SAS doctors must be afforded greater access to career progression opportunities and leadership roles for the sake of the NHS’s future, doctors at the BMA annual representative meeting agreed.

Doctors have called on the BMA to lobby for a raft of measures to promote greater representation of SAS doctors in leadership and managerial roles across the NHS, and to press employers and royal colleges to develop clear and transparent pathways to allow access to the 2021 specialist doctor grade.

The calls, which were unanimously backed by members voting at the ARM in Liverpool today [24 June], come after a recent Freedom of Information request by the BMA highlighted the shocking extent to which SAS doctors are underrepresented in the health service.

The FOI’s findings revealed that SAS doctors accounted for 0.1 per cent of medical directors, 0.2 per cent of clinical governance leads and 4.5 per cent of educational supervisors in the NHS.

Speaking at the ARM, Oxford associate specialist Vaishali Parulekar told the conference that SAS alongside locally employed doctors were among the largest growing sections of the NHS workforce, yet doctors from these ranks remained woefully underrepresented at senior levels.

Calling on the BMA to lobby for the routine collection and publication of data on SAS doctors in leadership and managerial roles at both trust and national levels, Dr Parulekar said that doing so would be a key step towards SAS doctors ‘finally getting the recognition they deserve’.

She said: ‘[Access to leadership roles] is one of the biggest ongoing challenges faced by SAS doctors hindering their career progression, and it is clear that more must be done to recognise the contribution and potential of SAS doctors and break down barriers affecting their progression.’

Backing calls for data collection on SAS doctors in positions of leadership, Professor Madapura Shashidhara said continuing to ignore this longstanding inequality in representation was no longer an option.

He said: ‘SAS doctors remain underrepresented in key leadership roles where direction of services and future of our NHS are shaped. This is not only unjust, it is a lost opportunity [and] SAS doctors can no longer afford to be overlooked.

‘If you truly want leadership that is reflective of our workforce and delivers our for our patients, then we must unlock the full potential of SAS doctors.’

The underrepresentation of SAS doctors within senior roles is a long-standing issue, one that the introduction of the specialist grade in 2021 was in part designed to help address.

Access to the specialist role requires doctors to hold at least 12 years of medical experience at a postgraduate level and demonstrate and meet the criteria set out in framework developed by the Academy of Medical Royal Colleges, the BMA, and NHS Employers.

However associate specialist Gauri Sankhe told the ARM that inconsistencies in how the role was promoted and lack of transparency around how it can be accessed had resulted in many specialty doctors being ‘overlooked and excluded’ from applying for the role.

She called for the BMA to lobby for the establishment of transparent and structured pathway allowing specialty doctors to progress to specialist based upon their accrued skills and experience rather than a certificate of completion of training (CCT).

She said: ‘This motion calls on our BMA to stand firm and advocate for the consistent and equitable implementation of specialists across all four nations.

‘We also ask for full and equal recognition, which does not mean we are chasing a consultant job title, but reward that reflects autonomy of our work.

‘This is about parity of esteem and not a hierarchy, while specialist roles are implemented fairly moral rises, retention improves, and patient care thrives.’

Backing Dr Sankhe’s calls, Lincolnshire associate specialist in general surgery Veera Karri said that empowering SAS doctors would ultimately empower the health service as a whole.

He said: ‘We all know that the NHS is under immense pressure, and we also recognise that the solutions exist within our current workforce.

‘SAS doctors are the backbone of many departments, bringing years, often decades, of clinical experience, yet too many are stuck in roles with no clear pathway for progression. Imagine a system where these skilled professionals can advance into a formal specialist roles providing continuity, leadership and expertise without requiring CCT.

‘It is not about lowering standards. It's about recognising capability, valuing contributions, supporting the creation and promotion of specialist roles, strengthens teams, improve patient care and eases some of the burdens currently born by consultants.’