Workforce & Rostering — Roster Design
Redesigning the Surgical SHO on-call roster to increase access to theatre-based training while reducing disruption to elective services — with the same 57 on-call duties.
SHO on-call duties were clashing with consultant theatre lists and outpatient clinics. This reduced SHO access to valuable theatre-based surgical training as well as affecting doctor availability for planned elective work.
Because the impact differed by doctor and by weekday, some allocations caused substantially more disruption than others — so the problem could not be solved by simply spreading duties evenly.
Mapped elective demand: consultant schedules were reviewed to identify the best, second-best and unsuitable on-call days for each SHO.
Established the baseline: 57 historical allocations across seven SHOs were audited to measure how often duties fell on suitable and unsuitable days.
Redesigned the roster: calls were reallocated toward lower-impact days while retaining the required overall number of duties.
The revised design treated on-call days as operationally different rather than interchangeable. It linked each SHO's call allocation to the consultant-led elective commitments they supported, increasing their opportunity to gain surgical experience in theatre while protecting theatre and clinic capacity.
The total number of 57 on-call allocations was unchanged — the improvement came from design, not from additional duties or additional staff.
Allocations on the best days increased by 16, from 33 to 49, giving SHOs greater opportunity to participate in theatre activity and develop their surgical experience. Unsuitable-day allocations fell by 13, from 15 to 2.
The redesigned method was then adopted as a standard part of MedModus' ongoing rostering for Surgical SHOs.
The same 57 on-call duties, redistributed. Each doctor's best and second-best on-call days were derived from the consultant-led elective commitments they support, then historical allocations were compared with the redesigned roster.
Summary
| Allocations | Before | After |
|---|---|---|
| On best day | 33 | 49 |
| % best | 58% | 86% |
| On bad day | 15 | 2 |
| % bad | 26% | 4% |
Detail
Before
| Doctor | On-call allocations | Total | Best day | % best | Bad day | % bad | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mon | Tue | Wed | Thu | Fri | ||||||
| SHO 1 | 6 | 1 | 1 | 8 | 1 | 13% | 7 | 88% | ||
| SHO 2 | 5 | 2 | 1 | 8 | 6 | 75% | 2 | 25% | ||
| SHO 3 | 2 | 5 | 1 | 8 | 5 | 63% | 1 | |||
| SHO 4 | 7 | 1 | 8 | 8 | 100% | |||||
| SHO 5 | 1 | 7 | 8 | 7 | 88% | 1 | 13% | |||
| SHO 6 | 1 | 7 | 1 | 9 | 0 | 0% | 2 | 22% | ||
| SHO 7 | 6 | 1 | 1 | 8 | 6 | 75% | 2 | 25% | ||
| Total | 57 | 33 | 58% | 15 | 26% | |||||
After
| Doctor | On-call allocations | Total | Best day | % best | Bad day | % bad | ||||
|---|---|---|---|---|---|---|---|---|---|---|
| Mon | Tue | Wed | Thu | Fri | ||||||
| SHO 1 | 1 | 6 | 1 | 8 | 7 | 88% | 1 | 13% | ||
| SHO 2 | 7 | 1 | 8 | 8 | 100% | 0% | ||||
| SHO 3 | 4 | 5 | 9 | 5 | 56% | 0% | ||||
| SHO 4 | 4 | 4 | 8 | 8 | 100% | 0% | ||||
| SHO 5 | 7 | 1 | 8 | 8 | 100% | 0% | ||||
| SHO 6 | 2 | 6 | 8 | 6 | 75% | 0% | ||||
| SHO 7 | 1 | 7 | 8 | 7 | 88% | 1 | 13% | |||
| Total | 57 | 49 | 86% | 2 | 4% | |||||
Shaded cells show each doctor’s best and second-best on-call days, based on their consultant-led elective commitments. Numbers are historical allocations before the redesign and planned allocations after it.
What changed for the organisation once the platform was live.
33 → 49
allocations on the best day
15 → 2
allocations on an unsuitable day
57 duties
on-call coverage unchanged
More theatre time
for surgical SHO training
Protected electives
fewer clashes with lists and clinics
Adopted as standard
in ongoing SHO roster production
We will walk you through how this engagement was delivered and what the equivalent first phase would look like for your organisation.
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