SAS DOCTORS IN 10 YEARS TIME

Dr Ramana Alladi

ROLE OF SAS DOCTORS

Large section of Medical work force in Anaesthetics

First line cover to ITU’s and Maternity departments

On-call and out of hours work District General Hospitals

STATISTICS

RCOA CENSUS 2004Total Number of SAS doctors 1243

AAGBI Postal SurveySAS doctors 527

SAS DOCTORS

Clinical Assistants

Associate Specialists

Staff Grade Doctors

Trust Grades

Hospital Practitioners

CURRENT POSITION

30 % over 50 yrs of age 45 % between 40-50yrs of age

Large percentage will leave NHS in 10 yrs

Leaves a BIG GAP in the service

INCREASING NUMBERS

Phasing out of SHO jobs Introduction of Foundation years Training De-recognition of Registrars’ jobs in DGHs Trainee hours are cut further Consultant hours are down to 10 sessions Foundation doctors fail to get on to the run

through the grade with MMC

NEED FOR SAS IN NHS

To fulfil service needs To make up for shortage of

Consultant applicants To cope with increasing demands for

anaesthetic services

WHO JOINS SAS GRADE?

By Choice Not keen on consultant responsibilities Not keen on post-graduate exams or

failed to get through Committed to the specialty and have

experience Wish to work part time

WHO JOINS SAS GRADE?

Gap in service Too old and too experienced to join

SpR grade Not short listed Other interests in life and family

commitments

SAS SURVEY 2005 AAGBI

40 % work 13 sessions 32 % work 11 sessions

65 % do 1 in 4 weekdays on-call50 % do 1 in 4 weekends on-call

A major part of work is cover for ITU and Maternity

SAS SURVEY 2005 AAGBI

Many are performing consultant duties

70 % have post-graduate qualifications

50 % have > 10 yrs experience

43 % have English or Irish fellowships

75 % work full-time and 25 % part-time

MAIN ISSUES FACING SAS DOCTORS Wide variation in job plans with no

guidelines for sessional allocation No pathways for Career Progression No established mechanism for up-

grading from Staff grade to Associate Specialist

AMBITION FOR FUTURE

30 % - Will be in the same job

20 % - Will re-enter training programme to become a consultant

25 % - Up-grade to Associate Specialist

IMPLICATIONS

There is a need for this grade There is a need for improvement of

working conditions There is a need for incentive and

recognition of work and increasing work load

Can cause disillusion among SAS doctors

SAS ISSUES

Carrying out independent work but no independence

Work commitment is not commensurate with age, qualifications and experience

Foundation Drs fail to get on to the run through grade

Not experienced enough to qualify as Staff Grades

SUGGESTIONS

Definite guidelines on job plans specific to Anaesthetics

Establishment of career pathways for completion of CCST Supernumery jobs, day release courses, in-

job training and assessment,allocation of jobs for SAS doctors exclusively

SUGGESTIONS

Creation of a Specialist grade e.g. Europe Limited or modular accreditation to be a

specialist through assessment of competency

Increasing involvement in teaching and training

Creation of single spine with a two-tier system

Role of AAGBI and Linkman SAS Committee and representation

AAGBI Glossy on Guidelines for SAS doctors

Guidance on contractual and educational issues

Role of Linkman Encourage SAS colleagues to join the

Association Be sensitive to the needs and problems of

SAS members of the department Involve them in all the departmental

activities e.g., teaching, audit and training Identify SAS doctors that are enthusiastic

and encourage and assist to complete CCST

FUTURE

PMETB New Contracts Availability of training and training

jobs for SAS doctors Changes in accreditation Dependant on Resources!

Finally

There is a need

There is a demand

There is a pool

So the numbers will definitely increase

IN 10 YEARS !?

Two-tier structure to make career progression easierincreased moralebetter motivationbetter reward for skilled work

IN 10 YEARS !?

Work of staff grades better recognised

Foundation years trainees do not diminish the role of SAS doctors

Allow to transfer to the appropriate point for those who wish to return to training

IN 10 YEARS ?!

New ContractEnhanced status of SAS group of

doctorsImprovement in payImprovement in terms and conditionsImplementation in April 2006A national contractTackle discrimination

Thank you

Dr Ramana Alladi

19%

49%

15%

1%

16%

Yes, compulsory Yes, compulsory

Yes, non-compulsory Yes, non-compulsory

No No

Don’t know Don’t know

Not applicable Not applicable

attend divisional meetings?attend divisional meetings?Do SAS doctors in your department Do SAS doctors in your department

27%

2%

39%

16%

2%

14%

1.1. Yes, in theatre Yes, in theatre

2.2. Yes, out of Theatre (Lectures and Tutorials) Yes, out of Theatre (Lectures and Tutorials)

3.3. Yes, in and out of Theatre Yes, in and out of Theatre

4.4. No No

5.5. Don’t know Don’t know

6.6. Not applicable Not applicable

involved in teaching trainees? involved in teaching trainees? Are any of the SAS doctors in your department Are any of the SAS doctors in your department

25%

51%

24%

1.1. With Consultant cover With Consultant cover

2.2. Without Consultant cover Without Consultant cover

3.3. Not applicable Not applicable

anaesthetiseanaesthetiseDo Associate Specialists in your department Do Associate Specialists in your department