Making the most of study leave budgets for junior doctors – From acute hospitals to postgraduate schools

Dear Sir

Study leave is an important element supporting training of junior doctors (Gold Guide 2010). Traditionally held and managed by the hospitals that employ doctors, the Severn Deanery in the South West of England moved the study leave budget from individual hospitals (Trusts) to be managed centrally by the Postgraduate Deanery. We evaluated the impact of this change, and assessed whether the objectives of centralising Study Leave budgets set by the Severn Deanery were achieved and how success factors, drawbacks and unexpected consequences of the implementation of the new system may have impacted the Severn Deanery's major parties. Data was collected through a mix of quantitative and qualitative research methods including interviews, focus groups and questionnaires. Key stakeholders of senior Severn Deanery staff, Directors of Medical Education, Medical Education Managers and Heads of Schools were interviewed about the changes in May 2010, 13 months after the changes had been made. Trainees attending the Severn Deanery for other purposes, such as assessment, were given a questionnaire and asked to complete it, 201 responses were received. This was equivalent to 16% of all trainees in the Severn Deanery.

In general, the centralisation of Study Leave budgets was perceived to be a significant improvement by those actively involved in managing the postgraduate schools, who valued the new opportunity to have an overview of training taken by trainees and to be able to provide courses in bulk for common elements like exam preparation. Controlling the Study Leave budget centrally made is easier to track individual's allocations, and ensured consistency with the Deanery by ensuring equal levels of funding and more uniform curricula across all Trusts, informed by the relevant speciality Head of School.

Lastly, by centralising Study Leave funds the Severn Deanery was able to benefit from economies of scale and therefore to bulk-buy common courses, particularly exam preparation courses required by all trainees.

It was less positively received by the hospitals that lost funding. Trainees were positive, with 149/201 (74%) feel that the Study Leave budget is managed in their best interest.