Rota design should be a collaborative process, with equal opportunity for employers and doctors to provide input, and a commitment to reach agreement on final rota design through a clear and transparent process.
Rotas should comply with both the letter and the spirit of the law. A rota may be strictly compliant with the rules, but can still be poorly designed. Being compliant with all the relevant rules in the terms and conditions is the minimum required, and workload intensity should also be taken into account when considering whether a working pattern is safe.
A well-designed rota avoids excessive variability of shifts, which can increase fatigue. It has a balanced rota cycle, with different types of shifts evenly distributed, allowing for flexible access to annual leave so that all those on the rota have an even share.
Rotas should be designed to ensure all doctors can take their full leave allowances (study, annual, etc) with sufficient capacity in place for unexpected absences such as sick leave.
Rotas should reflect a realistic and safe assessment of service need, with actual work done when on-call, shift handover and administrative time included accurately.
The process of rota design should start as early as possible, so that accurate job information is available well in advance of the start of a post to ensure adherence with Code of Practice timeframes.
Training is work for doctors in training posts, and rotas should be structured around training needs, as well as service needs, to ensure there is sufficient time for training and access to study leave.
Shifts should be rostered according to genuine service and training needs and not designed to reduce the payment of enhancements such as for night and weekend work.
It can be particularly challenging to design rotas effectively for LTFT doctors. They should be designed taking into account the specific needs of these doctor(s) instead of being planned with a full-time worker as the automatic default.
Non-resident on-call rotas can be particularly challenging to design. The roster should accurately reflect the work that will be done to allow for both fair pay and sufficient rest and breaks.
Consideration should be given to whether the rota needs to be designed to stand alone or whether it could be combined with another to create a greater pool of resources and allow greater flexibility.