Building a culture of collaborative working in Barnet: one conversation at a time

In the high-pressure world of hospital medicine, registrars are at the centre of absolutely everything – juggling clinical work, managing teams and leading complex care. For many, particularly those rotating into new hospitals or teams, it can be an isolating and overwhelming experience.

Facilitated by two RCP chief registrars, new cross-specialty monthly meetings were established under the banner of RegReflections. It was a simple but powerful idea – a registrar-led space for middle-grade doctors to come together over lunch to talk, reflect and support one another.

The sessions are semi-structured but flexible, and topics have ranged from the evolving nature of clinical leadership to helping other resident doctors in difficulty.

With an emphasis on honesty, connection and collaboration, the meetings are not just a forum to vent, but a place to be heard, to think aloud and to find common ground with colleagues working in different specialties.

Feedback from participants has been overwhelmingly positive. Registrars have valued the opportunity to pause, reflect and hear perspectives beyond their specialty, and over time, the wider impact has been noticeable: improved communication across teams, stronger peer networks and a growing sense of shared purpose.

The initiative has also helped uncover shared challenges that cut across specialties – from the emotional burden of middle-grade leadership to persistent gaps in training, from the pressure of covering rising patient demand with stretched rotas to the use of language in the hospital setting.

Recognising these as shared and collective struggles has helped. Wellbeing has improved and the sense of isolation has reduced. People reported feeling more optimistic, closer and more relaxed at work.

The project has also shone a spotlight on clinical leadership. By creating time and space for registrars to speak up and support one another, it is empowering them to drive change. 

The initiative has addressed the professional isolation of those working at a registrar level, improved communication and teamworking and promoted a more compassionate leadership ethos. Registrars feel better equipped to do their job, which ultimately enhances patient safety through stronger teamwork, closer collaboration and more connected care.

In an NHS under pressure, initiatives like this remind us that sometimes the most effective change starts with a conversation. In the recent RCP national next generation survey, positive team culture came out top when resident doctors were asked about the best bits of medical training. By breaking down silos and nurturing relationships, RegReflections is helping to build a better culture from the inside out.

If you’re a registrar looking to implement something similar in your trust, get in touch – simple ideas can have a big impact.