Foundation programme review - self development time

Self-development time (SDT) was introduced as an outcome of Health Education England's (HEE) Postgraduate Medical FoundationProgramme Review. The review identified that foundation doctors could find it difficult to find time to carry out essential non-clinical or educational activities and to have time to consider future career pathways. The lack of time was reported to be contributing to the high levels of burnout in foundation year two doctors and to some delay in foundation doctors applying for specialty training.

It is time which will be formally included in the personalised work schedule of a Foundation doctor to allow them to carry out non-clinical activities related to their curriculum or career exploration, it is similar to the Supporting Professional Activity (SPA) time included in consultant contracts. SDT is intended to be used for non-clinical activities that are essential for meeting the curriculum requirements for successful sign-off at ARCP or for developing future career plans – examples include meeting with supervisors, working on the ePortfolio, carrying out Quality Improvement work, formally reflecting on your clinical practice, and exploring career opportunities. Fuller descriptions of intended uses of SDT can be found in the Intended Uses of SDT Time document linked above.  

Health Education England has asked from August 2021 for a minimum of 2 hours on average per week for F1 and F2 doctors. When was SDT introduced?

SDT was rolled out in August 2020 in all English Foundation Schools for F2 doctors in order to support their health and wellbeing, it was introduced for all F1 and F2 doctors from August 2021.

SDT has been designed particularly for doctors undertaking the foundation programme. It aims to ensure that there is parity among the provision of non-clinical time across all foundation posts. It also recognises the move for foundation doctors from full-time study, to their first role as a junior doctor, and ensures that the NHS does all it can to adequately support foundation doctors.

Some specialty training programmes already have rostered time for non-clinical activities but use alternative names for this, for example, in GP training, trainees receive a half day for private study.

There is no direct link. The recommendation is emphasising what should already be practice. The junior doctor contract allows for trainees to exception report if activities to be undertaken are required by the employer or agreed with the educational supervisor. It does not allow for exception reporting for educational activities for personal development or career enhancing purposes which are outside of the contractual requirements

Some hospitals already roster time for foundation doctors to carry out the self-directed professional activities which will be done in SDT, this time can contribute to delivering the recommended SDT.

Self-development time is not intended to replace time already available in work schedules for foundation doctors to carry out other routine non-clinical activities such as:

• attending departmental or trust-delivered teaching programmes
• attending trust or departmental meetings, such as audit, quality improvement, morbidity & mortality or governance meetings
• taking study leave
• doing taster days / sessions to gain insights into potential career options
• attending induction programmes for trusts or departments
• completing trust mandatory training, for example fire safety or information governance.

As long as Foundation doctors get 2 hours of SDT on average every week, trusts can be flexible about how it is rostered. Feedback from our 2020 pilots suggested that SDT is more useful to Foundation doctors when weeks’ worth of ASDT is taken together, e.g. two weeks’ worth of SDT for an F1 could be given as 4 hours, in one afternoon, once a month. Such arrangements may well work better for both Foundation doctors and service delivery. 

The activities carried out in self-development time should all be recorded in the trainee’s ePortfolio and these records should form part of the regular discussions between the trainee and their educational and named clinical supervisors.

Please refer to NHS Employer’s and the BMA’s joint good rostering guide which sets out ways in which good rostering practice can be utilised to develop rotas. It aims to support and create an effective training environment that also meets the needs of the service, while enabling flexibility for doctors and employers.

If clinical demand peaks again due to exceptional circumstances (such as another wave of COVID-19) then we would not expect trainees to continue with SDT time during that period. It would be a local decision as to if it was appropriate to continue with SDT time.

No, this is not time off, this would mean being paid twice for the same time, this will be considered fraud.

SDT should be given pro-rata to the percentage of whole time equivalent they are working.

Foundation doctors are expected to develop career planning skills and to proactively explore and plan their career options. SDT can be used for activities to support this, such as gathering careers information from internet resources (such as Royal College websites or the Health Careers website), seeking advice from relevant clinicians, and taking time to reflect on career options and plans. Taster days are meant to provide a much longer opportunity, usually of several days to a week, for experiencing one or more specialties and are provided out of the Foundation doctor’s study leave allowance.