Consultant SAS doctor

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Hospital doctors accept SAS framework

Hospital doctors in the West Country have agreed to support the independent work of their associate specialists colleagues.

Local negotiating committee members at South Devon Healthcare NHS Foundation Trust ratified a framework recognising associate specialists as ‘autonomous practitioners’ at a meeting last month.

Development of the Associate Specialist Role: Moving to Autonomous Practice maintains there are several potential benefits to this approach, including:

  • Recognising the high clinical skills and professionalism of associate specialists
  • More cost-effective clinical service
  • More flexible use of doctors’ time and skills
  • Personal and professional development for senior associate specialists.

BMA south-west regional staff, associate specialists and specialist doctors committee chair and trust LNC member Louise Robinson welcomed the framework as a positive move.

Positive move

She said: ‘I see it as another important step in the recognition of the enthusiasm, experience and expertise of a group of senior SAS doctors who wish to develop a niche service not already provided within their directorate for the benefit of their patients.’

SAS doctors have traditionally worked under the supervision of named consultants who have ultimate clinical responsibility for patients, but this has mostly evolved through custom and practice.

The pre-2008 model contract specifies that associate specialists are responsible to consultants, but there is no legal reason for this and it is not repeated in the newer contract.

Advice from indemnity organisations also suggests there is no blanket policy preventing SAS doctors from working independently or being covered as long as they are competent in their roles.

The Devon framework stipulates that associate specialists wishing to work autonomously would require evidence of competency and appropriate training supported by ongoing audit, support and development, with access to advice from peers.

Chance to shine

The move would need to be endorsed by most consultants in the directorate, with any disagreement arbitrated by the medical director, who would ratify autonomous status before it was signed off by the clinical director and recorded in the associate specialist’s personnel file.

SASC UK joint deputy chair Anthea Mowat recognised the value of the framework for the grade.

She said: ‘This will be a helpful document to enable LNCs to develop guidance for enabling SAS grades with appropriate skills to work autonomously, while still adhering to the requirements of clinical governance.’

Medical director at South Devon Healthcare NHS Foundation Trust John Lowes said: 'At Torbay Hospital we have long recognised the significant contribution and role that associate specialists play in delivering excellent care, as well as the high level of clinical skills needed. This ratified and updated framework will enable this vital staff group to better utilise their skills and experience, with improved access to support and personal development.'

Doctors wishing to see the framework can email Dr Robinson.