Redesigning a general surgery foundation doctor rota to improve shift equity, staffing levels, doctors' pay and patient care.

Inefficient rota design is a key cause of rota gaps, additional work hours and poor rest among doctors. These are major factors in declining NHS doctor workforce retention rates and compromised patient care. Eighteen improvements were made to the Broomfield Hospital General Surgery foundation doctor rota to improve shift equity, staffing levels, doctors' pay and patient care. The rota can be used as a template by rota coordinators across NHS trusts. Doctors should be actively involved with improving local rota design.