The Royal College of Physicians (RCP) has today published new job planning guidance as fresh data reveals more than half of senior doctors feel their job plans do not accurately reflect the work they do every day.
Calling on NHS employers to modernise consultant and specialist doctor job planning, the new guidance Empowering physicians: effective job planning for better patient care advocates for a more balanced, flexible and realistic approach that will protect patient safety and improve workforce retention.
This new RCP guidance comes as fresh data from the 2025 Focus on physicians survey reveals that many senior doctors in the NHS are concerned about unmanageable workloads and insufficient time for high quality teaching, research and clinical leadership.
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In 2025, only 63% of Focus on physicians respondents had a full time working contract of 10 or more programmed activities*.
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More than half (54%) said their job plans do not reflect the work they do.
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Respondents told us that when things get too busy, the first three things to go are:
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time for their own professional development
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time for service quality improvement
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time to train and supervise other doctors.
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RCP clinical vice president Dr John Dean said:
‘Physicians are changing the way they work, in large part due to the significant pressures on the health service – and their job plans simply aren’t keeping up. Many physicians report being unable to deliver their role within the constraints of their current job plans. We also now have a workforce which is increasingly diverse in terms of how physicians contribute to the NHS. That includes part-time roles, job shares, academic work and leadership in service transformation.
‘Yet more than half of physicians are telling us that their job plans don’t reflect what they do. This is more than a contractual issue – it's also a clinical risk which must be addressed. If doctors don’t have the appropriate time in their jobs plans for training the next generation of physicians, improving safety systems or leading much-needed digital change, then those areas suffer and so will patients as a result.’
NHS England national medical director for quality and clinical effectiveness Professor Stella Vig said:
‘Job planning is far more than a contractual process – it is the foundation for a modern, thriving NHS. By embracing flexibility, valuing the full range of doctors’ contributions, and creating space for leadership, education and innovation, we can build a resilient health service that delivers exceptional care for patients.
‘Service-level activity planning, involving the multidisciplinary team across our healthcare community not only empowers today’s clinicians to deliver excellent patient care but also strengthens both recruitment and retention of our workforce.’
The guidance sets out 10 principles for effective job planning and offers over 40 practical recommendations for clinicians and service leaders. These include:
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a minimum of 2.5 supporting professional activity (SPA) sessions per week in a 10 PA job plan, including 1.5 SPAs for essential CPD, clinical governance and appraisal
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annualised, team-based workload planning to reflect modern care delivery, with greater flexibility for less than full time doctors
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formal recognition of time for research, education, clinical leadership and new models of care, such as same day emergency care and virtual clinics
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job planning that accounts for growing administrative burdens associated with digital systems, ensuring physicians are supported by appropriate infrastructure and staff.
The RCP is calling on NHS organisations, integrated care boards and national policymakers to adopt the guidance and work with clinicians to implement change.
Dr John Dean added:
‘If we want to retain experienced clinicians, attract new talent and deliver safe high-quality care, we must ensure job planning reflects the real work physicians do every day. Job planning must recognise modern ways of delivering care. That means flexibility, fairness and a recognition that medicine is clearly built on more than just delivering clinical hours, it’s also about leadership and innovation.
‘The longer we delay adapting job plans for the modern workforce, the more we risk losing the clinicians the health service relies on.’
The report sits alongside existing specialty specific guidance and is intended to support meaningful job planning conversations between doctors, clinical leads and service managers.
Read the full job planning and supervision findings from the 2025 Focus on physicians survey.
An embargoed copy of the RCP’s job planning guidance, Empowering physicians: effective job planning for better patient care, is available on request.
The Focus on physicians survey is a joint project between the Royal College of Physicians (RCP), the Royal College of Physicians and Surgeons of Glasgow (RCPSG) and the Royal College of Physicians of Edinburgh (RCPE).
There were 2,038 respondents to this year’s survey, open from 12 March to 2 June. 92.3% were working as a consultant (substantive or locum) or an SAS doctor in a clinical setting in the UK. 90.3% were employed by the NHS/HSC, 4.4% by a university, 2.1% by a private provider and 1.5% by a hospice.
Most respondents (89.6%) told us their primary work setting was a hospital, with 3.3% saying they worked primarily in a community setting, 2.1% in a university, 2% in a hospice and 1.9% in a clinic. 82.4% worked in England, 10.6% worked in Scotland, 4.7% worked in Wales and 2.2% worked in Northern Ireland.
94.1% were employed as a substantive consultant, 3.2% as a specialty (SAS) doctor and 2.7% as a specialist or associate specialist (SAS) doctor.
*One programmed activity (PA) is defined as 4 hours of activity Monday to Friday 7am–7pm (3.75 hours in Wales)
Out of hours (OOH) is premium time during which one PA is 3 hours of activity.