Consultant job plans – the basics | Association of Anaesthetists

Consultant job plans – the basics

Consultant job plans – the basics

A consultant job plan is an annual, prospective agreement between the employer and the consultant, and should be based around the terms and conditions of the Consultant Contract agreed in 2003 and subsequently updated in England (2018), Scotland (2007), Wales (2011) and Northern Ireland (2013). Broadly speaking, the principles are common in all the home nations although the implementation may differ slightly between countries. The job plan should set out everything that a consultant does in a typical working week, including any private or independent practice, ensuring that no activity is double counted. Specifically it should set out what work is done for the NHS, when and where that work is done, how much time the consultant is expected to be available for work, what flexibility there is around that, what objectives are to be achieved by the consultant and what resources the employer should provide to support these.

The typical full-time consultant job plan is based on working an average of 40 hours per week in England, Scotland and Northern Ireland and is nominally comprised of ten blocks of programmed activities (PAs) of four hours each; in Wales it is based on an average of 37.5 hours per week in blocks of 3-4 hours. PAs are generally classed as those related to direct clinical care (DCC) and those related to supporting professional activities (SPA). In some circumstances other (temporary) PAs may be included for additional programmed activities (APA, or EPA in Scotland), and less commonly for additional NHS (HSC in Northern Ireland) responsibilities or external duties. The job plan should not usually exceed a total of 12 PAs. Annualised job plans may allow working in excess of 12PAs in some weeks as long as the annualised average is no more than 12 per week. Increasingly electronic job plans are being used; these offer increased transparency and avoid double counting of activities, and should follow the principles agreed in the 2003 consultant contract.

DCC PAs include predictable and unpredictable work performed while on call and include activities shown in Box 1 (this list is not exhaustive). SPAs are divided into core activities necessary for CPD, job planning, mandatory training, appraisal and revalidation, and others including research, teaching, and training (Box 2; again this list is not exhaustive). It is very helpful if tariffs are agreed centrally with the employer for involvement in educational and clinical supervision, personal appraisal and appraisal of colleagues, and undergraduate teaching (e.g. educational supervisor 0.25 SPA per week per trainee, appraiser 0.25 SPA per week). The wording in the model consultant contract is that job plans ‘will typically include an average of 7.5 PAs per week of direct clinical care and 2.5 PAs of supporting professional activities’. Recently, however, consultant job plans have been produced with a different DCC:SPA split, often 8:2, but sometimes 8.5:1.5 or 9:1. The Academy of Royal Medical Colleges, Association of Anaesthetists, Royal College of Anaesthetists and BMA consider that 1.5 SPA is the minimum required to allow a consultant to keep up to date and undertake mandatory CPD and activities to permit appraisal and revalidation. Where a job plan has fewer than 1.5 SPAs, there should be opportunity for the consultant to make the case for increased SPA recognition at job planning which should occur at least annually (and often within 3-6 months of a consultant’s initial appointment). A survey of anaesthetists working in Scotland and appointed within the previous ten years found 74% had 1 or 1.5 SPA at the time of appointment - this dropped to 33% after job plan discussions. Additional or Extra PAs may be agreed for clinical and non-clinical activities. These APAs or EPAs are temporary, should be reviewed annually, and currently are not pensionable.

Additional NHS or HSC responsibilities may also be recognised; these are special responsibilities not undertaken by most consultants and are duties performed on behalf of the employer or government that are beyond the typical range of SPAs. These include medical leadership/clinical director roles, senior roles in governance, lead roles in appraisal, regional adviser, and undergraduate or postgraduate dean roles. External duties may be recognised separately; these are not done directly for the NHS employer but are often in the broader interests of the NHS, and may be related to work for Royal Colleges (and the Association of Anaesthetists), GMC, governmental roles, CQC and involvement in consultant appointment committees.

In addition to PAs, payment (calculated as a percentage of basic salary) is made for on-call availability. The amount ranges from 1% to 8% and depends on the frequency of on-call rota and the typical nature of the response (such as whether immediate return to work is required or not).

Job plans should be reviewed annually – such reviews should encompass the whole range of the consultant’s work, including clinical duties and SPA. Further details may be found in the supporting information listed below.

David Ray
Consultant in Anaesthesia and Critical Care
Royal Infirmary of Edinburgh

Supporting information

BMA - Consultant Contract (updated 7 December 2018). There are separate sections for each of the four home nations. 

Job planning for your first consultant post. Guidance from the Scottish Consultants Committee, BMA Scotland (2014). (Available by following links in the BMA URL in reference above) 

A best practice guide for consultant job planning. NHS Improvement (updated 19 July 2017). resources/best-practice-guide-consultant-job-planning/ 

Ray D, Aitken H. Supporting professional activities and job planning – a survey of consultant anaesthetists working in Scotland. Anaesthesia News 2017; 361: 16-8

Box 1. Typical DCC activities

  • Operating theatre sessions 
  • Outpatient activities 
  • Ward rounds 
  • Emergency duties 
  • Administration directly related to patient care 
  • On call duties 
  • MDT meetings and preparation for these

Box 2. Typical Supporting Professional Activities (SPA)


  • Continuing professional development 
  • Job planning 
  • Mandatory training 
  • Appraisal and revalidation 


  • Teaching & training, undergraduate and postgraduate 
  • Research 
  • Management of doctors in training 
  • Audit 
  • Contribution to service management & planning 
  • Clinical governance activities