Contribution
It is worth highlighting that around 82% of applicants get their first preference. That is a significant improvement—it was 71% in 2023. We are taking steps in the right direction, but we would love to get to 100%. It is difficult to get to 100% of anything in a large and complex system, but that is our aspiration. Of course, those who do not get their first place are welcome to re-engage with the system, and efforts are made to ensure they get their preference, although we do not always succeed in that process. I will take the hon. Member’s question away and discuss it with my colleague the Minister of State for Health—she leads on this portfolio, although she was not available for this debate—and we will write to him with further clarifications on the important point he makes.
The introduction of the PIA was broadly supported by stakeholders, and I am pleased that we have seen an improvement under this system in the number of students allocated their first preference programme. As I said, 82% of applicants to this year’s foundation programme were allocated their first preference, up from 71% in 2023. However, we are committed to ensuring that the system remains fit for purpose. NHS England will conduct a review to ensure that it is still working for applicants. The timelines of that review will be confirmed in due course.
Furthermore, although some individuals may want to move away from their university area for foundation training, some need greater certainty, for a range of reasons, about their foundation placements. In the last two years, we have supported a portion of students in three UK medical schools by allocating them to foundation programmes in their local area. Last Friday we went further, announcing that we will work with medical schools and foundation schools to extend that support to trainees across the country from disadvantaged backgrounds. Providing a post close to where they live will mean more stability for trainees and will support employers in developing a local workforce.
I would like to say a final word on the PIA. I think we all accept that it is not perfect—it is very difficult to have a perfect system—but I take issue with the characterisation by some Members in the debate that it is a random system. We do not agree with that characterisation. We are clear that the system in place is enabling people to clearly articulate their first preference, and in the overwhelming majority of cases they are getting their first preference. That does not feel like a random system to us, but we absolutely accept that it is not perfect, and there is always room for improvement.
Let me turn to rotations. We recognise the importance of stability for doctors in training and the impact that frequent relocations can have on wellbeing, retention and workforce planning. Following the 2024 resident doctors agreement, the Department of Health and Social Care conducted a review of rotational training and found that rotations can provide valuable breadth of experience. However, we know that in some cases they can disrupt learning, wellbeing, team integration and patient care. To tackle that, NHS England is developing pilots under the medical education and training review to test longer placements and more flexible arrangements for less-than-full-time trainees. The evaluation of those pilots will inform future policy decisions on placement length and continuity benefits.
I turn now to the wider working conditions for resident doctors. It is essential that we create a supportive environment for doctors throughout their training that looks after their health and wellbeing. NHS England’s resident doctors’ working lives programme continues to implement several measures aimed at supporting resident doctors, encouraging them to stay in training and the NHS and reducing overall attrition. That includes measures such as the less-than-full-time training options to allow trainees to continue to work in the service and progress with their training on a reduced working pattern where that is beneficial for their personal circumstances.
We have made significant progress over the past year to improve the working lives of resident doctors, including agreeing an improved exception reporting system, which will ensure that doctors are compensated fairly for additional work, and rationalising statutory and mandatory training to reduce unnecessary burden and repetition.