Doctors in Training

There are approximately 55,000 doctors in training (DiT) at any one time within the NHS.
Due to the nature of training, regular movement between employing Trusts is a fundamental part of their training programme. Over a 10-year training career, doctors in training move organisation an average of ten times, however for some doctors this could be as many as 16 times. This high frequency of movement reinforces the need to get the rotational process right to ensure a good experience for the trainees while enabling Trusts to run an efficient and effective process.
With pressure on resources and an increasing demand for a highly skilled competent workforce to meet the demands of todays’ NHS, employers should be looking to streamline their local recruitment, pre-employment and induction processes.  Junior Doctors are the most transient group of NHS professionals, moving from one employer to another on their rotation; one way to speed up the process, reduce inefficiencies and get Junior Doctors into frontline care quicker is to redefine the induction and mandatory training process.

There is a requirement set by Health Education England (HEE) for all Trusts in England to have a streamlined process in place by August 2018. 

A national core working group has developed the ‘Perfect Rotation Process’ that is to be applied across all NHS Trusts.  The principles of the perfect process include removing the duplication of pre-employment checks and mandatory training, something that can be facilitated by using ESR.   

Best use of ESR

HEE has developed six key deliverables, four of these directly relate to the best use of ESR.

More detail about the perfect rotation process can be found on the NHS Employers website.  

Pilot study

The national core working group has recruited a number of NHS organisations as pilot sites and fast followers; they are currently piloting the perfect rotation process across England which will complete in April 2018. The aim of the pilot study is to ensure the six principles work effectively and that all associated supporting materials are accurate, useful and fully tested before the full release of a national toolkit in May 2018. 

You can find out which organisations are involved in the pilot study on the NHS Employers website

What should NHS organisations do?

The national core working group, along with the NHS ESR Programme team recommends that organisations undertake the following pre-requisite tasks in readiness for August 2018:

  1. Align all statutory & mandatory training to the Core Skills Training Framework (CSTF).
  2. Record CSTF competencies in ESR Oracle Learning Management System (OLM).
  3. Enable the ESR/TIS Interface.
  4. Determine local process for running the Pre-hire Inter Authority Transfer (IAT) for doctors on rotation.
  5. Medical staffing should run the Pre-Hire IAT.
  6. Accept CSTF competencies via the Pre-Hire IAT and remove all unnecessary duplicate training.

To support your work to implement the streamlined process by August we recommend you establish a project team that includes subject-specific expertise, this will ensure that staff are engaged with the changes and the benefits of the new process are understood.

ESR expertise should include:



Executive Sponsor 
(For example, HR director or medical director) 

Overall responsibility for the project and its successful implementation. Steer the project, influence and support to overcome issues and ensure maximum benefits

Project Lead 
(For example, Deputy HR Director) 

Overall responsibility for ensuring tasks are completed, kept on track, address issues, raise issues to executive sponsor and/or streamlining team where necessary. Be the point of contact for Exec sponsor & streamlining programme team.

Medical Staffing Lead

Providing expert medical staffing knowledge, ensuring all medical staffing process changes are implemented across the medical staffing team.

Learning & Development Lead

Providing expert L&D knowledge, ensuring all process changes are implemented across the L&D team. Leading on the alignment & declaration to CSTF. Leading on the Competencies in ESR principle

IT Lead

Ensure all IT requirements are met to ensure the successful implementation of all six principles. Key is the MM0-100 ESR Organisation Site IT Printer and Network Infrastructure Readiness document. Support where necessary of any automation of reports, forms and processes.

ESR Reporting Lead

Provide expert ESR reporting knowledge, providing reports required as part of the project implementation and continued support of reporting required as business as usual. In particular, reporting that will enable pre-population of forms/documentation.

ESR Work Structures Lead

Provide ESR work structures support where needed as part of the project. This will mainly be part of the ESR TIS Interface principle and the set up/amendments as necessary to positions in a timely manner to enable to successful implementation of the interface.

ESR System Admin Lead

Provide ESR system admin support where needed as part of the project, to allocate URP's and notification roles in a timely manner to enable the success of the project.

Payroll Lead

Provide expert payroll knowledge and support to any changes of current processes particularly around the pre-hire IAT principle.

Medical Education Lead 

Providing expert education knowledge, ensuring that any process changes maintain the DIT required standards and training requirements.

Support and guidance

If your organisation does not use ESR OLM for recording training records you can contact your NHS ESR Account Manager who can provide advice and guidance about how to align to the Core Skills Training Framework (CSTF) and the steps you need to take to ensure that your training data is recorded in ESR and transferrable via the IAT process. 

There are helpful Frequently Asked Questions available on the NHS Employers Streamlining DiT webpage, or you can contact your NHS ESR Account Manager for advice and support.  

If you have a question relating directly to Streamlining, contact your regional Streamlining Programme Office, if you have one.  If you do not know details of your regional PMO or do not have one, contact: streamliningnhsemployersorg.