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SASC

Background on the staff and associate specialists group.

Aims and objectives of SASC

The BMA established the Staff and Associate Specialists Committee (SASC) at its annual representative meeting in July 2002 specifically to represent the unique needs of this group of senior hospital and community doctors. SASC is made up of representatives from:

  • 12 regional English committees
  • the national committees for Scotland, Wales and Northern Ireland
  • 8 members are elected by the representative body at the BMA’s annual representative meeting 
  • a representative from the BDA 
  • observers from other BMA craft committees and the Academy of Medical Royal Colleges.

The SASC aims to:

  • improve access to training
  • promote the enormous contribution made by the SAS group of doctors to the NHS
  • address poor pay for this group and the growing pay differential between them and medical colleagues
  • support the new contract and negotiate any necessary amendments. 
  • improve opportunities for career progression
  • develop clinical independence within recognised areas of competency for doctors in the SAS group
  • develop and improve links with and influence over the Academy of Medical Royal Colleges and the PMETB
  • refine its policies on the role of competency-based assessment for SAS doctors
  • work with the Departments of Health, employers organisations and the medical royal colleges for improved career progression for the SAS group through the implementation of many of the proposals set out in Choice and Opportunity

SAS group doctors workforce

Figures as at April 2004 are: Associate Specialists 4290, Staff Grades 2101, Clinical Assistants 3165, non-standard grades 181. These figures exclude hospital dentists in SAS grades.

The title associate specialist, introduced in 1981, arose out of the medical assistant grade, which was a permanent career grade of limited responsibility created in 1964. Since 1991 an inclusive professional contract, similar to that of consultants has been in place with discretionary points replacing the performance supplement in 1996. Associate specialists are employed on contracts based on 11 notional half days per week where 1 notional half day is equivalent to 3½ hours worked flexibly. Associate specialists are senior hospital doctors specialists, technically responsible to named consultants. Research in 2001 found that 15% of associate specialists work at a similar level to that attributed to consultants.

The EC Working Time Directive limits working time to no more than an average 48 hours per week. Further information, including Minimum Entry Requirements, Appointments Procedure and Salaries, is available through the secretariat in BMA guidance notes. This grade was closed in April 2008 with regrading accepted to the 2008 with regrading accepted to the 2008 SAS contract (which included new Terms and Conditions of Service) until 1 April 2009.

The staff grade was introduced in 1988 to meet service requirements and a national ceiling on numbers limited to 10% of Consultants’ was removed in 1997 (except in Scotland) when the current contract was introduced (a significant number remain on the old contract). A session equals 4 hours and EC Working Time regulations limit work to an average of 48 hours per week (12 sessions). Staff doctors are regarded as senior hospital doctors and research has shown that 3% of Staff Grades work at a similar level to consultants. Further information, including Minimum Entry Requirements, Appointments Procedure and Salaries, is available through the secretariat in BMA guidance notes. This grade was closed in April 2008.

Clinical assistants (part-time medical officers) are appointed under aragraph 94 of the terms and conditions of service in ‘notional half day’(NHD) sessions. There are limits on the number of NHDs for which clinical assistants can be appointed – no more than 5 for non-GP clinical assistants, and no more than 9 for others. These restrictions are now very rarely enforced, resulting in full-time clinical assistants being employed in non-standard grades without clearly defined national terms and conditions of service.

Non standard grades

Many trusts have created new grades of doctors with non-standard terms and conditions of service to circumvent manpower planning mechanisms controlling the proportion of staff and associate specialist doctors within trusts, and as a result of resource pressures. Such irregular posts are not protected by national terms and conditions of service and the BMA has campaigned for many years against their use.

The speciality doctor grade was introduced on 1 April 2008 after neogtiations between the BMA and NHS Employers. It replaces the existing Associate Specialist, Staff Grade, Hospital Practitoner and Clinical Assistant (part time medical officer and part time general dental practitioner) grades. Specialty Doctors will be employed on a contract similar to that for consultants of 10 Programmed Activities. Optional points have been subsumed into the pay scale. Further information including summary documents and terns and conditions of service are available on the BMA website.

Specialist register

From 1997 it has been a legal requirement for all doctors to be on the GMC’s specialist register before they can take up a consultant post within the UK. The aim of this requirement was to allow the freedom of movement of doctors throughout the European Economic Area (EEA). Access to the specialist register has been very limited for doctors in the staff and associate specialists group under this legislation, which has now been replaced by an Order setting up the Postgraduate Medical Education and Training Board (PMETB).

The PMETB replaced the STA as the competent authority for specialist registration. The Order aimed to broaden access to the specialist register by allowing specialist medical experience and knowledge, wherever gained, to be taken into account when assessing doctors for specialist registration. This legislation provides an opportunity for SAS doctors to gain access to the specialist register via article 14. SAS doctors are advised to maintain a good logbook, get their CVs up to date and (if eligible) to apply to the PMETB.  Further advice can be sought directly from the PMETB secretariat and guidance is available on the BMA website.

New contract

SASC has pressed for new terms and conditions with new pay arrangements for SAS doctors and dentists throughout the UK since the committee was established. In January 2005 the Government gave a mandate for negotiations to start with NHS Employers. Formal Negotiations started in May 2005 and were concluded in November 2006. Read more information on the contract negotiations.

SASC key principles in forming the framework of a new contract are to:

Contacting SASC

These briefing notes are intended as a reference for SASC committee members, particularly for helping you if you are ever interviewed on SASC and its work. If you have any comments or feedback on these notes, please contact SASC at info.sasc@bma.org.uk or by writing to Hugh Townsend, Secretary SASC, BMA House, Tavistock Square, London WC1H 9JP. We are always interested to hear from you.

 

Contact

Royal Berkshire
NHS Foundation Trust
London Road
Reading
RG1 5AN

0118 322 5111