Who are SAS psychiatrists?

Over recent years, an increasing number of doctors have chosen to become SAS psychiatrists rather than enter higher specialty training. Due to the ever-evolving demographic of the senior medical workforce and changes to national contracts and training programmes, this trend may continue. SAS psychiatrists play a vital role in service delivery both within the NHS and private sector. The latest Royal College of Psychiatrists census (2025) indicated there are around 2, 222 SAS posts across the 4 nations of the UK; however, vacancies exist. 

The current national SAS contract was introduced in 2021. This added the role of Specialist to the existing Specialty Doctor contract. Previous roles such as Staff Grade and Associate Specialists have been closed to new entrants for many years now, although some staff have chosen to remain on these contracts where they were already in place. 

SAS psychiatrists are a diverse group with regards to their level of knowledge, clinical skills, training, performance and needs - both educational and career wise. Many SAS psychiatrists have extensive postgraduate qualifications and are Members or Affiliate members of the College.

Significant numbers of SAS psychiatrists work clinically at a very senior level and have the expertise and ability to take responsibility for patients themselves, without consultant supervision, under certain circumstances. These circumstances need to be considered and agreed on an individual basis.

The ability to work autonomously depends upon the training and experience of the SAS psychiatrist, the range and scope of their clinical practice, and evidence of satisfactory practice reviewed at annual appraisal. However, all Specialty and Specialist psychiatrists are still responsible to a named Consultant psychiatrist.

Despite not being in a training grade, Specialty and Specialist psychiatrists are required to actively engage in continued professional development activities (CPD) both internally and externally to their organisations, as defined by the College. Similarly to consultant psychiatrists, they are subject to annual appraisal reviews and revalidation via the General Medical Council (GMC).

Working hours can vary according to the post, but a standard full-time working week will be based on a job plan containing 10 Programmed Activities (PA). A minimum of 1.5 PAs (for a full-time doctor) should be used per week to engage in Supporting Professional Activities, as per the national SAS contract.

Such activities include participation in: