there is so much more to do, but we have a foundation to build on. And through the Board Champions and the Resident Doctor Peer Leads we have the infrastructure to ensure we maintain focus over the long term.

Trusts have now been asked to focus on the following priorities as next steps

Point 3 – Annual leave

A Guide to Good Practice in Annual Leave for Resident Doctors will be published soon explaining how annual leave should be requested, approved, and fairly allocated to ensure equity, fairness, clarity, and consistency. Please:

• review your annual leave policy against this guidance
• ensure your policy is available and easily accessible to all resident doctors
• identify a named individual to support implementation and oversee appeals

Point 4 – Board level leadership

To further develop local senior ownership please:

• continue regular Board Lead and RDPL meetings to support improvements
• nominate a Non-Executive Director to support the Board lead and RDPL

Point 7 – Exception reporting

The new national system will simplify the process, ensure fair compensation for additional hours, and support safer working. Please:

• ensure your exception reporting system is updated and accessible
• communicate the changes to all resident doctors and guardians of safe working
• ensure exception reporting is encouraged, not discouraged

Resident Doctor Peer Lead engagement

Your Resident Doctor Peer Lead is a critical link between your board and your resident doctors. Please:

• ensure your Resident Doctor Peer Lead has regular access to the board
• support their attendance at national peer lead drop-in sessions
• consider how their rotations will impact their role and plan for the future
• use their insight to drive and communicate local improvements