Medical Job Planning and Rostering: How to Build Clinical Buy-In and Navigate Difficult Conversations

Job planning should be the most important conversation a consultant has each year. In practice, these conversations can become difficult, delayed or focused primarily on activity and capacity. In this panel from the Connected Health & Care Summit 2026, Rahul Chodhari, Consultant Paediatrician and NHS England lead for medical workforce productivity and consultant job plans, and Jonathan West, Head of Shared Medical Workforce Services at Royal Free London, share what makes job planning work, what goes wrong, and how to reposition it as a collaborative process that benefits clinicians and organisations alike. 

Watch Rahul Chodhari and Jonathan West discuss how to turn consultant job planning from an adversarial exercise into a collaborative conversation, with practical advice on sign-off rates, disagreement handling and team-based approaches. 

What the panel covers and the key messages

This panel explores consultant job planning from both the clinical and administrative perspectives. The key messages were: 

• Job planning is a bilateral, mutual conversation. Consultants want respect for their career stage, development aspirations and wellbeing. Organisations need to know their available capacity 

• The commonest reason for conflict is not disagreement but silence: parties becoming entrenched and stopping talking 

• Clinical directors should not need to “win” a job plan discussion. The goal is the best mutually agreed outcome 

• Nationally, sign-off rates were sitting around 30-35%. The push to improve is not punitive but exists so NHS England can demonstrate to Treasury that clinical resource is well deployed 

• One-third of the 3,500 clinical directors in the country have less than two years of job planning experience, and nobody teaches them 

• Only 60% of newly appointed consultants last year took a full-time 10 PA job, reflecting a generational shift toward work-life balance 

• NHS England is developing eight open-access training modules on consultant job planning, the first four aimed at non-specialists