SAS stands for specialty, associate specialist and specialist.
SAS doctors are fully qualified, experienced doctors who work permanently with the healthcare team in their chosen area of medicine.
For a patient, seeing a SAS doctor will mean that you will receive expert medical care from a senior doctor who can diagnose and treat you.
What is the training process and qualifications for SAS doctors?
There are three different roles:
Associate specialists: This is a senior SAS grade which was first introduced in 1981. Although it closed to new entrants in 2008, many are still working so most current associate specialists have over 20 years of experience.
Specialists: A new senior role introduced in 2021 to provide a career pathway for experienced SAS doctors. Specialists typically have 10-12 years postgraduate experience, and more than six years in their specialty.
Associate specialists and specialists run their own services and are in charge of their own patient care.
Specialty doctor: This is a SAS doctor with more than four years of experience after finishing training, and who will have worked for more than two years in their relevant specialty.
In reality, more than 50% of current specialty doctors have over 15 years of NHS experience and are already working and delivering clinical care at the specialist level.
What do SAS doctors do?
SAS doctors provide medical care for patients. Many are also involved in training doctors and students or can be responsible for managing and organising health services.
On a day-to-day basis, SAS doctors work in acute/emergency care, are responsible for operating lists and clinics, deliver ward care, diagnostics, education and leadership. Many run clinics and theatres independently, within agreed local clinical governance structures.
Are SAS doctors consultants ‘in training’?
No, SAS doctors are not in a formal training programme. They are qualified and hold permanent roles. They can advance to the specialist grade. However, if a SAS doctor wanted to become a consultant, they would need to complete further training.
How are they different to other types of doctors in the NHS?
Unlike resident doctors (formerly known as junior doctors) SAS doctors have finished training and are fully qualified.
A consultant is a senior doctor who has overall responsibility for the care of their patients in hospital. They have completed a minimum of six years training in their speciality area to gain a certificate of completion of training and are listed on the GMC’s specialist register.
Many SAS doctors deliver comparable care taking responsibility for the care of their patients, working to a clearly defined role and clear guidelines.
General practitioners work in primary care and are on the GP register; SAS roles are mainly hospital/community specialty posts.
Do they cover all specialties?
SAS doctors work across most hospital and community specialties – including anaesthetics, surgery, medicine, paediatrics, psychiatry, pathology, emergency medicine, palliative and end-of-life care and are integral to theatres, clinics, and ward care.
How many SAS doctors there in the NHS in the UK?
There are tens of thousands of SAS doctors working across the NHS in various specialties. They are a fast-growing part of the workforce.
When combined with LEDs (locally employed doctors), doctors on fixed-term contracts not in training posts, the group is even larger. Together, SAS and LEDs are major pillar of the medical workforce and represent a very substantial share of licensed UK doctors, providing continuity and stability to NHS services.
Are there SAS doctors in general practice?
Traditionally, SAS roles sit within hospital teams. Some SAS doctors can work in community or home-based care, including in older adult and general adult community teams, liaison services, and specialist psychotherapy services.
What would happen to the NHS if there were no SAS doctors?
Professional bodies are clear: the NHS would unravel without SAS doctors. They are the quiet backbone of the health service, delivering direct patient care, keeping rotas safe, theatres running, and clinics open. They not only treat patients but also train the next generation and provide the continuity that stabilises services.
Without SAS doctors, the NHS would face cancelled operations, unsafe staffing on wards, gaps in emergency cover, and the collapse of many specialist services. The value they add goes beyond numbers; they are the steady hands and trusted specialists who make the system safe.
Losing SAS doctors would not simply stretch the NHS, it would critically destabilise it.
The NHS Constitution in England gives patients a right to choose the consultant they see, do we have the same right with SAS doctors?
Under the NHS Constitution, patients in elective care have a legal right to choose their consultant-led team. That legal entitlement is framed around consultants, not specifically SAS doctors, but many patients already ask for a specific SAS doctor, and hospitals often accommodate this.