7 Build a realistic development plan

A plan needs an opportunity

A development plan is useful when it connects a need to something that can actually happen. “Develop autonomy” is an aspiration. It does not identify the activity, the support, the person who will review it or the resources required. A plan should make those elements visible.

Begin with one priority from your capability map. State what you want to be able to demonstrate and why it matters to the intended role. Then ask whether the next step is learning, practice, observation, better evidence or a decision about access. The four-gap model prevents a development plan becoming a list of courses by default.

For example, if the immediate problem is an unclear account of established work, the action may be a scope review and specific corroboration. If the activity is new, a supported opportunity may be needed. If the opportunity exists only on paper because your current duties prevent attendance, the plan needs a resource decision before it can proceed.

T04 records the objective, opportunity, support, resources, reviewer and review point. These are proposed planning fields, not a national application requirement. Adapt them to your circumstances while keeping the underlying questions clear.

Define an objective that can be reviewed

A good objective describes an activity and the judgement or contribution you want to demonstrate. It should be possible to ask later what happened and what was learned. Avoid objectives that depend entirely on an outcome beyond your control, such as obtaining a grade by a particular date.

You can plan to prepare evidence for an application or complete an agreed development activity. The formal decision remains with the relevant process. Keeping that distinction clear makes a plan more honest and allows progress to be recognised even when an organisational decision takes longer.

An objective might be: “Demonstrate that I can lead the agreed review activity, explain my prioritisation and use the escalation arrangements appropriately.” It is more useful than “become more confident”, although confidence may improve as a result. The review can examine decisions, feedback and limits rather than rely solely on how the doctor feels.

For an established practitioner, the objective might be: “Produce an agreed account of the activity I already lead and obtain relevant corroboration of my decisions and responsibilities.” This is legitimate work. It does not need to be disguised as a new training experience.

Planning a new clinical activity

Consider a hypothetical development objective involving an outpatient follow-up clinic. The doctor has relevant clinical experience but has not led this particular clinic. Planning starts with the patient group, decisions already within the doctor's practice, unfamiliar aspects and available support. The opportunity covers a defined clinic session and its associated work.

The supporting clinician observes selected aspects of the activity and discusses reasoning at planned reviews. The service identifies clinical advice and backup arrangements. The manager addresses the effect on other duties. Brief evidence notes capture learning without transferring patient-identifiable material into a personal portfolio.

A review might identify sound judgement in familiar consultations and a need for more discussion around a less familiar presentation. The resulting plan should address that specific need while retaining established responsibilities. A single label such as independent or dependent would lose this distinction.

The revised plan responds to the evidence. More focused or closer support can be the appropriate next step.

Put the resources beside the objective

Every objective has practical consequences. An observed session uses the doctor's time and the observer's time. A project may need data support. A teaching activity requires preparation and feedback. A clinic opportunity may displace existing work or require cover.

If those consequences are not discussed, the plan may depend on unpaid time, goodwill or repeated cancellation. Write them down early. The resource request can be modest, but it should be explicit enough for someone to decide.

Do not assume that a supporting clinician can absorb the work indefinitely. A reliable arrangement requires agreement about availability and review. Similarly, do not assume that the doctor can collect and organise evidence outside all agreed work. The activity should be proportionate and planned.

Chapter 8 develops the resource discussion. An approved objective still needs a feasible opportunity.

Choose indicators that show learning

An indicator is something that helps you judge whether the objective is being achieved. It need not be a numerical target. In clinical work, it may include the quality of reasoning, recognition of limits, communication of uncertainty or appropriate follow-through. In education, it may include a revised teaching approach informed by specific feedback.

Avoid choosing a measure simply because it is easy to count. The number of requests for advice is not a reliable measure of autonomy. The number of certificates is not a reliable measure of applied learning. A large project sample does not establish the quality of the doctor's contribution.

Use a small number of indicators linked to the actual objective. Ask who can observe them and what limitations the evidence will have. A review should bring together relevant material rather than rely on one favourable encounter or one confident statement.

If a target is used, make its status clear. A locally agreed number of observations may be a practical arrangement for this plan. It should not be described as a national minimum unless the applicable source establishes that requirement.

