The 2021 specialist grade explained

The new 2021 specialist contract presents new career opportunities for SAS grade doctors. Read our guidance on the roles and responsibilities it involves and how you can make a case for meeting the essential requirements of the grade.

Location: England
Audience: SAS doctors Consultants
Updated: Monday 14 November 2022
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Specialist grade statement

A statement on the specialist role from the BMA and NHS Employers. 

Read the full statement - July 2022

As part of the 2020/21 SAS contract negotiations, the BMA and NHS Employers have agreed to the creation of a new national grade for senior SAS doctors, known as the specialist grade.

The specialist grade is a new contract, and applicants must meet a set of generic capabilities criteria to be eligible for this grade. All specialist posts in the future will be created at the discretion of the employer, where they have identified a specific workforce need.

​This means that specialty doctors on the 2021 and 2008 contracts will not have any automatic right to progress from their current grade into the new specialist grade. Instead, they will have to apply for such a role when it becomes available. 

This is also the case for any associate specialists appointed after the grade closed in 2008, as they will be on local contracts. If you are seeking appointment to the new specialist grade, you will also need to use the approach set out in this guidance.


Implications for specialty doctors

Without any formal contractual means of regrading or progressing directly from the specialty doctor grade to the specialist grade, there is the risk that dedicated specialty doctors could be working at a senior level of responsibility and competence without appropriate recognition and remuneration. This also means employers have little incentive to create a senior grade post for which they could apply.

This issue has become more significant since the associate specialist grade was closed on a national basis in 2008/09, allowing the boundaries in roles and responsibilities between specialty doctors and more senior SAS doctors to become blurred​.


Demonstrating a workforce need

In creating the specialist role, the BMA and NHS Employers have focused on the requirement for employers to identify a specific workforce need. 

When an employer identifies such a need, they are expected to use their overall allocations to fund new specialist posts. The creation of new specialist posts was factored into the overall cost modelling for contract reform. This would mean opening a competitive and transparent appointment process for SAS doctors.  

If you think that you are currently working beyond your level as a specialty doctor, and should be given the opportunity to be appointed to a specialist post, here are the steps you can take: 

  • understand the differences between the specialty doctor and specialist roles
  • identify any current roles and responsibilities you share with the specialist grade
  • reassess any acting up arrangements
  • review your job plan, and dispute if necessary.

Roles and responsibilities

Each grade of doctor has distinct roles and responsibilities. By demonstrating that you are delivering activities at a specialist level, you are proving that your employer does indeed have a clear need for such a post. If you were not undertaking this senior-level work, they would need to create a post to ensure that it was being done.

We have produced a comparison table that sets out the differences between the specialty doctor, specialist and consultant roles to help you understand what roles and responsibilities should be expected of each.

What to do next

Once you have identified the aspects of your current role that you think are more closely aligned to those of the specialist grade, you should produce a document setting these out, highlighting the relevant parts of the generic capabilities framework that they relate to, and explain in detail what these activities involve.

This should be initially submitted to your line manager, with a suggestion of entering into a job plan review, but you may wish to escalate it to a more senior manager with overall responsibility for the service you deliver.

The BMA and NHSE have jointly produced a specialist grade appointment guidance for existing associate specialists on the 2008 national contract who wish to transfer to the specialist contract.

This guidance may also be useful to anyone looking to make the case that they meet the essential requirements of the grade, or that their existing role requires work that should ordinarily be expected of a specialist role.

It will assist you in reviewing the generic capabilities framework and making suggestions for how each can be demonstrated using evidence that may already available elsewhere.

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