Spotlight on local innovation – supporting locally employed doctors in Southend

This work was presented to the RCP president and other senior officers during the RCP college visit to Southend University Hospital in April 2025.

Over the past year or so, one of the most rewarding parts of my job has been to develop and strengthen the support we offer to our LEDs here at Mid and South Essex NHS Foundation Trust.

As the medical workforce changes and more colleagues join us through non-traditional routes, it’s never been more important to ensure that LEDs feel welcomed, valued and able to progress. Their contribution to patient care is huge and we need to reflect that.

We run a structured LED induction twice a year. Every new LED receives a comprehensive handbook covering everything they might need in those first few weeks – referral pathways, key departmental contacts, revalidation and appraisal processes, quality improvement opportunities, exception reporting, even career progression advice. It’s designed to sit alongside the departmental induction so that no one starts their role feeling lost.

But induction is only the beginning. We’ve put in place ongoing support structures because LEDs have told us they don’t want a single ‘welcome session’ – they want a community.

That’s why we have introduced:

• regular LED meetings where issues can be raised early and openly
• active WhatsApp groups for peer-to-peer support
• a coffee-and-catch-up model that enables colleagues to flag concerns in a safe space
• dedicated teachers and champions, who offer pastoral guidance
• a buddy system from the moment they join the trust.

We also run simulation courses in human factors and communication skills – and bespoke sessions whenever LEDs tell us there’s a gap.

We ran a survey at the beginning of 2025 to understand how well our support is landing. The results were honest and helpful.

Around half of LEDs were aware of the full range of support available. Encouragingly, most now receive a clinical supervisor soon after joining. But only 60% had received a departmental induction, which is something we clearly need to tighten up. We’re already sharing these findings with specialties and will be repeating the survey regularly so we can measure our progress.

Unfortunately, funding and portfolios came up as sticking points time and time again.

LEDs do have a separate study budget – but it remains smaller than that of training doctors. Several colleagues also told us they struggle to access formal e-portfolios or use exception reporting systems designed with doctors in training programmes in mind. Both issues affect their ability to demonstrate progression, and ultimately, to compete for national training posts.

We are working closely with the trust on this. Our medical education team has submitted bids for:

• improved portfolio access
• clearer, LED-specific exception reporting pathways
• formal mentorship aligned with career goals
• recurrent funding for training, not one-off fixes
• better engagement mechanisms, including scheduled LED forums.

These may sound like small administrative details, but for LEDs they are the difference between feeling like a valued member of the medical workforce – or an afterthought.

What struck me most in the survey feedback and conversations was this: LEDs overwhelmingly feel valued at our trust. They appreciate the community, the pastoral support and the genuine effort to include them. But they are also clear about what still needs work.

They want – and deserve – equitable access to training resources, fair recognition, and clear pathways for progression. None of this is unreasonable. In fact, delivering it will make us a stronger organisation with better retention and a more confident workforce.

For me, supporting LEDs isn’t a ‘project’ – it’s a long-term cultural shift. The initiatives we’ve introduced are a start, but they need embedding and improving. We will keep listening, keep adjusting and keep advocating for the resources LEDs need.

Your RCP membership, local to you

RCP college visits are a vital part of our ongoing commitment to local engagement with our fellows and members across the UK.

Supported by our dedicated regional membership team, our 18 networks across England, Wales and Northern Ireland provide access to events, CPD, training and conferences close to home. These networks also create opportunities to connect with fellow physicians, external stakeholders and RCP officers.

Our regional advisers, college tutors and associate college tutors play a key role in ensuring that local issues are represented and addressed at a national level.