The 10 point plan sets out actions for NHS England and individual trusts to ensure meaningful progress, it will be formally incorporated into the new NHS Oversight Framework.

However, NHS England says trusts should proceed on the basis that it is already in effect and take appropriate action without delay. Progress must be reported to their boards and, where actions are not met, a formal explanation and corrective measures should be provided.

Trusts are also expected to develop a Board Assurance Framework to provide oversight of this work and the outcomes should be included in their annual reports to demonstrate accountability and progress.

Summary of the 10 point plan

1. Improve workplace wellbeing for our resident doctors - trusts are expected to take meaningful steps to improve the working environment for resident doctors. Within the next 12 weeks every trust should: Conduct a self-assessment of the feasibility of improving priority areas and develop action plans to address any gaps. Trusts will be expected to provide updates for national reporting on progress.

2. Resident doctors should receive work schedules and rota information as per the requirements of the Rota Code of Practice - From now, and for all rotations going forward, NHS England must provide at least 90% of trainee information to trusts 12 weeks prior to rotations commencing. From now, trusts must use this information to ensure that resident doctors receive their work schedules at least eight weeks in advance and detailed rotas no later than six weeks before the rotation begins. Where these standards are not met corrective action must be taken.

3. Resident doctors should be able to take annual leave in a fair and equitable way which enables wellbeing - it is vital that leave is allocated in a way that meets individual needs while maintaining service delivery. Within 12 weeks, NHS England will: conduct a review of how annual leave is currently agreed and managed for our resident doctors. This review will identify areas for improvement and lead to clear recommendations to ensure a more consistent, transparent and supportive approach across all trusts

4. All NHS trust boards must within six weeks appoint two named leads - one senior leader will be responsible for resident doctor issues, and one peer representative who is a resident doctor. Both should report to the board. In September 2025, NHS England will publish a national role specification for the board lead. Boards should also ensure their executive teams engage directly with resident doctors to understand local working conditions and priorities. 

5. Resident doctors should never experience payroll errors due to rotations - within the next 12 weeks, every trust should participate in the current roll out of the national payroll improvement programme and ensure that payroll errors as a result of rotations are reduced by a minimum of 90% by March 2026. All organisations are required to establish a board-level governance framework to monitor and report payroll accuracy and begin national reporting as required.

 6. No resident doctor will unnecessarily repeat statutory and mandatory training when rotating - within the next 12 weeks if they are not already doing so, every trust should comply with agreements set out in the MoU signed by all trusts in May 2025 by ensuring acceptance of prior training. By April 2026, NHS England will reform the entire approach to statutory and mandatory training with a revised framework as outlined in the 10-Year Health Plan for England.

7. Resident doctors should be enabled and encouraged to Exception Report to better support doctors working beyond their contracted hours - A new national Framework Agreement for Exception Reporting was agreed on 31 March 2025 and will be rolled out for implementation in due course. The changes agreed simplify the reporting process for resident doctors, ensure they are being fairly compensated for the additional hours they are required to work, and will support the safety of their working hours.

8. Reimbursement for course-related expenses within four to six weeks of submitting their claims - We will transition nationally from an approach where expenses for approved study leave are reimbursed only after a resident doctor has attended a course/activity, to one where reimbursement is provided as soon as possible after the expense is incurred. Within the next 12 weeks every trust should review their current processes to ensure they can reimburse resident doctors upon submission of valid receipts for all approved study leave-related expenses, including travel and subsistence.

9. Reduce the impact of rotations upon resident doctors' lives while maintaining service delivery - a review of how rotations are managed is now underway and is being led by the DHSC in conjunction with the BMA. NHS England is working closely with the BMA to find constructive and workable solutions to address their needs as a matter of priority. Within 12 weeks, NHS England will develop and launch suggested pilots of reformed rotational changes, while continuing to look at wider reform.

10. Minimise the practical impact upon resident doctors of having to move employers when they rotate, by expanding the Lead Employer model - by October 2025, NHS England will develop a comprehensive and financially sustainable roadmap, underpinned by a robust business case. This will include detailed recommendations on costing and funding, service catalogue requirements, and pricing models for national implementation. The roadmap will provide a clear framework for expanding Lead Employer arrangements across the system.

NHS England said: ‘Supporting resident doctors improves the quality of care offered to Many of these steps will also improve the lives of other staff groups across the NHS.

‘Our educators work hard to ensure that resident doctors' education and training is world class, but too often they have been let down on basic issues. The 10 Point Plan will help us respond to what resident doctors have been telling us.

‘We have long recognised the need to improve the working lives of resident doctors, but we know we need to go further, faster to build on what we have already done.

From the autumn NHS England will publish new data and information on:

• trusts delivering access to the basics – lockers, rest facilities, hot meals, on-call parking spaces
• delivery of eight-week work schedules and six-week rota notice on rotations
• number of payroll errors
• self/preferential e-rostering
• percentage of trusts delivering board level reporting of issues
• changes to the way in which annual leave can be taken.

In response, Dr Anthony Martinelli and Dr Catherine Rowan, co-chairs of the RCP's resident doctors' committee, said: ‘This 10 Point Plan is not setting out to tackle new problems. Many of these issues - such as accurate pay and access to parking - represent years of systemic failure that have profoundly eroded trust between resident doctors and the health service.

‘As NHS England rightly points out, many still face unfair and inconsistent working conditions, and the success of the plan will not be measured by its publication, but by its delivery. We therefore welcome the requirement for NHS organisations to report progress to their boards in November, and we look forward to reading these updates.'