Principles for progression

The principles for progression or movement through the grades are that:

• the process for progression should be fair and clear 
• the evidence required must be as objective as possible
• there should be no ‘surprises’ at any review - good employment practice is to provide employees with feedback on a continuing basis
• you should agree on the requirements well in advance of a threshold - similarly, you should provide evidence of progress towards objectives (known as outcomes in Wales) at any point in the year
• threshold progression should be discussed in appraisals and job plan reviews.

Standard progression requirements

It is expected that all SAS doctors will progress incrementally through the pay scale each year but this is not automatic. You will need to meet certain criteria before you can progress.

Under the 2021 contracts, progression follows a 'closed gateway' approach. Previously, an employer would have had to take action to prevent progression if criteria had not been met. The new approach means that the employer is obliged to actively ensure that criteria has been met and then confirm progression.

Standard progression will depend on you having:

• made every reasonable effort to meet the time and service commitments in your job plan and participated in the annual job plan review
• participated in the appraisal process in accordance with the GMC’s requirements set out in ’Good Medical Practice’
• made every reasonable effort to meet personal objectives (outcomes) in the agreed job plan
• worked towards any changes identified in the last job plan review as being needed to support achievement of joint objectives
• undertaken any additional programmed activities in accordance with schedule seven of the TCS (terms and conditions of service) and met the standards governing the relationship between private practice and NHS commitments set out in schedule 10 of the TCS (this point is not applicable in Wales)
• demonstrated yearly completion of the employing organisation’s mandatory training, or made every reasonable effort to do so where this was not achieved for reasons beyond your control
• have no formal capability processes or disciplinary sanctions live on your record.

Specialists on the 2021 contract will also need to:

• perform a full audit cycle into a chosen aspect of their personal clinical practice and demonstrate that any learning needs are being addressed
• demonstrate the ability to deliver learning to others by completing clinical or educational supervisor training and/or delivering a minimum of one educational lecture/workshop relevant to their area of practice.

Thresholds

There are two thresholds within the pay scales of the 2008 contracts for specialty doctors and associate specialists. Under the 2021 specialty doctor contract, there is only one and is aligned with the existing threshold two (see below).

Certain criteria must be met to pass the threshold and continue progression through the scale.

The purpose of the thresholds is to enable you to demonstrate the provision of continued high-quality service.

Threshold one

All doctors will pass through this threshold unless they have failed to comply with the following criteria:

• requirements for incremental progression
• undertaken 360 degree appraisal and feedback (in the year preceding threshold one). It is the responsibility of employers to enable implementation of multi-source feedback. Progression cannot be denied to the SAS doctor or dentist owing to the absence of 360 degree appraisal, if the employer has not made the process and necessary resources available.

Threshold two

While the specific criteria for progressing through threshold two are slightly different for specialty doctors and associate specialists, they both recognise the higher level of skills, experience and responsibility of those doctors working at those levels.

You will pass through threshold two if you have met the criteria for threshold one, as well as those set out below. These are not time dependent and do not all have to be achieved only in the year preceding threshold two.

You should be able to demonstrate an increasing ability to make decisions and carry responsibility without direct supervision, such as:

• involvement in management roles or team leadership
• service development and modernisation
• significant involvement in teaching and training (of others)
• significant involvement in research (where applicable)
• committee/ representative work
• innovation within their area of specialisation
• regular completion of audits to demonstrate high quality work. 

Evidence for passing through thresholds

Build a personal portfolio

Building a personal portfolio will enable you to provide an ongoing record of your achievements and development and provide evidence for you to pass through the two thresholds.

This will contain documentary evidence of work undertaken and skill development, including:

• relevant CPD (continuing professional development)
• appraisal, revalidation and job plan documents.

The portfolio can be used to gather information and evidence for movement into formal training posts or for CESR (certificate of eligibility for specialist registration) applications to the specialist register should you wish to use it in this way.

Examples of evidence

The following are examples of evidence for progressing through the thresholds.

An up to date job plan

This should include objectives from the previous year setting out requirements for progression. Objectives may include the attainment of skills for application to a formal training scheme or the application to the specialist register by means of CESR.

Up to date appraisal forms

Any documentation relating to your revalidation processes.

Decision-making

Evidence of decision-making and responsibility without immediate supervision, such as:

• records of patients seen
• operations per session
• reflective notes
• letters and communications to clinical teams
• clinic records and patient management plans
• evidence of providing cover for absent colleagues
• records of senior role in procedures, etc.

Contributions to a wider role

Evidence of contributions to a wider role within the department or nationally, such as:

• improving efficiency in clinical processes
• notes of multidisciplinary meetings or case conferences
• evidence of work as a representative
• records of development of teaching and training, such as outlines of courses or programmes.

Innovation

Evidence of innovation within an area of specialisation, including:

• records of system development
• new procedures in a particular treatment setting
• business cases and proposals.

Research

Evidence of research (if appropriate) such as:

• outlines of studies or trials
• records of involvement in ethics committees
• evidence of study planning and supervision, etc.

Meeting the criteria

If you are prevented by any action or inaction on the part of the employer and or senior colleagues from undertaking any of the threshold one or threshold criteria, you should not be prevented from moving through the threshold.

For example, if an employer has not allowed you to lead a team or there is no opportunity to lead a team, this is no indication of whether you are capable of doing so.

Mediation and appeals

You have the right to mediation and appeal processes if you take issue with an employer’s decision that you have not met the criteria for annual incremental progression, or the criteria for progression through thresholds one and two.

Mediation and appeals are also available where it has not been possible to agree a job plan, including job plan reviews and interim reviews.

Further information is available in schedule five of the terms and conditions of service.

SAS doctor development guidance

The SAS doctor development guide has been updated to include new case studies and more information on continuing professional development, autonomous working and extended roles for the SAS workforce.

The guide has been updated with our partners NHS Employers, British Dental Association, Health Education England and the Academy of Medical Royal Colleges