Harnessing the experience and clinical expertise of staff and associate specialist (SAS) doctors

Friday 24 January 2020

The Royal College of Radiologists (RCR) has published a new report on Harnessing the experience and expertise of staff and associate specialist (SAS) doctors.

Staff and associate specialist (SAS) doctors are vital to the delivery of healthcare in the UK. These clinicians may be leaders, managers, appraisers and clinical and educational supervisors. They provide essential contributions to multidisciplinary teams and can manage a wide range of clinical services and patients. SAS doctors are thus an integral part of the NHS, whose contribution to patient care and service continuity cannot be underestimated.

The RCR agrees with the ethos and suggested measures of the four SAS Charters and asserts that the SAS doctor role offers an attractive career path of itself. For doctors who are interested in developing a portfolio career, this grade can allow a more generalist clinical skillset, and potentially facilitate a greater diversity of roles to be undertaken.

Following the removal of the associate specialist (AS) grade in April 2008, the conditions for senior specialty doctors have deteriorated. Issues include limited options for career progression and longer periods between incremental remuneration. Understandably, this has left many SAS doctors feeling undervalued with autonomy in practice more difficult to achieve and a pernicious perception that the wider team does not appreciate their contribution.

In this context, the Secretary of State for Health and Social Care, Matt Hancock’s recent plea to the Doctors’ and Dentists’ Remuneration Board (DDRB) for SAS-grade contractual reform asserts that the new contract must be ‘one that gives valued staff a fair pay rise alongside improving recruitment and retention and developing reforms which better reflect modern working practices, service needs and fairness for employees’. The RCR is committed to fostering a collaborative culture between SAS, consultants and the wider team in clinical radiology, clinical oncology and interventional radiology to support optimum patient care in these times of NHS austerity.

The RCR and SAS doctors

Currently, there are 69 clinical radiologists and 87 clinical oncologists in SAS posts (based on 2018 RCR workforce census data). This is relatively low compared to many other specialties.
The RCR will advocate the value of the SAS role among the wider team, to support mutual respect and generate a truly collaborative culture where competency, not role, defines clinical autonomy and career development.

  • The RCR is committed to supporting the professional development of all SAS-grade doctors, including those who wish to pursue a Certificate of Eligibility for Specialist Registration (CESR).
  • The RCR will develop attractive clinical roles to increase the SAS presence in our clinical teams (such as our credential for breast clinicians).
  • The RCR will ensure the wellbeing and support work stream includes every doctor, regardless of grade.
  • The RCR will work with all four nations and arm’s length bodies to enhance and support the SAS role.
  • The RCR will engage with SAS doctors to ensure their inclusion within the wider work of the RCR.

In conclusion, the RCR fully supports the implementation of a revised contract for SAS-grade doctors if it delivers on the promise of giving greater recognition to their roles and responsibilities. We believe that enabling, nurturing and promoting SAS-grade roles as a career choice is important for all our specialties. This will benefit the whole team as well as supporting better patient outcomes.

Please see our background report on SAS doctors for more information. 

Download the report (PDF)


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