Consultants carry ultimate clinical responsibility for every patient seen under their care. The public is therefore entitled to expect that all consultants will have reached the highest standards of skill and knowledge and this is guaranteed by means of a statutory appointments procedure laid down in regulations. The regulations and supporting guidance were revised in July 2009 (The National Health Service (Appointment of Consultants) (Scotland) Regulations 2009).
While the majority of the actions within the consultant recruitment process, which were previously subject to regulation, now lie with the NHS boards who hold responsibility for the process, some key elements are still subject to regulation and remain under statutory control. The statutory element includes the appointment of a trained External Adviser from a different NHS board as a full member of the consultant assessment panel: this is intended to ensure the clinical quality of appointed candidates is maintained. The External Adviser will have been trained in selection processes and, with experience of other appointments, can provide advice on the appointment from a different perspective than the local clinical team.
Planning and advertising a consultant post
Employers should begin planning for a consultant appointment well before the post is to be filled. They should consider service needs, the amount and level of training that may be required, teaching, supervision of junior staff, continuing professional development, research and any special interests and produce a draft job description and person specification which must be sent to the External Adviser for their advice and comment. They should also identify a lead officer to manage each individual recruitment process.
All potential applicants should be given the job description; the person specification; information from the board with details of arrangements for practice, e.g. units, clinics etc; details of staffing and relevant services covered; where appropriate, information about undergraduate or postgraduate medical/dental teaching; and the relevant TCS including pay. The employer should also ensure that a job plan is available for the consideration of candidates for appointment to a consultant post.
Employers should look to advertise details of vacant posts widely which should normally include a professional journal. The use of the SHoW (Scotland’s Health on the Web) vacancy database is strongly encouraged.
Candidates for consultant posts should always request details of the TCS from the board in advance of the appointments committee. Advice can also be sought from the BMA, and from the LNC, which should have been involved in negotiating any local flexibilities to national agreements.
Eligibility for appointment and specialist register
On successful completion of specialty training, doctors are awarded a certificate of completion of training (CCT), allowing them to practise across Europe as recognised ‘specialists’. The GMC recommends CCT holders for inclusion on the specialist register, which it administers. The specialist register includes the names of all CCT holders together with those of other eligible specialists, and shows their specialty and, if requested, any particular field of expertise within it. Eligible specialists are defined as:
- European Economic Area nationals holding recognised specialist qualifications
- other overseas nationals holding specialist qualifications that are deemed equivalent to the CCT
- doctors who have followed academic or research training paths, resulting in a level of knowledge and skill consistent with NHS consultant practice in that specialty.
From 1 January 1997 it has been a legal requirement for all doctors to be on the GMC’s specialist register before they can take up a consultant appointment. (In the case of consultant dental posts, individuals must be a registered dental practitioner or a fully registered medical practitioner). However, trainees may explore the possibility of post-CCT careers as soon as it is apparent that a CCT will be awarded in the near future. Consequently, SpRs and StRs are able to apply for a consultant appointment provided the expected date of award of their CCT (or recognised equivalent, if outside the UK) falls no more than six months after the date of interview for the consultant post. The consultant assessment panel must also be satisfied that the applicant is sufficiently near to the completion of training to enable them to judge the applicant’s suitability for a consultant post.
Membership of the assessment panel
The assessment panel is convened by the appointing board to conduct the candidate assessment. This assessment may include profiling, aptitude tests or multi-station interviews. The panel must include at least one consultant from the specialty. Where possible that consultant should be from the employing board. Depending on the nature of the post and the extent of any undergraduate teaching or training duties, the board may include university representation on the assessment panel. While there is no set limit on the size of the panel, under the regulations the panel must as a minimum include a Chair, with delegated authority from the Board, an External Adviser and one other consultant from the specialty.
The regulations require that a single External Adviser is included on the assessment panel for consultant appointments within the NHS in Scotland. The role of the External Adviser is to advise the recruiting board on each stage in the process, including commenting and advising on the job description, person specification, the selection methodology and participating in the selection process. This External Adviser is identified from the list of External Advisers maintained by the Academy of Royal Colleges and Faculties in Scotland, and must be external i.e. not employed by the recruiting board, and must be in the same specialty as the post being appointed to. In rare instances of small specialties it may be necessary to seek an External Adviser from outside Scotland.
All newly appointed External Advisers undergo training before they are included on the adviser list, and if reappointed to the list again, should undergo refresher training.
This training is co-ordinated by NHS Education for Scotland and includes:
- detailed training on equality and diversity issues;
- refreshers on specialty training curricula and assessment methods used;
- updates on selection methodology and tools that have been used successfully;
- the option to shadow an External Adviser and observe the process, although it should be emphasised that observers will play no role in the recruitment process.
Under the regulations, recruiting boards will appoint a Chair for the assessment panel. The Chair will hold delegated authority to offer the post on behalf of the board once the panel has considered the candidates.
Boards should draw up a policy on the use of visits as part of the employment process and communicate this policy to all applicants. Visits are intended to inform the applicant regarding the department and the requirements of the post. Depending on the nature of the post the policy on visits should look to offer applicants an opportunity to visit the department and meet with key staff. The option of a visit, and the timing of such a visit, should be determined by the board, and should be made available to all applicants at the same point in the recruitment process.
Once the assessment panel has made a decision on which candidate(s), if any, should be offered the post, the Chair and the HR Department will then take responsibility for offering and contracting with successful candidates. Any candidate wishing to appeal a decision made by the panel should do so through the appointing board.
All members of the assessment panel hold equal responsibility for raising concerns at any stage within the recruitment process with the Chair. In these instances, it is for the Chair to assess these concerns and to determine whether or not to proceed with the recruitment process. If the decision is taken to proceed to appointment, the Chair should note the concerns raised and indicate the basis on which the decision to proceed was taken. If the Chair decides not to proceed, this decision is reported back to the board, outlining the basis on which this decision was taken. It is for the board to decide on next steps and whether to re-run the process.
If any member of the assessment panel has concerns about the appointment made or the conduct of the appointment, they should make their concerns known in writing to the Chair of the recruiting board, and if it is the External Adviser who has concerns, these should also be made known in writing to the Scottish Academy.
Fees and expenses
Applicants: Doctors who are currently employed under the national TCS (e.g. consultants or SpRs/StRs seeking a first consultant appointment) are entitled to have their expenses reimbursed by the prospective employer at the appropriate rate. This may include pre-interview visits, providing the applicant is subsequently shortlisted.
Members of assessment panels: External Advisers are entitled to a fee and travelling expenses. Consultants are only entitled to a fee if the AAC duty is undertaken outwith agreed PAs.
- CEL 25 (2009) The NHS (Appointment of Consultants (Scotland) Regulations 2009 (PDF)
- The NHS (Appointment of Consultants) (Scotland) Amendment Regulations 2010