Review dates and review questions

Set a review point that fits the opportunity and working pattern. It may be a date or a stage in the activity. The essential point is that everyone knows when the plan will be reconsidered and who will take part.

At review, ask what actually happened. Was the opportunity available? Was support reliable? What did the evidence show? Which part of the objective was achieved? What remains uncertain? What should continue, change or stop? These questions distinguish failure of access from difficulty in practice.

If sessions were repeatedly cancelled, do not record the doctor as having failed to demonstrate the objective without acknowledging the missing opportunity. If the activity occurred but feedback was not provided, address that gap. The review should examine the plan as well as the person.

Record the conclusion, next action and any specific disagreement requiring further discussion.

Coordinating development support

Development often depends on several contributions. Clinical review requires a colleague with relevant expertise. Access to a session or project may require a manager's decision. Evidence collection may need administrative or information-governance support. Identify these dependencies early and record who is responsible for each.

Select learning activities against the objective. A course can provide useful knowledge, a project can offer practice in applying it and feedback can test what changed. None should become a compulsory stage simply because it appears in someone else's development plan. Existing evidence may already answer the question.

Development without an immediate post

It can be reasonable to develop an activity before a Specialist post becomes available, provided the purpose and uncertainty are clear. The work may improve your present role, strengthen evidence and prepare you for future opportunities. It should not be sold as a guaranteed promotion.

Ask what the agreed activity will contribute now and when the wider career question will be reviewed. If responsibilities change substantially, revisit the role and contractual arrangements. Do not allow a temporary development plan to become an indefinite expectation of higher responsibility without appropriate consideration.

An honest plan may state that no immediate vacancy is identified while committing to a defined opportunity and review. In a jurisdiction with a regrading policy, clarify separately whether the current circumstances fall within that route. Development and formal recognition should not be allowed to obscure each other.

When circumstances change

A service reorganisation, colleague absence, change in working pattern or personal difficulty can make an agreed plan impractical. Review it rather than maintain an unworkable timetable. Identify what can continue, what needs postponement and what support remains available.

If a learning opportunity falls outside an agreed working pattern, consider an equivalent session within that pattern. The objective and expected standard remain the same. The arrangement changes so that participation is feasible.

Some plans should stop. If the activity no longer serves the intended goal, or if the required support cannot be provided safely, continuing simply to complete a form is unhelpful. Record the reason and choose the next appropriate action.

Write a plan that survives the first cancellation

In the outpatient example, agree how existing work will be covered, who can provide clinical support if the usual colleague is unavailable, and what happens if a session or review is cancelled. A good plan accounts for foreseeable interruptions.

At review, separate the clinical finding from the service arrangement. The doctor explains familiar decisions but needs further experience with one type of uncertainty; feedback time has also repeatedly been displaced. The doctor receives a focused learning action, while the manager and supporting clinician resolve the access and feedback problems.

A cancelled opportunity is not evidence of inadequate performance. Record what occurred, what the evidence shows and who will arrange the next appropriate opportunity.

Agree what would justify a change in the arrangement

Before practice begins, discuss what information would support continuation, a change in scope or additional support. You are agreeing review questions, not promising a result. For example, the review might ask whether the doctor identifies relevant uncertainty, communicates priorities clearly and follows through on agreed actions across the activity encountered.

Also ask what would make the evidence insufficient. An observer may see only straightforward cases. A planned activity may not occur often enough. Feedback may concern communication but leave clinical reasoning unexplored. Recognising these limits in advance helps the review remain fair.

For an already autonomous practitioner, the review question may concern documentation: do the profile and corroboration now explain the established work accurately? That can justify completing the evidence action and moving to the formal route. Development should end when its agreed purpose has been met; it should not continue indefinitely simply because it has become familiar.

What the service needs to arrange

The service should identify who can authorise the opportunity, provide support and review the work. Professional guidance from the RCP encourages meaningful educational and career support for SAS doctors; the handbook's proposed planning method turns that principle into specific arrangements. [S19]

Where a request cannot be met, give a reason and consider an alternative. Where development is recommended after an assessment, connect it to a specific concern and a feasible opportunity. A doctor cannot be expected to solve a resource or access problem alone.