On-call rota template for doctors: an 8-week rolling rota you can copy

How a rolling rota template works

Most UK hospital rotas are built as rolling rotas. You design one pattern of N weeks, called a line, and every doctor on the rota works the same pattern, starting one week apart. With eight doctors and an 8-week line, doctor 1 starts on week 1, doctor 2 on week 2, and so on. After eight weeks everyone has worked every week of the pattern exactly once.

This is where phrases like "a 1 in 8 rota" come from: each doctor does the out-of-hours part of the pattern once every eight weeks. The big advantage is that you only have to check one line. If the line is safe and every day of the week is covered exactly once across the eight weeks, the whole rota is safe and covered, before leave and swaps are added.

The template below is for a full-shift rota: one doctor on a long day and one on nights every day of the week, with ordinary weekday days in between. It suits a typical ward-cover rota with eight doctors. The shift times are examples; change them to match your handovers.

• LD long day, 08:00–20:30 (12.5 hours)
• N night, 20:00–08:30 (12.5 hours)
• S standard day, 08:30–17:00 (8.5 hours)
• – off, or rest after nights

The rules the template has to pass

In England, the BMA handbook on the 2016 contract summarises the limits that a rota must respect. These are the ones that shape a long-day and night template:

For the contract, a weekend counts as worked if any work falls between 00:01 on Saturday and 23:59 on Sunday. So a Friday night that ends at 08:30 on Saturday puts you on the weekend. Our guide to rest after night shifts and call covers these limits in more detail, alongside the EU and US rules.

The 8-week template

Each row is one week of the line. Doctor 1 starts on week 1, doctor 2 on week 2, and so on, wrapping round from week 8 to week 1.

Read the week 3 row carefully: the Friday, Saturday and Sunday nights finish at 08:30 on Monday of week 4. That is why Monday and Tuesday of week 4 are off. In week 8 the four nights finish at 08:30 on Friday, and the doctor is off until the long day on Monday of week 1.

Why the template passes

You can check every property directly in the table.

• Cover. Across the eight weeks, each day of the week has exactly one LD (Monday to Thursday in week 1, Friday to Sunday in week 6) and exactly one N (Friday to Sunday in week 3, Monday to Thursday in week 8). Because the eight doctors are one week apart, every calendar day has one long day and one night.
• Average hours. The line totals 370.5 hours over 8 weeks, an average of about 46.3 hours a week, under the 48-hour average. Check this again once leave is deducted, as the contract describes.
• 72 hours in 168. The busiest 7-day windows are weeks 3 and 6 at 63 hours, and the window that runs from the week 8 nights into the week 1 long days comes to 62 hours.
• Shift length. Long days and nights are 12.5 hours, under 13.
• Rest between shifts. The shortest gap is between back-to-back long days: 20:30 to 08:00, 11.5 hours.
• Long-shift runs. The longest runs are four long days (week 1) and four nights (week 8). Both are followed by more than 48 hours off.
• Rest after nights. Week 3 nights end Monday 08:30, and the next shift starts Wednesday 08:30: 48 hours. Week 8 nights end Friday 08:30, and the next shift starts Monday 08:00.
• Weekends. The doctor works the weekend in week 3 (nights) and week 6 (long days): 2 weekends in 8, or 1 in 4.

A non-resident on-call variant

For registrar or consultant-led services, cover overnight is often non-resident on-call (NROC): the doctor is available from home and comes in when needed. The 2016 contract treats these as separate on-call periods with their own rules:

• An on-call period can last up to 24 hours (plus a short extension for handover).
• No more than three on-call periods in any seven consecutive days, unless agreed locally.
• On-call periods cannot run back to back, except Saturday and Sunday. Longer runs of up to seven days can be agreed locally if all other limits are met.
• The doctor should expect 8 hours of rest per 24 hours on call, at least 5 of them continuous between 22:00 and 07:00. If that is not expected, work the next day must not be rostered beyond 5 hours.
• The day after an on-call period must not be rostered for more than 10 hours.

A simple NROC line for 6 doctors uses a 6-week cycle. Each doctor does one Saturday–Sunday on-call pair per cycle (1 weekend in 6), and the 30 weekday on-calls in the cycle (5 each) are spread so that, apart from the weekend pair, nobody is on call on two consecutive days and nobody does more than three in any seven days. Mark the day after each on-call as a short day (10 hours or less) on the rota itself, so clinics and theatre lists are not booked by mistake.

Adapting the template to your rota

1. Count the posts first. List every shift that must be filled each day, then multiply by 7. That number divided by the shifts in one line tells you how many lines you need.
2. Keep the blocks, change the times. If your nights are 21:00–09:00, re-check the rest gaps, but the structure (four nights, then 48 hours off) stays the same.
3. Less-than-full-time doctors. LTFT doctors usually work a share of the out-of-hours pattern in proportion to their hours, and their average must stay within their own limit (the BMA handbook gives 40 hours on average for an LTFT schedule). Put them on a slot-share or a proportioned line rather than squeezing them into a full-time line.
4. Leave and rota gaps. Annual and study leave come out of the standard days first, so out-of-hours cover stays intact. If a gap opens on a long day or night, fill it like for like and re-check the 72-hour and rest rules for whoever takes it. Our guide to handling leave and swaps walks through this.
5. Publish early. The BMA handbook says the duty roster should be available at least six weeks before the placement starts, and the generic work schedule at least eight weeks before.

Pre-publish checklist

• Every day has exactly the posts it needs, including bank holidays.
• No week in any line goes over 72 hours, and the cycle average is 48 or under after leave.
• Every night block and every run of four long shifts is followed by the required rest.
• No gap between two shifts is under 11 hours.
• Weekend frequency is 1 in 3 or better, or the exception has been agreed.
• Weekends and bank holidays are tracked across the year, not only the cycle. See how to balance weekend and holiday shifts.

If you work outside England, read the Working Time Directive and junior doctor rotas for the EU and UK statutory baseline. For a quick single-post call list, the free call schedule generator runs in your browser and your data stays on your device.

Sources

• BMA, Resident doctors' handbook on the 2016 contract: work scheduling, hourly limits, consecutive shifts, nights and 46-hour rest, weekend frequency, on-call periods and rest, roster notice periods.
• NHS Employers, FAQs for the 2016 doctors in training contract: rota rules and safety limits.