Hate rota gaps: I'm loving (Guardian) Angels instead - a successful standby initiative to prevent staffing gaps

Last-minute gaps in the rota are demoralising for those still at work and reduce the standard of patient care. Agency staff are the most common solution, but at peak times, it is often impossible to find a locum at the last minute. We present a novel solution that improves conditions for doctors, patients and rota coordinators.

We implemented a standby system to prevent unfilled late notice gaps over 3 weekends. This was compared with previous weekends where cover was required. Additionally, we surveyed the junior doctors involved in the scheme.

In 2022-2023, 19 had late gaps. Only five of these were successfully covered.The following year, doctors volunteered to be Guardian's Angels for 29 standby shifts. Of the 25 filled standby slots, 4 (16%) were converted to full shifts.24 junior doctors responded to an online survey, 95% felt the scheme is beneficial.

Staffing gaps result in poor morale, stressed staff which may lead to poor outcomes for patients. Doctors taking part in this scheme feel more valued and supported. Disadvantages of the scheme are the modest cost to the hospital (this may be offset by avoiding locum agencies with higher fees).