RCP visit to Bolton highlights strong training culture alongside national workforce pressures

RCP president Professor Mumtaz Patel, accompanied by RCP registrar Dr Omar Mustafa, RCP regional advisers, Dr Rehan Qureshi and Dr Sahena Haque, and RCP Resident Doctor Committee representative, Dr Leigh Wilson, met with resident doctors, consultant physicians, specialist, associate specialist and specialty (SAS) and locally employed doctors at Royal Bolton Hospital as part of a programme of membership engagement visits across the UK.

Across all groups, a consistent picture emerged of a supportive and collaborative environment, with doctors highlighting strong team relationships and high-quality teaching. Foundation doctors described Bolton as a ‘really great place’ to start training, pointing to approachable consultants, strong peer support and a culture where escalation is encouraged. Many said they felt safe to make decisions while continuing to learn, with senior support readily available when needed.

Teaching and education were also widely praised. Regular grand rounds, foundation teaching sessions and bedside learning opportunities were described as well organised and consistently delivered. Resident doctors highlighted opportunities for career guidance and mentoring, with consultants providing advice on specialty pathways and portfolio development.

Doctors new to the NHS emphasised the value of a supportive environment. International medical graduates (IMGs) described Bolton as a place where they felt welcomed and helped to adapt to the system and clinical practice. Consultant physicians echoed these views, describing a strong sense of camaraderie and shared purpose. Several said the team dynamic and willingness of colleagues to support one another were key reasons they continued working at the trust.

Alongside these positives, doctors raised a series of challenges reflecting wider national pressures across the NHS workforce. Rota gaps in medical on-call teams were a consistent concern, with residents describing situations in which reduced staffing increased workload and risked burnout.

Some highlighted the impact on continuity and communication when shifts could not be covered. Doctors also spoke about the growing intensity of general internal medicine workloads and the difficulty of balancing service delivery with training. Access to supervised learning opportunities, such as workplace-based assessments, was described as challenging in busy on-call settings. More broadly, resident doctors expressed concern about national workforce issues, including competition for training posts and reductions in specialty training numbers. Many called for greater advocacy to increase training opportunities and ensure fairer recruitment processes.

The importance of safe staffing levels was also highlighted, with doctors warning that short-term workforce constraints can lead to longer-term impacts on patient care and outcomes.

For locally employed (LED) and SAS doctors, discussions focused on career progression and access to structured development. While participants described high levels of day-to-day support, many said further work is needed to provide clearer pathways and protected training opportunities.

In response, Mumtaz emphasised the RCP’s ongoing work to address many of these issues through the next generation campaign. She stressed that improving training and support must include all doctors, not only those in formal training programmes, and highlighted the need for greater consistency, fairness and accountability across the system.

Summarising the visit, the RCP heard that Bolton remains a highly regarded training environment, with strong leadership and a culture that supports learning and collaboration. At the same time, doctors were clear that national workforce pressures – including staffing gaps, increasing workloads and uncertainty around training progression – must be addressed to sustain this environment and support the next generation of physicians.