From compliance to capacity: how SaTH is making medical job planning count
The Shrewsbury and Telford Hospital NHS Trust transformed medical job planning compliance from 6.55% to more than 95%, giving teams greater visibility of medical workforce capacity. That insight has supported changes to operational planning across the Trust, including a rewrite of theatre schedules that increased utilisation from 68% to 87% and supported the suspension of weekend insourcing.
For The Shrewsbury and Telford Hospital NHS Trust (SaTH), the NHS England Senior Medical Job Planning Improvement Programme provided an important catalyst to strengthen medical job planning. While achieving the 95% compliance target was an immediate priority, the work also presented an opportunity to improve how the Trust understands and plans its medical workforce.
In April 2025, just 6.55% of SaTH’s medical job plans met the required definition for sign-off. By the end of August, the Trust had reached 97.54%.
SaTH then turned its attention to prospective planning. Starting from 0% in December 2025, it reached 95.42% prospective job planning compliance by 31 March 2026.
Getting there took sustained work across the organisation. More importantly, having agreed job plans in place has given teams greater visibility of medical workforce capacity, helping SaTH make better-informed decisions about how that capacity is used.
The Trust has since reported an increase in theatre utilisation from 68% to 87%, the suspension of weekend insourcing and reductions in agency, outsourcing and waiting list initiative (WLI) costs. SaTH also released SAS doctor capacity to support consultant outpatient clinics within Cancer Services, increasing appointment capacity.
Making job planning an organisational priority
SaTH’s work on medical job planning predates the latest improvement programme. The Trust had already introduced electronic JobPlan and developed an experienced Medical Director Services Team, alongside established processes around consistency, mediation and pay reconciliation.
The renewed push came when NHS England set a target for Trusts to achieve 95% compliance by 31 March 2026. SaTH chose to move faster, setting its own deadline of 31 August 2025.
Low compliance also had wider implications for the Trust. Without an up-to-date view of medical job plans, SaTH had limited visibility of the capacity available across its medical workforce, making it harder to plan services effectively. This limited visibility contributed to reactive use of agency staffing and other external capacity, including outsourcing and waiting list initiatives, to support service delivery.
In April 2025, the Medical Director and Chief Operating Officer led a Trust-wide launch bringing together clinical and operational leaders, Finance and HR Business Partners and medical workforce teams. It created a common understanding of what was expected and provided training on the fundamentals of good job planning, including programmed activities, supporting professional activities and objective setting.
Senior sponsorship remained visible after the launch. Progress was reported weekly to the Medical Director and Chief Operating Officer and discussed with divisional leaders, while the Medical Director Services Team provided ongoing support to doctors and managers. JobPlan notifications were used alongside regular follow-up to keep plans moving through the process.
SaTH also used the information in JobPlan to identify plans sitting at ‘Not Published’ or ‘In Discussion’ and introduced weekly reporting so these could be followed up with the relevant teams. As progress became increasingly visible across divisions, the reporting itself started to build momentum.
“We got to a point where teams were waiting for the report to land. There was a real competitiveness started to develop between the divisions, and we had… a bit of a league table going as well, and it really did drive people to get the job plans done.”
Susanne Crossley, Deputy Chief Operating Officer, The Shrewsbury and Telford Hospital NHS Trust
The approach was persistent, but SaTH was equally clear that achieving the target could not come at the expense of meaningful job planning. Where a doctor did not agree with a proposed plan, the expectation was that it went back for discussion rather than being signed simply to improve the compliance figure.
Building an approach that could be repeated
SaTH used the first cycle to refine its approach.
Some of the challenges were practical. Previous extensions to job planning deadlines meant there was initially some doubt that the August deadline would hold. Annual leave could leave plans waiting for a signatory, and the team was entering unfamiliar territory when plans needed to move into mediation or appeal.
When teams came back together in September 2025, SaTH used that experience to tighten the process for prospective planning. Plans should be fully signed off within two weeks of a job planning meeting, with escalation to Divisional Medical Directors where that did not happen. New starters should have a job plan within four weeks, and alternative signatories were identified to prevent leave from holding up approvals.
The reporting, support and regular performance discussions continued.
