CPD focus: The key to high quality care

Job planning gives physio staff the opportunity to define all the different elements of their practice.

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Key to high quality care

Effective work planning can help guide personal development and inform future service and workforce needs. We look at how it works in practice

NHS Improvement introduced job planning for the Allied Health Professions (AHP) workforce in the NHS in England in 2017, in a concept based on the process that medical consultants use to profile the way their work contributes to high quality patient care. It provides a consistent approach to profiling the elements of an individual’s role and, although it’s an England initiative, the approach is relevant for use in all contexts and settings, in all parts of the UK.

Job planning gives individuals an opportunity to ensure that all the elements that contribute to high quality care in their role are captured.

It’s applicable for the entire physiotherapy workforce, and involves producing and working to a job plan that captures all the activities you do as part of your role and how much of your contracted work time you should be spending on them. It can be useful for CPD and when considering and planning for the time needed to support colleagues, including students, learning in practice. And it can support those working at advanced clinical practitioner and consultant levels to be clear about the dedicated time needed in their role to contribute to teaching, research and leadership.

Earlier this year, the CSP published guidance to support physiotherapy staff in creating effective job plans that accurately document all their duties and break down how much time each task should be allocated. The guidance includes advice about how to approach the job planning process and a series of recommendations that align with NHS Improvement’s job planning best practice guide for AHPs.

Frontline talked to two physiotherapy workers about their experience of using job planning.

Anneka Edmondson Deputy head of therapies Blackpool Teaching Hospitals NHS Trust

'We have introduced job planning for more than 250 qualified and support staff in our AHP services, including physiotherapy, occupational therapy, podiatry, dietetics and speech and language therapy. 

When we started in 2017, there was very little guidance in terms of job planning methodology (aside from the system used by medics, which wasn’t suitable for AHPs) so I started with a basic Excel spreadsheet and formulated a template from scratch. I’ve tweaked it multiple times since then.  

We chose to start job planning with our senior staff.  Me and our service managers sat down with each person individually, discussing the various aspects of their roles and allocating the tasks into categories, which allowed us to divide the time proportionately into example weekly timetables. 

We found these discussions really valuable in highlighting some excellent work that staff do behind the scenes and some of the extra responsibilities that they have taken on, which has not always been visible previously.

This is in turn helping us to better promote the capabilities of our AHP workforce within our trust. 

The senior staff were then supported to gradually cascade the job planning process down through their teams. After a lot of hard work from all the staff involved, we are now in a position where each staff member has a job plan that is individual to them and agreed with their manager. 

The approach and content of our job plans is congruent across all our services and we have been able to share some good practice between teams and identify some opportunities to improve upon how we do things. 

There have been challenges along the way. We’re using the information gained from the job plans to gain a much clearer picture of capacity and demand within our services, and in some cases staff have faced a moral dilemma around taking increased time out of clinical work to concentrate on CPD and service development projects, but we’re now starting to gather insight and evidence that is supporting them to do this.

Job planning is allowing us to focus on achieving a much better balance for staff, both to invest in themselves and the future of their services, and ultimately to provide the best care for patients. 

When you begin to recognise some of the opportunities that job planning can provide, that’s when it becomes quite exciting. We have some way to go yet in terms of fully embedding the culture change, but I’m really proud of what we’ve achieved.’
'I’ve been using job planning for the past few years. My role is clinical but it has several other elements, including research and working with students, and job planning helps me see what my working week looks like, how much I’m doing, and what capacity I’ve got to take on additional work.

Adine Adonis Clinical specialist physiotherapist neurology, National Centre for Human Retrovirology Imperial Colleage Healthcare NHS trust and ACPIN vice chair

I've been using job planning for the past few years. My role is clinical but it has several other elements, including research and working with students, and job planning helps me see what my working weeks looks like, how much I'm doing, and what capacity i've got to take on additional work.

I use the job plan in my performance development review with my manager. We do it twice a year (at Imperial PDRs are yearly with a review at six months). We use it in the most basic form, laying out my working week and filling in what I do each morning and afternoon.

Looking at all my work makes me realise how busy I am, but it also helps to be specific about what I’m doing and look at why I’m doing or should be doing certain things.

We all feel incredibly busy. Things that look simple on paper usually take longer in reality: patients take longer than you expect, and cases can be more complex. Job planning has helped some colleagues deal with the stress that comes from feeling you don’t have enough time, but you do need to be quite proactive with it. And you need to be realistic about time and include the right level of detail – if you don’t, the plan could look a bit sparse and make it seem as if you have capacity to take on even more. From that perspective, it’s good for helping you manage your own resilience and wellbeing.

While my job plan is primarily a tool for me and my manager, it’s important that it is detailed enough to stand up to external scrutiny. I would say that this is one of the areas where the plan could be improved: at the moment it doesn’t allow you to show how long things take.

For us, job planning is well-established and works well, and I’d recommend it to others. We all benefit from it, it helps with your own development and with identifying opportunities to develop yourself further.’   

View from the CSP

Claire Fordham, CSP professional adviser: ‘We know that activities such as attendance at meetings, teaching and supporting other staff play an essential role in delivering good care. But far too frequently these activities are not acknowledged and recognised, which leads to unrealistic expectations about patient-facing capacity, and unreasonable pressure on staff to meet the full demands of their role without enough time to attend to them. 

Job planning offers physiotherapy staff a vital opportunity to gain clarity about all the activities they undertake as part of their role and how much time they should spend on each.  It provides a more explicit picture of how staff are required to divide their time between activities, giving clarity on the true capacity for patient-facing interventions. 

For service leads and managers job planning supports the management of unwarranted variation between similar roles in teams, driving up productivity in a fair and transparent manner and is a useful tool for wider workforce planning.’

How you can use the job planning process

  • Your job planning should be conducted as an inclusive, collaborative, open and transparent activity between you and your manager. 
  • Your plan should clearly outline all the activities you undertake in your role and agree how your time should be allocated to each one.
  • As part of the planning process, consider everything that you do or should do to provide your service, perform well in your role and meet the requirements of your job description. 

             These might include a combination of:

                  Face to face patient interventions;

                  Non face to face patient interventions;

                  Continued professional development activities;

                  Teaching and training others including students;

                 Audit and research;

                 Management and leadership activities;

  • Physiotherapists and physiotherapy support workers should have the same access to IT resources, time and support for job planning activity as colleagues in other disciplines.
  • Your job planning process should occur annually and be forward looking in nature. Initially, it should be undertaken as a discussion, taking full account of the clinical and non-clinical demands and expectations of your role, over the previous year and those predicted for the year ahead. 
  • There should be a consistent approach to defining clinical activity and supporting professional activities for all staff and in all clinical contexts. 
  • You should be supported to work in partnership with managers to identify and address any key issues and concerns regarding proportions of clinical activities and supporting professional activities. 
  • CSP guidance and recommendations for good job planning, which includes links to the NHS Improvement resources 

 

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