Sometimes, being good at your job can make you less visible. That may sound strange, but I have seen this happen with SAS doctors for many years.
An experienced SAS doctor may run an independent clinic, perform procedures, make important clinical decisions, teach junior colleagues and help keep a service running. Yet, how much of that work is actually recognised?
In some hospitals, even the clinical data has not always shown who really delivered the care. Work carried out independently by a SAS doctor could be recorded under a consultant's name.
We found this in Stockport. Many experienced SAS doctors were working autonomously, but the system did not allow their work to be properly recorded in their own name. We worked with colleagues locally and nationally to change this. SAS doctors approved for autonomous practice can now have their work recorded appropriately. The experience has since been shared as an NHS Employers case study on recognising autonomous practice for SAS doctors and dentists.
It sounds like a small change. But it matters.
SAS doctors are an important part of the NHS. Specialty doctors, specialists and associate specialists bring enormous experience to patient care. Many have worked in their specialties for many years. Some work autonomously. Others lead services, teach and supervise doctors, contribute to research, improve services and take on senior leadership roles.
SAS should be seen as a career in its own right
For many doctors, it is a positive career choice that offers continuity, clinical responsibility and the opportunity to develop in different directions. It should not simply be seen as an alternative for someone who has not followed a traditional training pathway.
We should also move away from labels such as ‘middle grade’ for experienced SAS doctors. Someone who has worked independently in a specialty for 15 or 20 years, leads a service and makes senior clinical decisions cannot be properly described by such a vague label.
Visibility needs evidence
Between 21 April and 2 June 2026, the GMC carried out a major survey of SAS and locally employed doctors across the UK. It was the first detailed survey of these groups since 2019.
This is important. We need good data to understand the contribution of SAS doctors, the challenges they face and the opportunities they need.
But collecting data is only the beginning. We need to act on what the data tells us.
Recognition must lead to opportunity
The SAS charter already describes many of the things SAS doctors should reasonably expect, including appropriate contracts, mutually agreed job plans, professional development and involvement in their organisations.
These should not simply remain words in a document. They need to become part of everyday working life. The specialist grade introduced in 2021 provides a route to recognise experienced SAS doctors who work autonomously and make expert clinical decisions.
But employers must recognise the need and create these specialist posts.
Trusts should identify experienced specialty doctors who already carry significant responsibility and help keep services running. Their experience should be recognised, and genuine opportunities for progression should be available.
We must also remember our long-serving SAS doctors. Someone should not miss the opportunity for recognition simply because they are in the later part of their career.
What can we do this SAS week?
SAS week should certainly be a celebration. We should share achievements and thank colleagues.
But it should be more than that. I would like every organisation to ask a few simple questions:
Are our SAS doctors recognised for the work they actually do?
Is autonomous work recorded in their own name?
Do they have fair job plans and time for professional development?
Are experienced specialty doctors being considered for specialist roles?
Do we have effective SAS tutors and SAS advocates who can bring the SAS voice into important discussions?
And, importantly, are we listening to SAS doctors themselves?
The SAS advocate role can help bring the SAS voice into the organisation and support wellbeing, development, recognition and career opportunities.
But SAS doctors themselves must also tell their stories. Stories can change culture.
My own journey has taught me how important it is for SAS doctors to take opportunities, develop confidence and become visible beyond their day-to-day clinical work. I have written previously about this in Embracing the journey: my leadership in extended SAS roles.
Recognition should start in our own trusts and departments
Whenever possible, let us bring recognition to SAS doctors where they work, rather than expecting them to leave their workplace simply to attend another event.
Let this be a week when SAS doctors are seen and heard. When people see what SAS doctors are already doing, they can also imagine what more they could achieve when given the right opportunities.
This SAS week, let us make our SAS doctors visible, value what they already bring, and give them the opportunity to grow further.
Bio: Professor Madapura Shashidhara is the BMA SAS committee deputy chair (education and development), BMA SAS committee North West chair, associate dean for SAS doctors, associate specialist in anaesthetics, IMG tutor at Stockport NHS Foundation Trust and visiting professor at the institute of medicine at the University of Greater Manchester.