How NHS Mid Yorkshire Teaching NHS Trust's Office of the CMO embedded a structured speaking-up infrastructure across a rotating resident doctor programme - and what it delivered when the evidence mattered most.
Two cohort years. Covering resident doctors including Locally Employed Doctors across NHS Mid Yorkshire Teaching NHS Trust, managed through the Office of the Chief Medical Officer.
Traditional feedback tools are designed for permanent workforces. A rotating cohort is something different.
Each August, a new group of resident doctors arrives at NHS Mid Yorkshire Teaching NHS Trust – unfamiliar with local systems, processes, reporting structures, and colleagues. By the time they have established habits and relationships, they rotate again. Any feedback infrastructure not embedded into the structure of the programme is quickly forgotten by the cohort that follows.
Medical Education needed a channel that could absorb a major workforce transition, sustain engagement across a full rotation year, create a documented record of leadership responsiveness, and provide evidence directly relevant to the GMC National Training Survey Speaking Up questions – not at survey time, but across the twelve months that shape how trainees answer them.
Trickle was launched in August 2024, timed to coincide with the arrival of the incoming cohort. A Champion team drawn from the Office of the CMO took ownership of every issue raised – with a commitment to named, documented responses across every category of concern that trainees brought to the channel.
Resident doctors, including Locally Employed Doctors, could raise concerns at any time, from any device, whether on a day shift, a night shift, or mid-rotation at a new site. Issues could be raised openly or anonymously. Every Trickle received a named Champion and a documented response – and the community could endorse or challenge proposed resolutions through a structured vote before an issue was formally closed.
"This year it has over-exceeded where I thought we'd get to."Ian Carr, Associate Director – Medical Directorate, NHS Mid Yorkshire Teaching NHS Trust
The August transition is visible in the data. So is everything that followed. 25 issues were raised in August 2025 alone – the highest monthly volume of the year – as the incoming 2025/26 cohort arrived and encountered the platform alongside the practical uncertainties of starting a new rotation. Volume then settled to a consistent 8 to 18 issues per month through the remaining rotation cycles. That pattern – high at cohort transition, sustained between transitions – is the signature of an infrastructure that embedded itself into the working rhythm of the programme rather than producing a one-off engagement spike.
Every issue raised was championed. Across both cohort years, 119 issues were raised with 100% Champion coverage, against a platform average of 74%. 91% community validation means that in nine cases out of ten, the cohort endorsed what their Champion delivered.
Resolution was fast and trusted. A 25-day median resolution time sits within the 30-day sector benchmark. 78% of comments were posted by staff choosing to engage under their own name – a strong psychological safety indicator in a deployment spanning a rotating, frequently transitioning workforce.
"We've actually surfaced issues that we were never aware of."Ian Carr, Associate Director – Medical Directorate, NHS Mid Yorkshire Teaching NHS Trust
The issues raised across both cohort years fell into five organisational patterns. Each reflects a category of friction characteristic of a rotating doctor cohort – and each demonstrates a consistent leadership response through named Champions.
The highest-volume theme across both cohort years. Staff raised concerns about rota publication delays, annual leave booking access, and TOIL calculation at rotation boundaries. Champions responded with cohort-wide updates reaching all affected staff simultaneously – aggregating shared concerns into single, documented resolutions rather than allowing them to arrive as scattered individual queries.
A new-to-trust doctor starting their first night shift raised the absence of any orientation to local clinical equipment and procedures. The concern was peer-endorsed, reached Medical Education management through the platform, and resulted in a formal commitment to produce a trust-specific clinical orientation document for all incoming resident doctors – a direct, evidence-led improvement to induction quality within the same programme year.
Leave entitlements, TOIL for mandatory training and bank holiday working, less-than-full-time rostering, and Structured Developmental Time allocation were consistent themes across both cohort years. Champions provided documented answers reaching all affected trainees simultaneously – building a permanent record of contractual guidance accessible to future cohorts and reducing the volume of individual queries arriving at Medical Staffing.
System login delays, smart card issues, exception reporting setup, and access permissions at new sites all featured in the resolved set. The platform aggregated shared onboarding problems into single documented escalations – distinguishing individual account issues from systemic implementation gaps and providing Medical Education with a structured record of what was breaking down at each rotation boundary.
Exception reporting access barriers and Structured Developmental Time cancellation were formally raised, named, and escalated through the platform – creating a documented compliance record supporting Guardian of Safe Working oversight of resident doctor contractual rights under the 2016 Terms and Conditions.
The GMC National Training Survey asks resident doctors whether they feel safe raising concerns and whether they believe their organisation listens and responds. The answers are shaped by lived experience across the preceding twelve months – not by policy statements or survey preparation.
What this programme demonstrates is that when resident doctors raised concerns, those concerns reached a named leader, received a documented response, and were endorsed by their peers at a rate above 88%. 100% Champion coverage across both cohort years means no trainee raised a concern that went unowned. That experience, delivered consistently across 119 issues and a live August cohort changeover, is what builds the conditions for positive NTS responses.
The Trust is now in its second cohort year, with quarterly reporting in place and a year-on-year comparison framework established across the August rotation boundary. The data from year one and year two will sharpen how the August 2026 transition is managed – with onboarding communications targeted at the concerns the first cohort raised most frequently in their first month.
The programme is also being considered as a model for other trainee groups within the trust who face comparable rotation-driven pressures around rota visibility, contractual clarity, and speaking-up culture.
Rotating cohorts present a specific engagement challenge that annual surveys and permanent-workforce tools cannot address. Trickle provides the infrastructure to absorb a major workforce transition, sustain engagement through the year, and generate the documented record of responsiveness that shapes how trainees experience – and report – their working environment.
The NHS Mid Yorkshire experience demonstrates that when resident doctors are given a trusted, always-available channel to speak up, and can see their concerns reach a named leader and receive a documented resolution, they engage – and they keep engaging across the full rotation year.
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