Sample weekly timetables for an O&G consultant

Job plan example 1

Mixed obstetrics and gynaecology job

1:8 non-resident on-call

Principle of Out of Hours (OOH)

• Four consultants provide 1:4 Monday-Tuesday overnight cover
• Their weekly fixed Direct Clinical Care (DCC) allocation is concentrated on Thursday and Friday
• Four consultants provide 1:4 Wednesday-Thursday overnight cover
• Their weekly fixed DCC is concentrated on Monday and Tuesday
• Fixed compensatory rest following overnight on-calls which does not interrupt daytime activity
• Flexible DCC such as admin and Supporting Professional Activities (SPA) is nominally placed around OOH work
• Ideally consultants should swap on-calls with those from their block to minimise disruption to daytime activities

Breakdown of PAs

Out of hours DCC                   2.5

Daytime DCC                         5.125

(of which admin 0.875)

Core SPA                                 1.125    

Leadership role                      0.75

Educational supervision       0.25

TOTAL PAs                               10 PAs

Advantages of this job plan

• Fixed non-working day
• Compensatory rest following OOH work and non-clinical work prior to OOH work
• Minimal/no disruption to regular daytime work caused by OOH work
• Scope for weekly DCC (e.g. ANC) and alternate week activity (e.g. gynae operating) if correctly aligned with OOH commitments
• DCC:SPA split 7.625:2.375
• Admin equal to or greater than 10% of DCC
• 1:2 gynae theatre list
• >0.5PA average for daytime delivery suite cover

Job plan example 2

Pure obstetrics post

1:12 Consultant of the Week ‘hot week’ model

1:12 non-resident on-call

Consultant of the week 1:12 delivery suite cover Mon – Fri 08:00-17:00  0.885

Principles of OOH cover and ‘hot week’

• Rolling three-week rota, with Consultant of the Week (CoW) occurring 1:12 (1:4 of every ‘Week 2’ of three in the example below)
• This principle could be extended to a 1:8 or 1:16 by making it a two- or four-week rolling rota
• On-call shifts are placed on either Week 1 or Week 3 to avoid clashes with CoW weeks
• Consultants should ideally swap their CoW shifts with other consultants from the same block (in the example below, the consultant should swap into another ‘Week 2’ CoW
• Fixed DCC activity is focused on Weeks 1 and 3 to minimise disruption by the CoW
• Week 2 during non-CoW weeks is heavily focused on non-fixed DCC (e.g. admin) and SPA.  This enables capacity for swapping the CoW
• Care should be taken when buddying consultants for ANCs etc. that compensatory rest days or on-calls for one do not regularly clash with CoW commitments for the other.

Breakdown of PAs

Out of hours DCC               2.07

Daytime DCC                     4.85

(of which admin 0.82)

Core SPA                            1.46      

Leadership role                1.37

Educational supervision    0.25

TOTAL PAs                          10 PAs

Advantages of this job plan

• Accommodates CoW model of working
• Minimal disruption to regular daytime activity by OOH working or CoW
• Scope for weekly DCC (e.g. ANC) and alternate week activity if correctly aligned with OOH commitments
• DCC:SPA split 6.92:3.08
• Admin equal to or greater than 10% of DCC
• 1:2 gynae theatre list >0.5PA average for daytime delivery suite cover