At Croydon University Hospital, we have re-imagined the way that the FY1 on-call rota is done. as with many rotas, the way that they work is that they are set as rolling and clinicians are expected to work the shifts they are rostered on to.

There are some problems which arise because of this approach:

1. Individuals on the rota end up doing a different amount of on-calls to their colleagues. There are usually a few people who are disadvantaged by this.
2. The rota does not take into account staffing levels during the week and because of rest days from the on-calls, annual leave and other colleagues’ on-calls, this can leave the ward short-staffed on occasions
3. Individuals have no say as to when they are on-call and have to negotiate with others when significant life events occur

We considered these to be significant enough issues that we decided to change the way the on-call rota works. Two months before the rota is due to be distributed, we ask all of our FY1 colleagues to let us know when they would like to annual leave and when they prefer not to be on-call. Once they have let us know the dates, we then design the on-call rota so that the following is achieved:

1. individuals are able to apply for annual leave, knowing that they will not be on-call during that period and that there will be clinical cover when they are not there.
2. Ward are in general not left understaffed, although there may be one or two occasions where that is inevitable.
3. Everyone does the same number of on-calls and if there are extra slots, they are offered as locums so as not to disadvantage any one person.