Paediatrics in the UK faces challenges from multiple fronts with increased intensity of workloads, the expectation of high levels of out of hours cover, changes to the ways in which children and young people access services, and ever-increasing complexity in child health. Within this context there are significant concerns about both the recruitment and retention of trainees. In the past decade departments have seen decreasing trainee satisfaction and increasing rota gaps.
Commonly cited concerns by trainees who leave the training programme or who may never enter it at all despite previous interest during medical school include work life balance and the length of the training programme.
The practice of rotational training within the UK is highly variable, with some trainees rotating jobs every 6 months while other may remain within a single post for 2 years or more. There is significant cost to both the healthcare service and to doctors in moving posts, time for induction, and the administration of these processes. There is also evidence of a loss of individual and team competence and capability during times of transition.
In UK training we have accepted an assumption that trainees must rotate between different places of work to gain sufficient experience, yet there is no evidence to state the optimal number or duration of rotations. Doctors work in consultant roles for the majority of their careers, during which their practice is likely to change considerably, yet we do not require them to gain experience in different settings.It is common for European doctors to train in a single teaching hospital, often the same institution in which they completed their undergraduate medical degree. With this in mind we propose a pilot of longitudinal placements within London which, once administered and evaluated, will help to evaluate how placements are administered in the future.