From Buckinghamshire to Oxford: Expanding a Novel Deanery Approach to Geriatric Medicine Rostering

Introduction
Resident doctors nationally report high burnout, poor work-life balance, and frustration with inflexible rota systems, as reflected in GMC and local trainee surveys. Buckinghamshire Healthcare NHS Trust had previously piloted 'preferential rostering', inviting doctors to submit rostering preferences ahead of rota construction, with significantly positive results. We adapted and introduced this approach for geriatric medicine registrars at Oxford University Hospitals (OUH), aiming to demonstrate similar benefits and support wider deanery adoption.

Method
20 geriatric medicine registrars at OUH took part in preferential rostering, submitting preferences for their on-call shifts, annual leave, study leave, and weekend availability ahead of the February - August 2026 rota. An anonymous survey subsequently assessed satisfaction, autonomy, fairness, and overall rota experience.

Results
13 of 20 registrars (65%) completed the survey; 54% were less than full time. Mean rota satisfaction was 9.1/10 (median 10/10, range 6-10). Excluding one registrar who did not receive email notification and so could not take part, all participating respondents had annual leave, study leave, and weekend availability requests accommodated (100%). 92% agreed the rota represented an improvement on previous systems and gave them greater control over their working life. 85% felt the system was fair and required fewer swaps, knowing more of their rota in advance. 92% would recommend preferential rostering to colleagues, and 85% supported expanding it to other hospitals in the deanery. The only negative feedback came from the registrar who did not receive email notification, who rated the rota neutrally overall.

Conclusions
Preferential rostering, adapted from learning shared within the deanery, was associated with high registrar satisfaction, perceived fairness, and autonomy, with the sole negative response attributable to a lack of email notification rather than the process itself. A follow-up survey will assess sustained impact, while future cycles ensure timely notification and wider deanery-wide expansion of the model.