Staff Grade and Associate Specialist

The need for regularising appraisals, unifying the erstwhile non-consultant career grade (NCCG) doctors, ensuring continuing professional development and personal satisfaction was recognised in late 1990s, and became an important agenda in workforce planning by early 2000s.

The Choice and Opportunity document published by the DoH in 2004 recognised the contribution made by Staff grade and Associate Specialist doctors to patient care and also the relative lack of career structure, professional development and satisfaction in this grade. Fifteen key recommendations were proposed in this document including the need for regular annual appraisals, continuing professional development, the role of the Deanery in supporting opportunities for ‘training’ and professional development.

The drivers for change were

• Safe working
• Quality standards
• Public expectation
• Career satisfaction
• International equivalence
• Economic - best use of medical workforce

In response to the above document, the Department of Health introduced a unified grade renamed the SAS grade with a new incremental payscale. It is expected that the new speciality doctor will, in the early stages of their career in the grade, be a competent doctor with experience in a defined speciality, rising up to become a highly competent doctor with specialised areas of expertise. The level of responsibility delegated to a speciality doctor will depend on experience and capability and will be agreed between the clinical manager and the doctor as part of the joint job planning process.

They will contribute to service delivery and patient care within a defined speciality as a member of a multidisciplinary team. Their continued professional development and acquisition of skills will be supported by the new career structure.

Entry into the Grade

The minimum entry requirements for the new speciality doctor grade are: full registration with the GMC, plus a minimum of four years (or equivalent) postgraduate training, two of which must have been in a relevant speciality.

The grade is made up of 11 pay points. There will be annual progression up to point 5 of the salary scale. In order to progress from point 4 to point 5 of the scale each doctor will need to pass through Threshold One. The doctor must evidence meeting the Threshold criteria before the move can be made. Progression from point 5 to point 8 will be at two yearly intervals. To progress from point 7 to point 8 of the scale, each doctor will need to pass through Threshold Two. Progression from point 8 to point 10 will be at three yearly intervals.

The DoH also made available to the Deaneries in England a sum of £12 million pounds to help support the career development and continued professional education of Staff Grades and Associate Specialists, as well as those in the new Specialty Doctor grade.

The SAS Doctors are more heterogenous than any other group of doctors – from the equivalent level of beginner trainees to senior clinicians operating independently and eligible to take up consultant posts, and thus have varying training and CPD needs.

The core features of training/CPD of all SAS doctors that set them apart are that they are:

• Not part of the managed trainee network
• Not Consultants
• No otherwise available system for CPD

Thus SAS doctors CPD requirements vary according to career stage:

• Those preparing for membership examinations
• Those (more senior) preparing to apply for CESR under article 14
• SAS doctors who have attained CESR under Article 14, whether or not they may be preparing to take up Consultant Posts
• SAS doctors who chose to seek CESR

Delivering CPD is not structured, with most doctors having their own action plan in line with the unit’s service development.

• Mainstream/College Faculty Agenda
• Own role agenda
• Regional Conferences
• Educational activities geared towards SSGs (Specialty Specific Guidelines -> CESR article14 curriculum development

Funding support has been made available for CPD including teaching/ training, personal development, mentoring, e-learning etc.

NESC (NHS Education South Central) has received funding of £0.5 million to be shared equally between the Wessex and Oxford deaneries. The funds have been devolved to the Trusts to support the above objectives, and the amount works out at around £500 per SAS doctor. However, within the limitations of strained NHS finances, it is unclear if these funds are going to be recurrent in the coming years.

The East Berkshire district and the Oxford Deanery

Who’s who:

John Lourie
Associate Postgraduate Dean, Oxford Deanery Lead for SAS doctors educational support project.
Contact: jlourie@oxford-pgmde.co.uk

Linda Day
Project Officer.
Contact: sas.doctors@mkhospital.nhs.uk

Pampa Sarkar
SAS Tutor for East Berkshire to include Heatherwood and Wexham Park (acute trust), Mental health trust (east) and Primary Care Trust.
Contact: SAStutor@hwph-tr.nhs.uk or Pampa.Sarkar@hwph-tr.nhs.uk

Maura Stock
Postgraduate Manager.
Contact: Maura.Stock@hwph-tr.nhs.uk, 01753 634377

Progress so far in East Berkshire

• Meetings of SAS tutors with the Associate Dean to discuss issues and how to move forward.
• Questionnaire sent out by Pampa Sarkar (April 2009, email and hard copy) to all SAS doctors in the District to collect baseline information about current status, personal development plans and inviting suggestions.
• Up-to-date database being set up requesting information about SAS doctors in all specialties. All doctors requested to help.
• A small committee set up comprising of representatives from different specialties to assess criteria for application for funding and other issues. The members being: Pampa Sarkar, Magdi Fanous, Arun Tyagi, Hanna Hanna, Vinita Shrivastava, Nisha Pal, Emmanuel Olawale, Emmanuel Awonaya.
• Criteria for application of SAS funds set in line with Deanery and National recommendations.
• Application forms for funds drawn up- a single form applicable to all units in the Oxford Deanery.
• Local Open Day on 8 July 2009 at Postgraduate Centre, Wexham Park Hospital.
• Deanery Study Day 25 September 2009 at Oxford.
• SAS notice board in the Postgraduate Centre, Wexham Park Hospital, next to the videoconferencing room.
• SAS webpage with links to Oxford Deanery, NESC and NACT.
• All day study day with Amir Khaki (external speaker), Dr Peter Sebire, Director of Medical Education, Medical Director and SAS tutor proposed for 12 February 2010.
• Production of a regular newsletter East_Berks_newsletterMarch_2010.doc (39.5 KB)

Links

NESC (NHS Education South Central) www.nesc.nhs.uk
NACT (National Association of Clinical Tutors) www.nact.org.uk