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Job Planning driving improvement: ensuring success for consultants, the service and for improved patient care

Dr Jeremy Cashman Consultant Anaesthetist St George’s Healthcare NHS Trust spoke at today’s Consultant Job Planning conference on:

• delivering successful job planning in practice: an update
• an update on the consultant contract negotiations and the drive towards a 7 day NHS
• successful job planning for consultants, the service and patient care: tensions and solutions
• promoting supporting professional activities (SPAs)
• job planning for new consultants

The purpose of the annual job plan is to agree a programme of work based on service need and the mutually agreed objectives of the individual consultant. Although consultants have been asked to agree job plans with their employers since 1991, job planning only really became a central part of consultants’ working lives with the agreement of the 2003 consultant contract. Ten years later a report by the National Audit Office observed that 97% of consultants had a job plan. However, 1 in 7 consultants had not had their job plan reviewed in the previous 12 months. Furthermore, the setting and alignment of individual objectives with trust objectives was not universal with objectives- setting and monitoring for SPAs being particularly poor. 

Traditionally job planning has been a face-to-face exercise. However, more and more Trusts are engaging in e-job planning. The advantages of e-job planning include the ability to manage complex job plans (multiple/rolling weekly timetables, variable weekly cycle lengths and irregular commitments)as well as monitoring of the job planning progress and providing reports (total PAs, PA groupings, total SPAs, DCC/SPA splits etc). E-job plans can now also incorporate links to personal and organisation objectives. 

Jeremy’s full presentation is available for download at the end of this page. 

In his presentation Jeremy made the following remarks:

Job planning is an annual prospective agreement between employers and consultants.

Team job planning – meeting annually as a team to review and plan elective and emergency work in relation to commissioning intentions for the coming year.

All elective work should be mapped out and an agreed plan drawn up to cover this work efficiently

e-JobPlan – useful for complex job plans, monitoring progress and providing reports, some also manage appraisal. It is very useful for audit.

DDRB commissioned by the Under Secretary of State for Health to critique proposals from the DH and NHS Employers and provide a report by July 2015 – on consultant contracts and recommendations on the trainee contracts.

Consultants are allowed to provide emergency work within their core hours – meaning consultants are allowed to refuse non-emergency work outside core hours (after 7pm and before 7 am weekdays and at weekends) – this is seen as a barrier to 7 day working.

NHS Employers and Government remit is to deliver more than 7 days services within the existing spend. This can only be achieved if more hours of the day and more days of the week are defined as core hours.

Survey of NHS Providers shows a support of extending core hours up to 10pm – Monday – Saturday.

Job planning assumes 42 weeks of working per annum (6 weeks annual leave, 2 weeks bank holidays and 2 weeks study/professional leave) – should 44 weeks be the default (excluding the 2 weeks study/professional leave – this can be applied for and is at up to the trust to approve)? Should there be a greater scrutiny of leave?

Using e-rota’s – can monitor consultants and staff – its saves money as trusts know where consultants are and can move them around.

Supporting professional activities – are quality improvement activities and can be split as personal quality improvement and additional organisational quality improvement.

New consultants – likely to start on fully flexible contracts

  • Work diary to ensure job plan accurately reflects the duties and workload of the post
  • Assessment of on call work
  • Full flexibe sessions

Can request an interim job plan review after 3 months in post.

Job Planning is becoming more evidence-based

The outcomes of the re-negotiation of the consultant contract is likely to have implications for job plans

Productivity can be informed by job planning and by consultant presence/absence monitoring

SPA activity requires the same scrutiny as DCC activity

Both DCC and SPA components of new consultants’ job plans may need early review

Jeremy Cashman is Associate Medical Director at St George’s University Hospitals NHS Foundation Trust with responsibility for Medical HR. He graduated from King’s College London before obtaining his medical degree from St George’s Hospital Medical School. He was appointed Consultant and Honorary Senior Lecturer in Anaesthesia in 1989. During his time as a consultant he has served in a number of leadership roles for his Trust and for his Royal College. He is currently a member of the BMA Committee of Medical Managers and the NHS Providers Workforce Reference Group. He was a finalist in the 2007 Hospital Doctor of the Year Awards.

Future events of interest:

Clinical Audit Masterclass
Thursday 7 May 2015 
Hallam Conference Centre, London

Effective Clinical Director Training Course
Monday 15 June 2015 
Hallam Conference Centre, London

A Practical Guide to Improving Outpatient Services
Monday 21 September 2015 
Hallam Conference Centre, London

Masterclass: Preventing Burnout in the Healthcare Professions
Tuesday 29 September 2015 
Hallam Conference Centre, London

Masterclass: Managing Stress & Promoting Resilience amongst Doctors
Monday 5 October 2015 
Hallam Conference Centre, London

Clinical Audit for Improvement
Wednesday 7 October 2015 
Colmore Gate Conference Centre, Birmingham

Expert Witness Intensive Training Course: 2 Day
Thursday 15 October 2015 — Friday 16 October 
Hallam Conference Centre, London

National PROMs Summit 2015
Tuesday 1 December 2015 
Colmore Gate, Birmingham

Caldicott Guardian Training Course
Tuesday 1 December 2015 
Hallam Conference Centre, London

Download: Dr Jeremy Cashman full presentation

21 April 2015


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