Medical Job Planning Improvement Project
Summary
Shrewsbury and Telford Hospital NHS Trust (SaTH) launched an organisation-wide medical job planning improvement programme to strengthen visibility of clinical capacity, improve operational efficiency, and support better patient access to care.
In response to NHSE’s Senior Medical Job Planning Improvement Programme, SaTH set ambitious local targets to achieve 95% compliance in signed-off job plans by September 2025 and prospective job planning by April 2026.
Delivered through a highly collaborative approach involving Medical Director Services, Operational Teams, Clinical Directors, and Medical Leaders, the programme has driven significant improvements in productivity, governance, and workforce planning across the Trust.
The Challenge
Across the UK, Senior Medical job planning compliance had historically been low, with COVID further impacting progress. At SaTH, compliance rates were among the lowest nationally, with 57% in 2018 and falling to 10.69% in 2019, as organisational focus shifted to other urgent priorities during a period of special measures. At the same time, wider performance challenges, including ED waiting times, 18-week RTT, cancer pathways, and theatre productivity, highlighted systemic capacity and efficiency issues.
Poor job planning compliance meant there was limited visibility of the Trust’s most expensive workforce resource, reducing the ability to plan capacity effectively or organise services efficiently. This resulted in reactive cost pressures, increased reliance on agency and temporary staffing, and the use of outsourcing and waiting list initiatives to maintain service delivery. Executive leadership from the Medical Director and Chief Operating Officer provided strong direction for the improvement programme, with designated deputies assigned to lead delivery and drive sustained organisational improvement.
The Solution
The programme was delivered through a structured, organisation-wide approach focused on improving job planning compliance, strengthening governance, and increasing visibility of clinical capacity across the Trust. Executive leadership from the Medical Director and Chief Operating Officer provided clear direction, supported by the Medical Director Services Team, Operational Teams, Clinical Directors, and Medical Leaders.
Initial work focused on understanding barriers to completion and engaging teams through a dedicated launch event in April 2025, alongside education and training sessions for Operational Managers, Clinical Directors, HR teams, and Finance teams. Weekly reporting and divisional trajectory reviews supported ongoing monitoring, while consistent escalation and mediation frameworks helped resolve job plans categorised as ‘not published’ or ‘in discussion’.
The programme also introduced prospective job planning processes, supported through a second launch event focused on embedding good practice job planning cycles and sustaining long-term compliance improvements. SaTH was additionally selected to pilot the API integration between ESR and RLDatix’s JobPlan, with ongoing work to strengthen governance through routine variance escalation processes.
Results & Next Steps
The initiative has delivered significant improvements in operational planning, workforce oversight, and service productivity across SaTH. Theatre schedules were aligned to job plans, increasing theatre utilisation from 68% to 87%, supporting the suspension of weekend insourcing and contributing to a £2.4m CIP. Improved understanding of workforce capacity has also supported reductions in agency, outsourcing, and waiting list initiative expenditure.
Robust job planning has underpinned wider service improvements, with SaTH becoming the most improved Trust for 18-week RTT performance and achieving reductions in patients waiting over 52 weeks. The release of SAS resource to support consultant outpatient clinics increased appointment capacity within cancer services, contributing to SaTH becoming the most improved Trust nationally for the 28-day faster diagnosis standard in 2025/26.
The initiative has also improved transparency of workload through targeted review of high PA job plans and validation of job planned versus paid PAs, strengthening governance and supporting more consistent workforce planning processes across the Trust.
At a regional level, the programme has been shared through NHSE Regional Job Planning forums and the RLDatix Health and Care Summit, with the framework generating significant interest as a scalable and replicable approach to improving job planning consistency, governance, and productivity across NHS organisations.
