Background

In 2008 the Department of Health ( DH ) made available to Deaneries resources to support the further training and professional development of non-consultant career grade doctors and dentists (mainly Staff Grades and Associate Specialists, generally known as SAS Doctors and Dentists, or " SAS Grades" - SASG s). Doctors in this group are those who “have completed the equivalent of at least four years of postgraduate training and who are neither in a Deanery-approved training post nor hold a consultant appointment”. New appointees to these grades are now known as "Specialty Doctors", and the Department of Health proposals are outlined in the April 2008 document "Employing and Supporting Specialty Doctors - A Guide to Good Practice" , which can be downloaded from www.nhsemployers.org/publications. 

The key recommendations of this guidance are that:

• All specialty doctors should be employed in the spirit of the national contract.
• All specialty doctors should have appropriate clinical supervision.
• Specialty doctors should have access to a minimum of one programmed activity per week to support professional activity, for example, professional development, audit, teaching and research.
• Specialty doctors should have fair and reasonable access to study leave with appropriate funding according to the national contract.
• All employers should apply the minimum requirement of entry to the grade.
• Employers should use the professional development framework for specialty doctors.
• Employers should use the aid for employers when writing a person specification for a specialty doctor post.
• All specialty doctors should undergo an effective appraisal that:
  • Ensures the specialty doctor is trained in being an appraisee
  • Results in a personal development plan ( PDP ) with clear achievable objectives
  • Identifies the appropriate professional development and study leave to support the maintenance of and development  of skills in a planned way, identified through the appraisal process 
  • Is supported by a portfolio of evidence.
• Experienced specialty doctors should be trained as appraisers.
• Employers should make time available in senior medical staff job plans (including senior specialty doctors) to ensure effective career discussions take place with specialty doctors.
• Employers should ensure specialty doctors are legitimate participants within their professional group within the employing organisation: supported in developing as managers, leaders, trainers and researchers.
• All specialty doctors should be seen as an integral part of the clinical team.
• All specialty doctors should be aware of support networks including the process for doctors who are under performing.
  

In the web-pages which follow, where the term " SAS doctor" appears, it should be taken to include both doctors and dentists, in the grades of Associate Specialists, Staff Grades, Clinical Assistants, Hospital Practitioners and Specialty Doctors (under the new contract).

The NHS has not always recognised the need for ongoing education and training for SAS Doctors. It is important to recognise that an SAS doctor is often in the post because their training is incomplete. Some SAS doctors aspire to further career progression which will entail them gaining top-up training to an appropriate level. Others wish to remain in the grade, but still require continuing professional development and updating of their skills and knowledge base. Additionally, changes to career pathways following the introduction of MMC are likely to result in greater movement between training and SAS grades in the future.

SAS Doctors are experienced and senior professionals in permanent posts working within the NHS . They work across all specialties, both in clinical and non-clinical areas. By tradition they have had a high level of service commitment, but training has not usually been part of the SAS doctor's contract. All too often, continuing professional development ( CPD ) for SASG s has been ignored as well. The new and recurrent funding from the Department of Health seeks to redress this lack, and offer career and professional development support to this important group who have been much neglected in the past.

This support might include arranging secondments to other units to learn new techniques, advising on and supporting continuing medical education for SASG s, representing their views to the Clinical Tutor/ DME and other senior Trust personnel, providing leadership and educational support relevant to their needs, advising on further training, involvement in audit and research, and liaising with the Royal Colleges. The funds can also be used to "top-up" the Trust study leave funding to which all SAS doctors should be entitled, to attend courses and meetings.

Please refer to the SAS Policy for more information.