Intended for healthcare professionals


Gaps in trainee rotas cause patient safety problems, say consultants

BMJ 2016; 352 doi: (Published 02 February 2016) Cite this as: BMJ 2016;352:i666
  1. Abi Rimmer
  1. 1BMJ Careers
  1. arimmer{at}

A fifth of UK consultant physicians believe that significant patient safety problems are being caused by gaps in trainee rotas, a census of the profession has found.

The 2014-15 census, produced by the Royal College of Physicians, Royal College of Physicians of Edinburgh, and the Royal College of Physicians and Surgeons of Glasgow, was sent to 13 003 UK consultant physicians and received a 56.6% response rate.1

Of the 6926 consultants who responded to the census, 21% said that gaps in trainee rotas were “frequent, such that they cause significant problems for patient safety.” Nearly half (48%) said that rota gaps occurred “often, but usually with a workaround solution such that patient safety is not compromised.”

Commenting on the findings, Harriet Gordon, director of the Royal College of Physicians’ Medical Workforce Unit, said, “Consultants are at present seeing consistent and repeated gaps in their trainee rotas—with over a fifth stating that they are concerned that it could be having an impact on patient safety.”

She said that the royal college had been monitoring gaps in trainee rotas and that they had remained stable over the past three years, so the problem was neither new nor resolving. “We know that consultants do ‘act down’ to fill such gaps, but as there is a consultant shortage this is not a sustainable solution. Such a situation is clearly unhelpful for staff, for our hospitals, and most importantly for the patients,” Gordon said.

The census also found that 64% of consultants supported a 12 hour, seven day a week acute medical service and that half (50%) would support seven day services in specialty medicine. Although 40% of consultant physicians said that their preferred compensation for working evenings and weekends was time off in lieu, just over 20% said that they would like an increase in their pay.


View Abstract