Following many years of campaigning by the BMA Northern Ireland SAS committee, the staff, associate specialist and specialty doctors leads were first appointed in each of the five Northern Ireland health trusts in 2019 with the aim of representing the branch of practice at a regional level, in stakeholder forums, and to promote integration of SAS doctors into trust leadership teams.

Since then, we have been extremely busy raising the profile of the grade and promoting greater understanding of SAS across our health trusts. SAS doctors are substantial in number – making up 25% of the medical workforce in Northern Ireland – so fostering better communication not only among SAS doctors but also to the wider workforce has been key to helping the SAS leads build development opportunities for the grade.

Once in post, we started off by conducting a regional SAS training needs survey. The results showed a stable, skilled workforce who averaged 10 years in post, and over three quarters with at least one postgraduate qualification. 

However, they were faced with a dearth of opportunity, especially in leadership, with 53% of respondents aspiring to be leaders but only 20% being in recognised positions and only 29% having had leadership training.

In the absence of the formal deanery structures that support SAS career development in the rest of the UK, we commissioned the first places for SAS staff on Proteus and Aspire leadership courses with the help of funding from the Department of Health.

We also co-produced a bespoke Regional SAS Development Programme with the DoH’s HSC Leadership Centre that we were able to deliver online as this was just as the pandemic was hitting all of our lives. 

The programme’s courses include: the Faculty of Medical Leadership and Management-accredited ‘Chrysalis’ leadership course; mentoring; human factors; quality improvement; communication and other skills mapped to the GMC generic competency framework. 

The programmes successfully culminated in ‘Share and Learn’ and alumni events over the past two years and, much to our delight, it was a finalist in the Healthcare People Management Association Awards 2022.

Over the past year, we have added to the training opportunities we have developed with the Res Consortium, offering the highly sought after Specialist Post Preparation course, and with MIAD in providing CESR ‘Train the Trainer’ negotiation and presentation skills training.

Feedback has been excellent and the opportunity to network and provide peer support has been much needed during the past two years. Approximately a third of SAS doctors in Northern Ireland have availed of training we have developed, leading to increased confidence among the grade in applying for leadership and educational posts.  These posts include Clinical Teaching Fellows for medical students, becoming an appraiser or a coach, and facilitating trainee education in the STEP leadership and QI programmes.

The SAS professional identity has also grown, with all SAS doctors regionally offered title lanyards which has highlighted the SAS grade as a career option to other clinical staff and medical students. We as SAS leads also represent the grade at senior leadership levels in the health trusts, DoH, workforce planning meetings and at the national Conference of Postgraduate Medical Deans SAS committee.

We still have more work to do to achieve parity with our colleagues in the rest of the UK. Appointment of an associate dean within the formal deanery structures in Northern Ireland would help cement our career choice as a positive step and improve accessibility of career development opportunities.

A SAS career offers many benefits, including improved work-life balance and geographical stability. Promoting this branch of practice to our newer doctors will aid recruitment and retention, provide them with the opportunity to develop a SAS career for life, and give them the option to return to traditional training at a later point.

The SAS career offers immense opportunity, but we need more of us! Modernisation of our workforce to include investment in the creation of specialist posts will enable experienced specialty doctors to perform to the top of their skillset, delivering services autonomously and complementing the multidisciplinary workforce. 

SAS advocate roles in each Northern Ireland trust to help counter the workplace and wellbeing issues identified in the GMC SAS and LED survey and a substantive associate dean appointment are all on our wish lists.

As SAS leads, we are there for you, so please reach out to us on the below contact details:

• Claire Brady – Southern Trust
• Julie Anne Forbes – Belfast Trust
• Haussam Elenin – Northern Trust
• Stephanie Warne – Western Trust
• Joanne Younge – South Eastern Trust