Job planning is a vital but often overlooked component of the day-to-day work of a GP.

Job plans are covered in the model salaried contract therefore all salaried GPs should have one. They are the most effective way of ensuring that your work is appropriate and achievable. The best time to job plan is before starting a substantive role or during any induction period as it can be difficult to arrange this retrospectively.

Salaried GPs already in post without a job plan can consider keeping a diary – this can be a paper-based diary or use of the BMA’s GP Diary – to demonstrate any regular and routine breach of working hours. This can provide helpful evidence for a job plan review. 

While we all expect to have to deal with occasional emergencies, many of the problems that salaried GPs face are due to routine overwork, an expectation that all work will be completed and that this will be done during unpaid time. Proper job planning will alleviate these pressures.

Job plans need to be mutually agreed between employer and employee and must not be unilaterally imposed or changed. They should be reviewed on an annual basis, or at any time before this if either party requests a review.

Job plans should be safe and achievable and not set out unrealistic expectations. There is little purpose in having a job plan with unsafe and unrealistic numbers of consultations during a clinic that will guarantee that a salaried GP will routinely overrun their contracted time.

Job plans need safe and appropriate numbers of face-to-face consultations, telephone consultations or any other modality of consulting. Time for completing administrative tasks also needs to be considered; administrative work can be the direct result of consultations (referrals) or indirect (reviewing pathology results, reviewing secondary care clinic letters, completing reports). The BMA advises one hour of protected time for administrative duties for every three hours of clinical work.

Home visits are work and should be included in a job plan as a further separate strand in addition to consultations and administrative work. Home visits should not be undertaken as a break during any break times (eg over lunch); visits are very much clinical work and all your time doing work needs to be accounted for.

Salaried GP sessions are typically four hours and 10 minutes (nine of these sessions therefore make up the full-time week of 37.5h) but not every session every day needs to be of this duration as long as the job plan hours match up to the contracted hours. Start and finish times can be adjusted to accommodate particular needs such as school drop-off, or salaried GPs can work condensed days, such as working two to three sessions in one day to cover duty sessions.

Annualised sessions can also be considered so that a salaried GP works a certain number of sessions for a practice per year but can have guaranteed time off, such as for school term-time working only.

Practices need to consider the following when employing salaried GPs:

– Adjusting start or finish times to the working day to reduce significant ‘break’ time during the middle of the day when many salaried GPs will still be expected to work for free

– Reducing the number of patients in a salaried GP’s clinic to accommodate time needed for home visiting

– Condensing more sessions into a day to accommodate workload and paying for more than two sessions in one day if this is what a salaried GP is routinely working

– Advertising the ability to annualise sessions – this is akin to having a retained locum for a practice

– The workload of a salaried GP should not be measured in the same terms as a partner’s – this is because the model contract defines work in set measures of time that are remunerated accordingly on a sessional basis, unlike partner pay which is based on profit share.

The salaried GP handbook is available to anyone irrespective of BMA membership status but BMA members can contact the BMA for further advice and support if they experience any difficulties with job planning. 

I would also recommend reading Dr Jessica Court’s article on safe working as this goes hand in hand with good job planning. 

Bethan Roberts is a member of the BMA sessional GPs committee