Aims It is currently unclear which approach to staff management during Covid-19 disruption allows clinical practice optimization whilst ensuring junior doctor resilience. Our project aimed to provide an optimised surge rota at East Sussex Healthcare Trust during the second Covid-19 surge to improve workforce experience and to allow us to prepare for future surges while ensuring patient safety.

Methods A novel surge rota was developed alongside a diverse group of representatives with backgrounds in medical education, hospital management and general medicine. The new rota was more flexible and built on the regular 2016 Junior Doctor contract with the addition of supportive staffing and environmental changes. These included a variety of changes informed by the previous discussions regarding the rota used during the first surge. Improvement was measured during feedback sessions with individual doctors. Furthermore, qualitative and quantitative questionnaire data was gathered and analysed using descriptive statistics for presentation and summary.

Results Our results suggest the novel surge rota was an improvement upon other rotas used during the first Covid-19 surge. The main factors that affected this were: more senior and specialist support, timely consultant assessment of newly admitted patients, and extra locum cover. The novel rota facilitated more flexible workforce distribution, translating into improved overall junior doctor wellbeing throughout the surge.

Conclusions The identified rota tactics are recommended for future disruption and more can be understood on this topic. Open communication through hierarchies and disciplines is pertinent when synthesising diverse stakeholder opinions. A well-received surge rota is possible and rewarding, with improvements to be seen nationally. Moving forward, it is important to develop surge rota designs to improve resilience to chronic disruption, reduce burnout, and most importantly improve patient safety.