Intended for healthcare professionals


Return of the “firm” gets cautious welcome

BMJ 2016; 355 doi: (Published 07 December 2016) Cite this as: BMJ 2016;355:i6556
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

The health secretary’s proposal to bring back the medical “firm” is broadly supported, but doctors point out that shift patterns and working hours are different now. Abi Rimmer reports

Among a range of initiatives announced last week as part of work to improve the moral of junior doctors in England was a plan to reintroduce the medical “firm” system.

Speaking at the NHS Providers annual conference, Jeremy Hunt, England’s health secretary, said that by dismantling the firm system when doctors’ working hours were reduced “we may have thrown the baby out with the bathwater.” He asked, “Can we bring back the firm or at least the best bits of it?”1

Hunt said that Health Education England would work with the Royal College of Surgeons, teaching hospitals, and education providers to explore whether a modern firm structure could enhance medical teams and make junior doctors feel more valued.

“This pilot will take the best parts of the …

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