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Rota gaps having a negative effect on your experience at work? Staff shortages can and do have a significant impact on those left to take up the slack. Tell us your experience of day to day life as a junior doctor in the NHS.
Junior doctors have spoken up loud and clear throughout the contract dispute about how rota gaps affect our day to day lives. We want to hear from you about how staff shortages impact on your physical and emotional wellbeing, your work-life balance and personal relationships, your education and training experience and the care you feel you can offer to your patients.
This page will become a live record of the day to day impact of rota gaps on our working lives, it is the first step in a project aiming to highlight the real world effects of rota gaps, vacancies and understaffing.
You may or may not choose to post anonymously, but either way, please tell us whether you are a foundation doctor, a core trainee or a registrar.
If you would be happy for us to contact you about including your experiences in BMA campaign activities, or taking part in further research focus groups or telephone interviews, please send your details to [email protected].
More about this research project…
We’re gathering additional anecdotal evidence to add to our existing body of member feedback. This will inform future work on the impact of staff shortages and the toll that takes on hospital doctors.
This project is expected to involve future requests for feedback from all secondary care doctors. We anticipate asking for information on workload intensity, physical and emotional health, morale, work-life balance and personal relationships, recruitment, retention and patient and public safety. We need your help to inform and develop potential questions and ideas for further quantitative research.
Emails asking for me to stay late and cover shifts have been a daily occurrence for some time. Over the past few weeks they have dramatically increased. Including recent requests for me to act as the medical registrar overnight, despite having only been a core trainee for 6 months. In our hospital junior doctors are regularly pulled off their wards to cover gaps, impacting on continuity of care for patients and the quality of training for juniors. Getting to clinic is a rare treat, rather than the routine training experience it should be. Its a real struggle to take annual leave as you know you are going to be leaving the ward short of doctors, but you need to break as the risk of burnout is so high when you are often covering the jobs of two or three colleagues.
Dismayed and fed up said:
They are certainly taking there toll. As a consultant obstetrician for 16 years I now regularly fill the vacant trainee slot in a busy unit.
oh not being able to attend BMA council and SJDC oh and never having more than one parent at home...
Safe staffing levels on our acute admissions unit should be 3 FY1s, 3 SHOs and an SpR at night - regularly there is only 1FY1 and 1SHO. Despite the rota coordinator and HR being aware of the gaps for weeks and weeks, there are so few locums available or able to travel to cover these shifts that the unit is left desperately understaffed. Patients are left many many hours without a medical review and the doctors work extremely hard without breaks to keep the patients safe. It is an unsustainable situation.
Core surgical trainee: out of 24 posts we have 14 doctors on the surgical SHO rota. Rest of the gaps (10 posts) are filled (or not) by locum doctors.
Paeds surgery SHO rota. We all have our arms twisted into working additional locum shifts on top of the normal working week, with seemingly no choice in it. This is in addition to being made to do 1-2 16 hour shifts each week on top of the usual 8-5. It's a totally unmanageable working pattern and volume, and despite being a core surgical trainee I'm learning nothing and just providing service provision. Terrible way to finish CT2 .
Medical registrar: I've been implied on most of my shifts ( especially after a night shift) to stay beyond what is needed to see all the patients with the consultant for the post take (as there are more patients pouring in and the day team ( who is short one sho) needs to start seeing the patients )which can take till noon and maybe a bit more than that and be expected to be in to cover another night shift.
Even there have been circumstances where I was put on the spot to cover the acute take when I'm doing the ward round and knowing the junior doctor on the ward has gone off sick due to "pressures" which the registrar has to cover for and then going for special interest clinics which I had signed for at the beginning takes a back step and in the end not leaving a good mark on the consultant who was counting on me to be there for my special interest clinic sessions.
In the end you are going to be getting a not well rounded consultant but Someone who is good at trouble shooting! I hope I'm wrong because that's not who I would like to become and I'm sure many would feel the same.
Gaps have meant any education days (for clinic, audit, presentation, teaching etc) on my rota have been removed to cover service. Meaning no clinic opportunities, I am ST5, unless coming in on my days off. Also, additional work such as audit (mandatory to pass ARCP), service improvement, projects all have to be done in my own time. Gaps at ST4+ level, I am concerned, have left junior staff unsupported in a specialist intensive care environment.
Registrar, London, major teaching hospital. 1:8 NROC rota down 3 people. Always being asked to fill in extra shifts. Leave was difficult to take - now fixed. Affects training opportunities during the day, as someone always off post-on-call. This rota has been short for at least 3 years (that I know of), and consultants trying everything to recruit but simply no suitably qualified people who want to do clinical fellow posts. Same situation across region in this specialty.
London Paediatrics SHO: on a 6 person neonatal SHO rota, we have 2.5 gaps, meaning that we are nearly half unfilled. The Trust has no money, and therefore will only provide locums for the long day shifts or night shifts. As a result, we are often covering more areas that we should be while at work (ie neonatal ICU and the postnatal ward). It leads to delays in discharges, and the morale amongst my colleagues is rock bottom. Our training is adversely affected, as we don't have the time (or energy) to take part in work such as audits, and we often miss teaching opportunities because of the pressures of service provision.
I gave just resigned from Core Surgical Training. Rota gaps have meant that training has been entirely sacrificed to service provision. Training only happens in your own time - evenings, weekends off and annual leave. The gaps in my hospital only look to be worsening as locums are now being driven away to other countries. The gaps are widening and care is suffering.
I was recently asked if I could work the day shifts at the weekend, in addition to the night shifts I was already doing. I said no, they said are you sure?
NROC rota in a surgical specialty. There have always been gaps on our rotas since I started in the specialty 6 years ago. I have now worked 6 different rotas in 6 different hospitals, and all required the existing doctors to cover the gaps.
In one instance, locum pay (at SpR level) was capped at under £30/hr. When many of us refused to cover the gaps the CD divided them up and allocated them to us all, saying that we were forced to do them.
At the moment, there are so many gaps on the SHO rota that overnight we are first on for receiving and the wards. Which, when we've been at work since 8am that day is just plain dangerous. If we do a 24hr shift that is a shift, rather than being NROC for the OOH bit, we miss huge amounts of training the following day.
Working on a 14 core medical trainee rota, with 7 trainees, 3 locums and 4 gaps that are never filled. Trainees are taken off days to cover nights, leaving day-time cover extremely short. Quite often, 1 trainee is expected to review over 50 patients as a normal day. All shifts overrun. Weekends are particularly dangerous, with trainees reviewing over 100 patients, dealing with emergencies as well as acute medical take. Despite requesting locums, there is nobody left to do these extra shifts. We are not allowed to attend clinics and study leave is restricted. Educational opportunities are virtually non-existent. The hospital itself is extremely stretched with ‘escalation beds’ in any free space or procedure room the hospital has left. We have raised our concerns with our clinical and educational supervisors who feel as hopeless as we do. Morale is gone and we are completely burnt out.
It's been a very busy winter in paediatric intensive care and we have had lots of registrar rota gaps. Frequent emails asking for us to cover extra shifts and we have had staff pulled from the transport service to cover the intensive care unit to ensure safety. Frequent incidences of registrars covering twice as many patients as usual due to low staffing.