This is an introduction to the basics of job planning, including how the process should work, what the job plan should contain and other keys points that you should be aware of.

Job plans are part of your contract of employment. They are an annual agreement that set out your duties, responsibilities, objectives and agree supporting resources for the coming year.

Job plans are based on a partnership approach with mutual agreement. You and your employer should reach an agreement about how you will use your time and resources to deliver individual and service objectives.

What a job plan should include

The following is a list of some of the things to include or consider when agreeing your job plan:

• a timetable of activities
• a summary of all the PAs (programmed activities) or sessions for all the type of work you are doing – clinical DCC and non-clinical SPA
• on-call arrangements (ie your rota frequency and your availability supplement category)
• arrangements for additional PAs or sessions, over and above your standard 10PA contract, are specifically identified
• agreed flexible working arrangements.
• a list of objectives or outcomes that are reasonable and achievable list of supporting resources necessary to achieve objectives
• a description of additional NHS responsibilities - duties carried out on behalf of the employer or another relevant body and which are beyond the normal range of SPAs. For example, being a medical director, clinical director, undergraduate/postgraduate dean, Deanery/HEE roles, GOSW, LNC roles, leadership roles for your employer etc.
• a description of external duties for the profession and wider NHS but not done directly for your NHS employer. For example roles related to trade unions, royal colleges, professional associations, GMC, public enquiries, NICE etc
• details of regular private work
• agreed arrangements for carrying out regular fee-paying services
• any special agreements or arrangements regarding the operation or interpretation of the job plan
• accountability arrangements
• Travelling time between base site and other sites

Commitments will be delivered with reference to 42 weeks, derived from the sum of annual leave, study/professional leave and statutory bank holidays totalling 50 days (10 working weeks) or 52 days (10.4 working weeks after years service as consultant). However, doctors with disproportionate number of sessions on recurring bank holidays (eg Mondays and Fridays), will not be expected to deliver 42 of those clinical sessions in a year. Agreeing to deliver a specified number of sessions per year represents annualisation of your job plan and if you do not deliver that number you can be asked to repay them or do them at a different time. Annualisation of any aspect of your job plan can only be done by mutual agreement.

If you are applying for your first post, be aware that it should include a proposed job plan in the application pack and if one is not included, you should ask to see one. Although accepting the job after a successful interview doesn’t mean that this advertised job plan is then the fixed outcome – there should still be a proper job planning discussion before you start.

Principles of the job planning process

The process should be collaborative and cooperative. The job plan must be agreed, and not imposed. Your job plan is agreed between you and your clinical manager, any third-party involvement (e.g. service manager) should only be done with prior agreement from you. A good employer will communicate in advance if there are any specific issues to be raised so that you are prepared. You should never feel intimidated or bullied in the job planning meeting or other stage of the job planning process.

Job planning is an ongoing process, you do not need to wait for an annual review to address concerns with your job plan. You or your employer can request an interim review if:

• duties or needs have changed
• you are concerned about whether your objectives can be met.

Programmed activities (PAs)

PAs are blocks of time, usually equivalent to four hours in standard time and three hours in premium time, in which contractual duties are performed. There are four basic categories of contractual work:

• direct clinical care (DCC)
• supporting professional activities (SPAs)
• additional responsibilities
• external duties.

A job plan will set out how many PAs you are working and how many will be used undertaking these different types of work.

A significant proportion of your time may be spent on DCC. Direct clinical care work is any work that involves the delivery of clinical services, including any multidisciplinary team discussions and administration directly related to it. For consultants, non-emergency work after 7pm and before 7am during weekdays or at weekends (this is called premium time in the contract) can only be scheduled by mutual agreement between the consultant and his or her clinical manager. Consultants have the right to refuse non-emergency work at such times.

It is also worth noting that resident working in premium time when ‘on call’ is also only by mutual agreement (including the rate of pay for that work). This includes work which is either job planned to be resident (ward round reviews of emergency admissions on a Saturday morning for instance) or simply so busy that going home is impossible (on call anaesthetist who is so busy they spend 8am-6pm running the emergency list).

A job plan will also cover other activities that are essential to your professional development and to the wider NHS.

Supporting professional activities (SPAs)

SPAs underpin clinical care and contribute to ongoing professional development as a clinician. They are the drivers of efficiency, service improvement and productivity; they are the professional glue and provide job sustainability. This includes, but is not exclusive to, activities like:

• teaching and training
• medical education
• continuing professional development
• clinical governance
• appraisal and revalidation
• service development
• medical research
• clinical leadership

The amount of time in an individual’s job plan allocated to SPAs will partly depend on their grade.

Local and national variation

For consultants, there is some national variation. 

Given the range of roles and responsibilities that consultants are usually expected to take on as senior doctors and leaders of a service, an appropriate job plan will allow for a minimum of 2.5 PAs (10 hours) of SPA time per week. For a full-time consultant the model contracts for England and Northern Ireland state that job plans:

’Will typically include an average of 7.5 programmed activities for direct clinical care duties and 2.5 programmed activities for supporting professional activities, where your agreed level of duties in relation to supporting professional activities, additional responsibilities and other duties is significantly greater or lower than 2 ½ programmed activities there will be local agreement as to the appropriate balance between activities’

The same split is set out in the Scottish consultant terms and conditions.

