Doctors employed on local contracts can now apply to become SAS doctors, as applications to the EPF (eligibility permanency framework) open across England.
From today, LEDs (locally employed doctors) in England will be able to put themselves forward for the opportunity to apply for specialist, associate specialist and specialty doctor contracts under the provisions of the EPF.
First unveiled in May this year, the framework is part of the 2024 SAS pay deal for England reached between the BMA and the Government, with the EPF being drawn up by the association alongside the Department of Health and Social Care, NHS Employers and NHS England.
To be considered eligible, doctors must be employed and have worked under the terms of a local contract with a single employer for two years or more, having exercised responsibilities and duties equivalent to that of an SAS doctor during that time.
Candidates will also have completed a minimum of four years post-graduate training with two of these years in the specialty relevant to the SAS post they wish to pursue.
Pathway search
Calls for a defined pathway allowing LEDs wishing to transition to national terms and conditions has been a long-standing demand of the BMA and its members, in view of the inequitable terms and working conditions faced by those on locally agreed contracts.
Many of these doctors have been employed on insecure, short-term contracts, which lack the safeguards and clear career progression pathways afforded by national terms and conditions.
After gaining his medical qualification in India, Mayank Singh joined the NHS in 2023 where he works at the Stockport foundation trust as an LED.
Job security
He said he was considering utilising the EPF as a means of accessing the SAS grades, in large part because of the stability and opportunities he believed such a move would provide.
‘I would be very interested in an SAS role, primarily because the progression, pay recognition of the work that I do will be greater,’ says Dr Singh.
‘I know people personally who have been in the same trust, same department for at least five years and they’re still not being recognised for that.
‘[Being an SAS doctor] gives you an opportunity to progress, to have a secure, long-term contract, to get enough training. It gives you the protected teaching and SPA [supporting professional activities] time and once you are an SAS doctor you’re protected by a national contract.’
Fellow LED Jasleen Kaur said that, while she felt well supported in some areas in her current role, locally agreed contracts were often not as straightforward and clearly defined as a nationally recognised terms and conditions.
Career opportunities
She added that, while the EPF would not solve all the challenges facing LEDs, such as the legal requirements around UK graduate prioritisation, it would provide opportunities for progression that had previously been unavailable.
While also welcoming the arrival of the EPF pathway, Stockport LED Sai Yatiraju said that more support and opportunities needed to be provided to doctors already employed under locally agreed contracts, if these staff were to be put in the position to properly benefit from transitioning to the SAS grades.
‘I have always wanted to get into radiology training rather than IMT training, but there is no locally employed post or support for specialties like radiology,' reflected Dr Yatiraju.
‘If you can't get experience in that branch, you can’t become an SAS doctor in your chosen specialty.
‘However, [as SAS doctors] we have protected time for attending clinics. We have protected time for our self-development. All these things that [as LEDs] we do after work on our own time.’
The path from LED to SAS doctor is one that anaesthetist Gauri Sankhe knows well. Having joined the NHS back in 2006 Dr Sankhe spent almost a decade working on a locally employed basis before becoming a specialty doctor in 2014.
Turning point
During her career, Dr Sankhe has enjoyed a range of achievements and firsts including election to the BMA specialist, associate specialist and specialty doctors committee and becoming the first doctor in England to be appointed an SAS advocate.
She said her extensive and varied professional experience meant she was able to appreciate the importance of a dedicated career pathway such as the EPF.
She said: ‘Becoming a specialty doctor was a turning point in my career, giving me the opportunity to achieve a healthier work-life balance after many years of uncertainty and struggle. These experiences have shaped my passion for improving the journey for others.
‘My lived experience has given me a deep understanding of the challenges faced by doctors navigating the NHS without a clear pathway, mentorship, or support. I experienced many obstacles along the way, often having to find my own direction without the benefit of family support or a mentor.’
Missing support
Dr Sankhe added: ‘I want my peers and future colleagues to have access to informed choices, transparent career pathways, and the support that many of us lacked. No doctor should have to navigate the system alone or face unnecessary barriers to career progression.’
‘I firmly believe that this framework has the potential to add real value – not only to individual doctors’ personal and professional development, but also to the wider NHS by improving morale, retention, workforce sustainability and long-term stability.’
In addition to the EPF, many LEDs can now transition from short-term to permanent contracts under provisions included in a deal on jobs and pay reached by the BMA resident doctors committee and the Government in June.