By 31 March 2026, 95.42% of prospective job plans were in place.
SaTH had shown that the improvement could be repeated rather than achieved through a one-off push.
What supported the improvement?
The Trust identifies several factors behind its progress: visible leadership from the Medical Director and COO; a single clear objective and definition of what constituted an in-date plan; ongoing training and query support; weekly reporting and performance discussions; clear routes for plans that had stalled; and established processes for consistency, mediation and pay reconciliation.
“At the very heart of this has been working operationally and clinically together.”
John Jones, Group Chief Medical Officer, The Shrewsbury and Telford Hospital NHS Trust
Turning job plans into a clearer picture of capacity
With job plans in place, SaTH could use the information differently.
For operational teams, having a clearer view of what the medical workforce was planned to deliver provided a stronger basis for comparing available capacity with the demands on individual services.
“Operationally, because we knew what our medical workforce was doing and our surgical workforce, we were able to increase our theatre utilisation, so that went up from 68% to 87%.”
Susanne Crossley, Deputy Chief Operating Officer, The Shrewsbury and Telford Hospital NHS Trust
SaTH used this improved visibility to rewrite its theatre schedule, ensuring theatre sessions were aligned to job plans. The Trust reports that the increase in theatre utilisation supported the suspension of weekend insourcing and contributed to a £2.4 million cost improvement programme. SaTH has also reported reductions in agency, outsourcing and WLI costs as its understanding of workforce capacity has improved.
Within Cancer Services, greater understanding of the workforce enabled SaTH to release SAS doctor resource to support consultant outpatient clinics, increasing appointment capacity. This came alongside wider improvements in cancer performance, with SaTH reporting that it became the most improved Trust nationally for the 28-day Faster Diagnosis Standard in 2025/26.
Improving the quality of job planning
Having established the process and achieved prospective compliance, SaTH is now putting more emphasis on the quality of its job plans.
Training has developed to include service-level planning, demand and capacity, objective setting and areas where teams had identified a need for greater consistency, including SPA allocation, additional programmed activities, private practice, retirement arrangements and on-call commitments.
The Medical Job Planning Consistency Committee is supporting this next stage, with action plans being fed back to individual specialties to inform future job planning.
This moves the focus towards how well individual and service-level plans reflect what services need to deliver, and how that information can continue to support workforce planning.
“It’s looking at the end of each cycle at what needs to be improved for the next cycle. It’s that iterative process of learning and moving it forward, so we can constantly look at improving what we’re doing and how we’re doing it.”
Sam Hooper, Senior Business Manager to the Medical Director, The Shrewsbury and Telford Hospital NHS Trust
Looking ahead: connecting job planning and pay
SaTH is also one of the pilot sites for the JobPlan–ESR interface, building on the Trust’s existing work to reconcile agreed job plans with pay.
The interface has the potential to make it easier for teams to compare programmed activities and availability supplements recorded within signed-off job plans with information held in ESR, supporting SaTH’s ambition to keep the two more closely aligned.
As the pilot develops, this represents another opportunity to strengthen the information available to teams and build greater confidence in the relationship between planned activity and pay.
What SaTH’s journey shows
SaTH’s progress has taken sustained leadership and a considerable amount of work across clinical and operational teams.
The Trust has moved from 6.55% signed-off job plans in April 2025 to more than 95%, repeated that level of performance prospectively, and is now focusing on the quality of the information within those plans and how it can support service-level planning.
The operational outcomes show why that work matters. SaTH has a stronger understanding of the medical capacity available across its services and is using that information to inform decisions around theatres, external workforce spend and outpatient capacity.
“The work that we need to do can’t be done unless you’re aligning people’s clinical activities with operational priorities. I hope that’s one of the long-lasting benefits of the work we’ve done, which is relevant beyond job planning.”
John Jones, Group Chief Medical Officer, The Shrewsbury and Telford Hospital NHS Trust
Hear the full SaTH story
SaTH shared the detail behind its medical job planning improvement journey at Connected Health & Care Summit 2026, including the practical approach taken across the Trust, lessons from the programme and its early experience of the JobPlan–ESR interface.
