Workforce and job planning

Physician workforce

The number of genitourinary medicine (GUM) and HIV/AIDS physicians recorded in in the GMC register of consultants in April 2018 and higher specialty trainees in the UK is:

Role

Total

Proportion working less than full time (LTFT)

Consultant

464 (428 active in GUM)

37%

Higher specialty trainee

122

30%

These figures relate to physicians who work substantively for the NHS. 


Job planning

The job plan below is an example included as guidance and not intended to be prescriptive. Activities will vary according to population served, demographics and location. For further information, see the BMA/NHS Employers guidance from 2011.

The job plan is divided into activities considered to be direct clinical care (DCC) and supporting professional activities (SPAs). The number of DCCs per week: 7.5 including admin. Administration is usually 1/6th PA per timetabled session but does vary according to the type of session. The number of SPAs is typically 2.5, including 1.5 CPD for activities related to revalidation. The Welsh consultant contract is for 7 DCCs and 3 SPAs.

On-call commitment varies from unit to unit. General internal medicine is not a general feature of a typical job plan.

Direct clinical care

The exact composition of direct clinical care will vary between consultants but time spent on the following activities should be included, where applicable:

  • outpatient or other clinic, whether performing or providing cover for the clinic. Outpatient clinics may include general GUM, integrated sexual health, HIV, colposcopy, psychosexual, erectile dysfunction, genital/HIV dermatology, young/older person, sex worker, and contraception clinics. This is not an exhaustive list and will vary between individual consultants.
  • community clinics
  • clinical supervision of doctors in training, staff and associate specialist (SAS) doctors and nursing staff. This is complementary, but separate to educational supervision or teaching. It may include a wide variety of activities but typically includes direct supervision in the clinic, discussion of cases, and reviewing the clinical management of patients.
  • patients seen in the clinic but outside the usual clinic times
  • patient or relative consultation
  • ward round
  • operating session, including minor procedures eg diagnostic skin biopsy, curettage
  • patient treatment or procedure eg lumbar puncture
  • investigative, diagnostic or laboratory work
  • telephone advice to other hospitals or colleagues, either secondary or primary care
  • visits to other hospitals, hospice centres and community facilities to see patients
  • meetings about direct patient care, these may be between doctors or multidisciplinary with other healthcare professionals
  • public health duties eg work with public health colleagues, clinical coding for SHAPT(ISD(D)5 in Scotland), HARS, and case note review
  • travelling time between sites, not to usual place of work
  • patient administration, including dealing with referrals, letters, following up results and reviewing case notes. This should also include the time spent on dealing with reports.
  • work on developing guidelines for patient care or clinical pathways
  • all clinical work relating to on-call emergency duties, including travelling and waiting time relating to on-call emergency work. Any prospective cover should be included. It does not include the time spent on-call but not actually working, this is recognised by the availability supplement. For some GUM consultants the on-call work may be predictable eg ward rounds after an on-call period and should be programmed into the job plan. However, it is more likely that the on-call work will be unpredictable eg recall for an emergency admission or a telephone consultation/advice.
  • unpredictable on-call work can be measured over a typical rota period and averaged to obtain a weekly amount for inclusion into the weekly job plan.

SPAs

Activities in this category include:

  • participation in training, including medical, nursing and support staff. It is important for educational supervisors to include the time spent arranging training, performing assessments and appraisals, and completing supporting documentation.
  • undergraduate examining and related duties
  • continuing professional development, including medical education and updating activities. This should also include the time spent in recording this activity with the royal colleges, either using the paper or electronic system.
  • teaching – this includes formal teaching responsibilities
  • upskilling and updating those working in primary care
  • audit
  • clinical governance
  • job planning and appraisal. This should include the time needed for completing personal appraisal as well as the time spent in appraising others.
  • research
  • clinical management. This includes work needed for service delivery within the GUM clinic, outreach facilities, community services or within the trust, but which is not related to direct patient care or categorised to specific additional responsibility duties.

Clinics

New to follow-up ratios

The Department of Health’s 10 high impact changes to achieve 48-hour access (opens PDF, 362.75KB) published in 2008 suggested that 1:0.75 was a reasonable new to follow-up ratio.

Outpatient clinic sizes

  • New patients require 20 minute appointments
  • Follow-up patients 15 minutes
  • HIV patients 30 minutes
  • The number of new to follow-up patients will vary – an average clinic session is 2.5 to 3 hours
  • Inpatient numbers – vary depending on the type of service provided.

18/09/2018