After 10 years, I and the team I have led have formally stepped down from being the medical Director of the Brighton marathon and running the medical team. It has been a wonderful role to have done and am so grateful to everyone who has volunteered and have helped especially @SJA_Sussex and @CarrieWeller1, david Bowen @cardmedic and @GreenhalghRob I hope the race goes from strength to strength - and I wish the best of luck to the new MD and medical team. But I feel that now it's being run by London marathon who next year will continue to be sponsored by voltarol - it's time for us to step away with our heads held high and for others to take on this role. I'm sad that it's come to an end but very happy it happened. I'm also and so proud that we provided a world class service which has set new standards in event medicine and prevention of hospital admissions to @UHSussex and without impacting on @SECAmbulance I'm also so proud of the research we have helped deliver including on heat stroke, new cooling techniques, renal failure, troponin rises in marathon running and the risks of taking NSAIDs when doing endurance sport. For next year, I hope to be a runner - something I've wanted to do for the last decade but haven't been able to do!

13 years ago, I came up with a formula. After 13 years of my life being obsessed by this formula, I am steeping back……. This formula works out how many clinical hours people needed to do when working annualised self-preferencing/self-rostering rotas and has become a passion of mine. Not because I care about maths but because it has led to what I genuinely care about; a financially efficient way of improving the quality of life for doctors and other NHS staff whilst improving patient care. Last week I stood back from being involved in medical workforce issues at my trust. Having spent these years helping colleagues to not burn out and get a better work life balance, I am now trying to do the same for myself, whilst allowing time to concentrate on my passion of teaching human factors and patient safety. Crucially though because of the systems created, I am no longer needed to ensure what we have set up continues at my trust. My last job in this role was inducting all the medical and A&E junior doctors at RSCH, Brighton and PRH, Haywards Heath Hospital into how their rotas would work. It sounds a dull talk to give but its so important and one I love doing, because seeing all the doctors genuinely happy with their rotas makes all the effort worthwhile. To provide care today, we need the doctors working where the service needs it. To provide care next year, we need to provide jobs which are sustainable and don’t lead to burn out. To provide care in 2 years’ time we need to do it in a way which is financially viable. Working with healthrota we have managed to do all three and transform the management of the medical workforce at Universities Hospitals NHS Trust @UHSussex . We certainly have not got everything right, but things are so much better than the used to be. We now we have rotas where the doctors have a much better work-life balance as they choose when they are off and its much easier to work part time. We have improved training for the doctors for example by guaranteed clinic weeks. We have better continuity of care, even staffing during the week and 7 days a week ward based care on medical wards, identical staffing 7 days a week in A&E, whilst guaranteeing the doctors all their study leave, self-development time, bank holidays and annual leave they are entitled to without endless fights as is sadly so often the case. We are locum free except for last minute sickness, had 100% fill rates in our jobs and at RSCH/PRH have over 70 FTE fellows doing 25% non-clinical time in research or education. These ideas are simple. Work out how many hours you need to do after all the leave and non-clinical time is taken off and make rotas which work for the individual and the service using those hours to do. This is what annualised self-preferencing/self-rostering rotas are. Simple ideas but ones initially not part of NHS policies and one impossible to implement with what was the dominant NHS rota technology. Originally just thought if as maverick thinking, it is now becoming more common place in the NHS. Lat year it was highlighted as an NHS exemplar, transform.england.nhs.uk/key… Indeed in April 2024 the Chief executive of the NHS sent a letter to all trusts imploring them to “Improve rota management by exploring the opportunities technology offers to move towards greater self-rostering, so doctors have greater control over their lives while meeting the needs of the service.” None of what we have done would have been possible without partnering with @healthrota who have developed the software which allows these ideas to become a reality. But its not just technology which is needed. Its about working with a trust’s HR team who genuinely wants to improve things for the better and have facilitated the idea to become a reality. But behind that is a team of people who share the passion and have the skills to make the ideas a reality. Without the team I have worked with, none of this would be possible. But there is one person who deserves not just a special word of thanks, but whom without none of this could have happened: Amy Brown. @theonlyamybrown Amy thankyou – the work you and your team have done is monumental to so many doctors and so many patients. I hope what we have developed gets spread out further across the NHS and not just with doctors– please email me for further information [email protected]