The British Medical Association (BMA) and NHS Employers, through the joint negotiating committee for specialty and specialist doctors (JNC) (SAS), have agreed to work in partnership to support employers to appoint specialist doctors. Our aim is to support and encourage employers to make best use of the grade, which was introduced in April 2021, and to ensure the highest standards of professional medical practice in NHS employing organisations when making appointments to the grade, across NHS organisations.

It is important for employers to fully recognise the opportunities that the introduction of the new specialist grade presents. This joint statement also accords with the Academy of Royal Colleges’ (AoMRC) paper ‘SAS – a viable career choice’ (November 2021).

SAS doctors can form a significant proportion of the medical workforce in any organisation, so having a clear and sustainable career trajectory will improve retention and recruitment to the grades. A SAS career should offer flexibility to mould the role according to the needs of the individual and service itself.

Specialists are senior clinical decision makers; the role provides an opportunity for highly experienced specialty doctors to progress their careers and give them the recognition they deserve. Specialists have specific capabilities and are distinct from other medical posts, such as specialty doctor or consultant.

Specialists work autonomously and they should be seen as a solution to attrition among the medical workforce. Trusts should develop and recognise autonomous practitioners, where appropriate to do so, by their contribution to patient care, which may include data captured by clinical coding systems. During workforce planning, we strongly encourage employers to look critically at their overall clinical needs and look to create specialist posts where there is a workforce need. Recruitment into specialist posts should be via competitive entry.

It is expected most applicants will be specialty doctors, with the appropriate level of seniority and competences. However doctors in other grades who meet the role competencies and requirements can also apply. Therefore it is important that SAS grades input into the creation of specialist roles. They will be best placed to advise and detail the necessary clinical requirements due to the high level of experience gained in their primary role, especially where they are working in line with the requirements of the specialist grade.

Where an associate specialist employed under the 2008 contract fulfils the conditions required for a specialist doctor post, JNC(SAS) encourages employers to allow them to progress onto the specialist grade contract. While the appointment of these doctors does not need approval from the Colleges, independent professional medical advice has an important role to play in the ability of NHS employing organisations to make the best possible appointments to the grade See the concordat on the appointment of specialist grades for more information. JNC(SAS) is content that where the entry requirements are met, appointments can be made without the need for a formal interview process.

During negotiations, the BMA and NHS Employers fully recognised the importance of a rewarding career for SAS grades and the development of the specialist role is a very positive step in that right direction. We now look to employers to establish positions at specialist grade, which will meet a specific workforce need, embrace their SAS workforce locally and truly value the overall contribution that SAS doctors provide.

Kathy McLean 
Management side Chair of joint negotiating committee (SAS)

Rajesh Kumar
BMA Chair of joint negotiating committee (SAS)