A charter which ensures Staff and Associate Specialist (SAS) doctors and dentists in Wales are properly supported in the workplace and get the recognition they deserve has been launched.
Jointly developed by the Welsh Government, BMA Cymru Wales, NHS employers, and the Welsh Deanery, the Charter set outs the rights and responsibilities of SAS doctors and dentists and their employers.
The focus is on ensuring that the huge contribution of these staff is valued and that their personal development is prioritised. It also sets out the importance of employers taking a zero tolerance approach to bullying, harassment and victimisation.
Specialty and associate specialist doctors are very highly qualified and experienced clinicians in specific areas who do not hold trainee posts.
Health Secretary, Vaughan Gething, joined representatives from the BMA and NHS employers at Keir Hardie University Health Park on the 10 August 2016 to launch the Charter.
SAS doctors make up around 20% of the NHS hospital workforce in Wales. They provide high-quality care to patients across Wales day in, day out.
We know SAS doctors are sometimes undervalued and experience a lack of support for their professional development. We want to see this change.
The Charter we are launching today will ensure these professionals are valued, that they get the get the support they need to progress in their careers, and that they can go about their work without fear of bullying or harassment.
SAS Charter for Wales
This Charter has been prepared and agreed by the SAS Reference Group, which includes NHS Wales employers, Welsh Government, BMA Cymru Wales and the Wales Deanery. It demonstrates a commitment to supporting and developing the role of the SAS doctor as a highly valued and vital part of the medical work force in Wales. It sets out both the rights and responsibilities of SAS doctors and their employers with a commitment to support and enable SAS doctors and dentists to realise their full clinical potential and to deliver the best patient care.
As senior clinicians, SAS doctors bring experienced and specialist care, possessing individual and often highly specialised skills. As they gain experience, SAS doctors will be encouraged to develop the ability to work independently and also to take on broader roles such as clinical and educational supervisors and as trained appraisers for their colleagues, including consultants.
SAS doctors must be supported in their ongoing career development and progression with recognition and support of their continuing educational and training developmental needs.
SAS doctors need support and resources to develop both personally and professionally. Employers in NHS Wales are committed to ensuring that the role of SAS doctors is fully acknowledged and respected by management, colleagues and patients. Each SAS doctor should be able to work in an environment which nurtures development within the grade and is free from harassment, bullying and discrimination. SAS Doctors should feel they are able to freely raise concerns about patient safety if they arise.
Employers in NHS Wales are committed to the following:
Appropriate Contract, Job Plan and activities
- A contract of employment which incorporates national terms and conditions.
- An appropriate agreed job plan specific and relevant to their role within the service and individual specialised skills. This can only be changed by mutual agreement between the SAS doctor and their Clinical Manager, taking into consideration any recommendations following appraisal. This should be reviewed at least annually.
- A job plan must contain appropriate SPA time for the role. The Welsh SAS Good Practice Guide recognises in the order of 20% of working time should be devoted to SPA. The 2008 SAS contract states a minimum of 1 session of SPA. This may change over time and should be reviewed as appropriate.
- Recommendations of the relevant Royal Colleges and the Academy of Medical Royal Colleges should be considered. Employers should ensure that doctors have the support needed to enable them to meet the requirements of the second threshold and can progress in their career. Threshold two requires evidence of demonstrating a contribution to a wider role which may require reassessment of the balance between Supporting Professional Activities and Direct Clinical Care duties and allocations.
- Terms such as middle grade/non consultant career grade should not be used.
- Work commitments and scheduling which recognise the importance of an appropriate balance between daytime and out of hours work depending on specialty/individual job plan.
- An annual appraisal which must address ongoing educational development and result in a personal development plan (PDP). The PDP will then inform the job plan review of any educational or developmental requirements for the following year.
- The use of fixed term and non-standard contracts should be avoided.
- A Doctor on a non-standard contract, whose role mirrors that of an SAS doctor should be considered for the Specialty Doctor contract once eligible.
- SAS doctors must be fully recognised, respected and valued by employers and colleagues. There must be zero tolerance to bulling, harassment and victimisation of SAS doctors.
- Appropriate access to resources such as office accommodation and technology to enable SAS doctors to do their jobs effectively and efficiently. This includes email, other software packages, and suitable storage facilities for confidential work. Appropriate secretarial/admin support should be provided.
- Effective induction into their role and their location including a mentoring programme for new SAS doctors.
- Appropriate IT support to ensure transparency of NHS data and provision of care as well as attribution of work to appropriate clinicians. This will include coding of patients and work activity under a SAS doctor’s name, guidance on how to code appropriately and access to this data when required.
- Access to appropriate (and individualised where available) data for appraisal & revalidation.
- Protected time for training and other professional activities for SAS doctors so that they can meet their individual, educational and career development needs.
- As per Academy of Medical Royal College Guidance on Taking Responsibility (June 2014), employers should ensure that where a SAS doctor is the clinician responsible for a patient’s care this should be appropriately displayed.
Employers will provide the following:
- Support SAS doctors in undertaking credentials or being accredited with credentials.
- Support for those SAS doctors wishing to apply for Certificate of Eligibility for Specialist Register (CESR) to identify and meet their needs and competencies. This may include the requirement for secondment for top up training which employers should fully support.
- Adequate support and time allocation to allow SAS doctors to fully participate in the employer’s annual appraisal process including access to appraisee training (and appraiser training where applicable) and the necessary CPD and study leave requirements.
- Sufficient breadth and depth of clinical work and relevant professional activities to enable the SAS doctors to achieve and maintain relevant specialist competencies and develop as clinicians.
- Accountability arrangements should be commensurate with the seniority of the practitioner. Local governance systems should consider BMA policy which supports appropriately skilled and experienced SAS doctors working autonomously. NHS Employers and the General Medical Council have confirmed that there is no contractual or regulatory impediment to SAS doctors working autonomously within defined local governance systems.
Involvement in organisational structures
- All SAS doctors should be encouraged to apply for management posts in their organisation.
- SAS doctors appointed to management posts should be remunerated appropriately. This may include a responsibility payment.
- SAS doctors should be welcome members of the Medical Staff Committee and should be encouraged to attend these and Directorate meetings.
- Access (in the same way as other colleagues) to time off for external, civic and trade union duties.
- This document sets out the joint aspirations of the parties and should be read in conjunction with the various Ts&Cs under which SAS doctors are employed.
The Ts&Cs, SAS Job Planning Guidance and the Welsh SAS Good Practice Guide can be found the on the website of the Welsh NHS Confederation for all medical staff and SAS doctors.