Foundation programme review

The foundation programme review seeks to tackle recruitment and retention issues in the NHS through enhancing the experience of doctors in training.

31 March 2020

Details regarding the foundation review and the role NHS Employers has to deliver four of the recommendations. Including information about self-development time.

The review is led by Health Education England (HEE) in conjunction with the Royal Colleges, the Medical Schools Council, the General Medical Council (GMC), the British Medical Association (BMA) and trainees.

It is one of the core threads of HEE’s programme to reform medical education and review the delivery of the UK Foundation Programme, which prepares graduates from medical school for specialty training. The recommendations within the report provide an important contribution to delivering the aspirations for medicine set out in the NHS Long Term Plan and subsequent Interim NHS People Plan.

Following completion of the foundation programme review, HEE published a report Supported from the start; ready for the future: The Postgraduate Medical Foundation Programme Review (PDF) which made 16 recommendations designed to develop the programme in line with ongoing changes in medical practice and healthcare delivery.

NHS Employers has been asked by HEE to play a lead role in delivery of four of the recommendations:

  • Recommendation 1: The transition for, and preparation of, those entering foundation training must be improved to better prepare foundation doctors for the next stages of their development
  • Recommendation 4: HEE will work with NHS Employers to develop a Foundation Doctor Charter defining how local education providers (LEPs) will support foundation training, including best practice and minimum standards
  • Recommendation 12: LEPs must ensure that foundation supervisors are valued and have appropriate training and skills and specific time allocated for their roles
  • Recommendation 14: HEE will engage with key stakeholders to assess how foundation doctors can be given time in the working week for professional self-development (‘self-development’ time)

Self-development time pilots were planned but due to COVID-19 the pilots will be delayed although the national roll-out date of August 2021 remains. See below more information on self-development time.

Further details on NHS Employer's work on the other recommendations will be available in due course on our website.

More information can be found via HEE’s foundation programme review page.

Self-development time

A recommendation from the review was that foundation doctors should have dedicated time for self-development.

One of the findings showed that some foundation year one (FY1) doctors and foundation year two (FY2) doctors struggled to carry out some of their educational/clinical supervisors, reflective practice and completion of e-portfolios and the transition from undergraduate study to employment as a junior doctor could be challenging.

Self-development time (SDT) is intended to be used for formal meetings with supervisors, reflecting on clinical practice, use of e-portfolio, preparing/delivering teaching, quality improvement activity and career exploration. More information on intended uses, and activities not intended for self-development time can be found in the HEE intended uses of self-development time document (PDF).

It is recognised that many trusts are already scheduling this time for foundation doctors, and that this initiative is not an additional two hours but should incorporate good practice that is already in place. However, this is not the experience for all foundation doctors, and this recommendation formalises the expectation of SDT.


STD will be rolled out from August 2020 in order to support the health and wellbeing of doctors.

  • All trusts with foundation doctors need to include two hours per week self-development time in the work schedules of FY2 doctors from August 2020.

HEE has evaluated the first year of this scheme, listening to feedback from trainees themselves and the system and it has been determined that from August 2021.

  • All trusts with foundation doctors need to include two hours per week self-development time in the work schedules of FY1 doctors.

The formalisation of self-development time will also be evaluated as part of the recommendations of the wider foundation programme review, allowing for any further adjustments to be made.

NHS Employers has developed a set of frequently asked questions on self-development time (PDF).

If you have any further questions or comments regarding self-development time, please get in touch with us at