6743 Prioritising life in rotas: understanding the role of smart rostering in improving the prioritisation of junior doctor life outside of work

Objectives We are at a time of workforce crisis for junior doctors; low morale, frequent strikes and a growing retention issue. A recent systematic review cited lack of flexibility, autonomy and respect for life outside of work as key issues for doctors.1 This particularly applies to the rapidly expanding group choosing to work less than full time (LTFT). We must work to retain trainees and we need change. Most trainees feel their lives are controlled by 'the rota', with rostering shown to be the major issue affecting working lives in annual survey data and focus group review of London paediatric trainees.2 We propose that innovative rostering could be used to improve the working lives of junior doctors. Methods Paediatrician trainees teamed up with Lantum, a workforce management platform, to develop a novel 'smart rota' solution that balances clinician preferences with departmental needs. This was implemented with 2 groups of trainees at 2 London hospitals spanning both SHO and SpR rotas. Pre and post implementation focus groups explored the impact of this more 'trainee centred' approach on working lives. Prior to the rotas being built, adaptations to traditional rota management requests were offered including; Which working days LTFT doctors would choose (rather than fixed job share partnerships) Frequency/length of night working (ie. more frequent but lower length versus less frequent longer length runs NB overall number of nights was set by whole time equivalent%, departmental work schedules and complied to junior doctor contract rules) Study and annual leave requests (including planned holidays, life events but also other commitments eg regular weeknight sports club) Results Themes from the focus groups emerged including: gratitude for acknowledgment that life outside work matters gratitude to choose working days increased flexibility to accommodate personal preferences/commitments eg religious holidays, Shabbat, ability to have uninterrupted medical or fertility treatments, ability to attend masters programme discomfort with deviation from a familiar rolling working pattern This was in addition to demonstrated quantitative benefits from reduced rota gaps and subsequent reduced departmental locum spend. Conclusion Trainees valued prioritisation of their lives outside work and the effort made to accommodate this. Trainees felt life events, both academic and personal, were easier to attend with reduced need for swaps. It is essential we adapt to retain our junior doctor workforce at a time of crisis in the NHS. Smart rostering has the potential to offer benefits to working lives, and in turn improve recruitment and retention References Lock FK, Carrieri D Factors Affecting The Uk junior doctor workforce retention crisis: an integrative review. BMJ Open 2022;12:e059397. doi: 10.1136/bmjopen-2021-05939 LSP annual survey: https://londonpaediatrics.co.uk/trainees-committee/survey/