Consultant work pattern modelling

Helping an NHS Trust to understand the impact of Covid-19 on staff rotas


During the initial Covid-19 crisis, our NHS Trust client faced unprecedented demand upon its consultants. Existing working patterns were torn up, as doctors were asked (at short notice) to extend their hours and change their place and days of work.

We needed to analyse the impact of these changes, using modelling to understand which elements could be retained after the crisis response period. It was crucial that this process took into account both the financial and human impact of any alterations to working patterns.


We worked with senior medical staff to build a model that could answer the human and financial impact questions of potential changes. These included 7-day acute medical and specialty ward consultant coverage.

Firstly, we developed a rota model where proposed working requirements were inputted for the various specialties. The output of the model showed the size of the consultant team needed to support the work and the hours that the work equated to. The hours were converted into contractual working units, which were used to cost the pattern.

Secondly, we developed a roster pattern model to take the working pattern, modelled in the rota model, and work out the best way to allocate hours across the various specialty teams.

At our NHS trust client, different specialties contributed to the General Medical roster as well as covering their Specialty Ward roster.  The patterns quickly become very complex and it was important to provide a safe level of staffing to deliver patient care, whilst also giving consultants a reasonable work-life balance.

Critically, we also captured and communicated the process needed to operate the models when future events occur. Changes to the team, their hours and working locations all impacted on the work roster. Having the ability to re-model, re-shape and update the roster was important to allow our NHS Trust client to move into a resilient situation.


  • Complete visibility – provided a holistic view of the pattern of work that their consultants were being asked to work


  • Accurate modelling – understood the impact of the desired changes to working patterns. This enabled the trust to assess the changes brought in during the Covid-19 crisis and to decide which were sustainable in the post-crisis recovery


  • Dealing with change – developed a process to enable the future potential changes to be modelled, assessed and proposed


  • Implemented recommendations – changes that have been included in the current model are: a 7-day consultant presence,  a seasonal roster to manage expected increase in demand over the winter (flu season)


If you would like to find out more about this work or think that we can help you, then please contact Tim Powlson or call us on 0845 222 0548.


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