In the Welsh model contract, three sessions of SPA time are recommended.

All SAS doctors are contractually entitled to a minimum of one PA or session of SPA time, though some have negotiated the same SPA time as their consultant colleagues and this will depend on experience and career level.

Local and national variation sometimes happens and a number of employers have sought to reduce the amount of SPA time allocated to doctors.

One way to defend your SPAs is to make it clear to your employer what work is likely to stop if your SPAs are cut back and what objectives are associated with this work. As can be seen above, the typical (although not absolute) split is 2.5/7.5 with variation by agreement. Where agreement on this cannot be found, the mediation and appeal process can be utilised. If there are concerns regarding SPA time hospital wide (e.g. so called ‘core’ SPA’s have become a de-facto maximum of 1-1.5) your LNC might organise local action if this is a deeply and widely held issue across the consultant body as a whole.

Additional or extra programmed activities or sessions (APAs/EPAs)

A doctor working full time will work a total of 10 PAs or sessions per week, inclusive of all the categories of work. You are not obliged to agree to a contract containing a greater number of PAs or sessions.

An employer may offer you APAs or EPAs in addition to your contracted number of PAs or sessions.  You may choose to agree to additional or extra programmed activities to maintain a clinical service provision or recognise additional responsibilities whilst maintaining existing clinical and SPA commitments.

If you agree to additional PAs over and above your standard contract, it may be beneficial to seek a separate written agreement or contract. This agreement should set out the purpose and duration of these activities. It should also set out the specific pay arrangements you have negotiated for undertaking this extra work.The job planning process should be able to accommodate these separate arrangements, however we know that many doctors’ additional work is simply rolled up into their standard contract and job plan.

It can be useful keep your standard workload and additional activity separate, so that if you later decide to give up this extra activity it will be clear what work you will no longer be doing. The agreement to provide additional PAs over and above your standard contract can be ended with three month’s notice by the doctor or the employer.

It is worth noting that this work is much cheaper for employers than the first 10 PA’s. There may be other more optimal ways of providing this extra capacity. Consider whether it is in your best interest to provide the additional work in this way.

Additional responsibilities and external duties

Additional responsibilities are duties carried out on behalf of the employer or another relevant body and which are beyond the normal range of SPAs.

External duties are not done directly for your NHS employer but are also vital to the functioning of the health systems across the UK.

In 2012, Chief Medical Officers across the UK wrote to NHS employers to urge them to support doctors in undertaking external duties that are of benefit to the wider healthcare system. Read the letter.

They are a category of work within your terms and conditions and as such there should be no expectation that reasonable quantities of this work will be unpaid if the work is agreed to within the job plan.

Tracking your time

The BMA offer our members a job planning tool called Dr Diary for NHS consultants, SAS doctors and medical academics. It’s a key part of the job planning process as it allows you to track your time accurately and evidence your workload.

Setting objectives

Objectives can be agreed by you and your employer. Objectives should reflect the phase of your career and must be reasonable and agreed. It is essential that you are confident that any objectives you agree are achievable. Failure to achieve objectives is one of the factors that could entitle the employer to withhold pay progression for that year.

It is essential that you are confident that any objectives you agree are achievable - unlike in appraisal, these are not stretch objectives, you need to ensure you can meet them. Failure to achieve objectives is one of the factors that entitle the employer to withhold pay progression for that year.

Things to consider when setting objectives:

• the outcome of the objective should be within your individual control
• they should be at a level which you are confident you will be able to deliver
• you should be able to provide evidence where necessary, that the objective has been delivered
• ensure your objectives are realistic, appropriate to your role and consistent with your professional obligations in terms of quality of care.

Discussion of objectives provides you with an opportunity to raise the issue of supporting resources. You can only achieve your objectives if your employer provides the necessary support, facilities, training and resources. It's essential such resources are recognised and reflected in your job plan.

Mediation and Appeal

The consultant and clinical manager will make every effort to agree any appropriate changes to the Job Plan at the annual or interim review. You should not feel forced to agree any changes that you believe to be unfair. It is perfectly reasonable to say that you are not happy with the proposed changes that are being made and that you will need time to consider these. In doing so, you can reasonably request information pertaining to the justification for the changes. If it is not possible to reach agreement on the Job Plan, you may use the mediation process and, if necessary, a job planning appeal.

Team-based service planning

A team-based service plan  can be agreed collectively across a team of doctors to set out the strategic goals within that team and organisation. However, your personal job plan is a contractual document which can only be agreed on an individual basis between consultant and the employer.

Therefore, a ‘team service plan’ needs to be done in a way which is compatible with the employer’s obligations for individualised job planning under the terms and conditions of services for consultants and SAS doctors.

Potential outcomes from a team-based service plan

• Could strengthen an individual’s negotiating abilities if they knew that their position is shared and supported by colleagues.
• Management may adopt a broadly similar approach to consultants across a team.
• Job planning meetings could be easier if a broad measure of consensus has already been achieved in advance by collective discussions.

Doctors should not agree team objectives in their individual job plans. This is because the achievement of these will often not be within their individual control.