Sixty seconds on . . . guardians

BMJ 2016; 353 doi: (Published 04 May 2016) Cite this as: BMJ 2016;353:i2486
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

So, are we talking guardian angels, guardians of the galaxy, or multiple copies of a leftie newspaper?

None of the above. “Guardians of safe working” are an entity created as part of the new contract for junior doctors in England.

It’s rather a highfalutin title. Who are these people?

NHS Employers said that the guardian would be a “senior person” who was otherwise independent from hospital management, so a consultant or senior manager. They would report to the board of the trust and to a BMA representative.

Right. So what are they actually going to do?

The idea is that guardians will act as the champion of “safe working hours” for doctors in training. It will be their job to ensure that rotas are safe. They will also be in charge of distributing money raised through fines incurred on trusts when junior doctors work too many hours. This money will be spent on improving the training and “service experience” of junior doctors.

Are the roles being advertised?

Yes, hospital trusts are now advertising the roles. One such role is for 12 hours a week, with a full time salary of £75 249 to £101 451, paid pro rata. The successful applicant, the trust said, would have “facilitation, interpersonal, and negotiation skills in order to promote medical and dental education and challenge practice.” They must also be able to “deal with constraints.”

Is the BMA happy with this idea?

In January the BMA warned that the guardian role had been diluted and lacked teeth. It said that there were still “serious and worrying omissions” regarding the role, which meant that the BMA’s concerns about the safety of patients and doctors remained.

Anything else I should know?

Just be careful not to confuse these guardians with “freedom to speak up guardians,” also referred to by NHS Employers simply as “guardians.” These have also been appointed by trusts, but they do a completely different job: to support staff who wish to raise concerns.

View Abstract

Sign in

Log in through your institution

Free trial

Register for a free trial to to receive unlimited access to all content on for 14 days.
Sign up for a free trial