Medical Workforce Rota Management Review

Descriptions

1 Background to the Medical Workforce Rota Management Review

1.1 King's College Hospital NHS Foundation Trust (KCH) is undertaking a strategic review of its medical workforce rota management as part of its wider financial and workforce transformation programme. The Trust's Financial Strategy highlights the need to deliver sustainable workforce efficiencies over the next five years, with a target of achieving a £37m recurrent cost improvement plan (CIP) in 2025/26 across clinical services.

1.2 Within this context, Workstream 7 - Workforce Improvement has been established to identify and deliver opportunities for workforce optimisation. A key focus is the medical workforce, where improvements in rota design, utilisation, and deployment are essential to balancing financial efficiency with patient safety, education and training, and staff work-life balance.

1.3 The Trust is therefore seeking an external partner to conduct a combination of deep dive reviews and diagnostic assessments of medical rotas. These will test whether the Trust can achieve sustainable financial efficiencies while maintaining high standards of care. The work will involve extensive engagement with clinical and managerial leaders, on-the-ground clinicians, and the use of proven analytical tools and methodologies to generate actionable insights.

1.4 This programme is expected to deliver not only cost savings (the financial value of the recurrent savings will need to be confirmed as part of this review) but also improved rota alignment with activity levels, better leave management, enhanced skill mix utilisation, and a more consistent approach to medical workforce planning across specialties - which includes a robust understanding of cost per medical WTE when benchmarked amongst peers.

2 Specification of Requirements

2.1 Objectives

The Trust seeks to appoint an experienced Provider to conduct a comprehensive review of medical workforce rotas. For clarity this will involve all doctor grades. The objectives are to:

2.1.1 Identify efficiency opportunities within rota design and workforce deployment.

2.1.2 Validate internal diagnostics on medical workforce efficiency.

2.1.3 Deliver two specialty deep-dive reviews. The two specialty deep dives will need to be confirmed but please expect one of them to involve a medical care group.

2.1.4 Deliver diagnostic overviews for 10 specialties with overspend.

2.5 Produce clear, practical action plans (e.g. job-planning improvements, rota right-sizing, rostering) with benefits, risks and dependencies set out.

2.6 Provide an optional proposal for later implementation/delivery support once the diagnostic phase has been completed at week 12 (do not price unless requested). This delivery support will be required to ensure that any recommendations are implemented appropriately and, in turn, provide advice and support to the Trust's own team on how to achieve it.

2.7 Ensure recommendations safeguard patient safety, education and training, working time and contractual commitments and staff work-life balance.

2.8 Provide evidence-based workforce planning solutions (which will include the design of new rotas) aligned with contractual, regulatory, and financial frameworks - i.e. all relevant doctor contracts. This work must link with the Trust's existing workforce management arrangements as provided by Patchwork and Allocate and how the Trust currently rotas its nursing, midwifery and other allied health professionals.

2.9 Support delivery of the Trust's financial strategy, aiming for recurrent pay savings from 2026/27 - the actual recurrent value will need to be determined as part of this engagement.

2.10Ensure that any new rota solutions and/or workforce planning solutions will take into account the Trust's existing commitments to deliver its agreed levels of clinical activity and operational performance against the national waiting time targets.

2.2 Necessary Experience

The selected Provider must have:

2.2.1 Demonstrated expertise in medical workforce analysis within NHS or equivalent healthcare systems.

2.2.2 Access to analytical tools.

2.2.3 Experience working collaboratively with clinical and operational leadership.

2.2.4 Understanding of NHS workforce contracts (Consultant, Resident Doctors, Agenda for Change) and EWTR compliance.

2.2.5 Ability to evidence medical workforce efficiencies.

2.3 Scope of Work

The selected Provider will undertake the following:

2.3.1 Deep Dive Reviews

• Two specialties (to be confirmed).

• Detailed review of workforce utilisation, rota design, leave management, and skill mix optimisation / cost per WTE.

• Simulation and modelling (e.g. 24/7 attendance flows, consultant presence planning, heat mapping).

2.3.2 Diagnostic Review

• Light-touch reviews of 10 additional specialties where budget overspends are anticipated.

• Data-driven diagnostics validated with specialty clinical directors and general managers.

• To consider how/if any of the 10 specialties would benefit from a wider South East London Acute Provider collaborative approach. The collaborative is assessing what a scope of works could look like for an acute Provider-led approach to medical workforce rota management.

2.3.3 Implementation Planning

• Develop a 12-week delivery programme, including milestones and resource requirements.

• Provide an implementation roadmap with options for Phase 2 delivery support.

2.3.4 Capability Assessment and Knowledge Transfer

• Assess the Trust's internal capability to implement recommendations.

• Provide training/knowledge transfer to build sustainable capability.

2.4 Deliverables

The Provider will deliver:

• Week 2: Baseline diagnostic report

• Week 6: Draft deep dive findings

• Week 10: Diagnostic outputs for 10 specialties

• Week 12: Final consolidated report, including financial opportunity assessment, workforce plans, and implementation roadmap.

• Final Presentation: Board-level presentation summarising findings, recommendations, and next steps.