A significant number of doctors working within psychiatry are neither consultants nor trainees. This group of staff is referred to as the Specialty Doctors and Associate Specialists (SAS) group.
In recent years an increasing number of doctors have chosen to become SAS Doctors rather than enter higher specialty training.
Due to the ever evolving demographic of the senior medical workforce and enforced national contracts, this trend may continue. SAS Doctors play a vital role in service delivery both within the NHS and private sector.
The latest Royal College of Psychiatrists census (2015) indicated that there are 1671 SAS posts nationally however vacancies exist.
The national contract in 2008 saw the closure of the Staff and Associate Specialist grade and most new appointees to this non training grade post are now titled Specialty Doctors, however some Associate Specialists remain working in posts.
SAS doctors are a diverse group with regards to their level of knowledge, clinical skills, training, performance and needs - both educational and career wise. Many SAS doctors have extensive postgraduate qualifications and are Members and Affiliate members of the College.
A significant number are working 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 Doctor, the range and scope of their clinical practice, and evidence of satisfactory practice reviewed at annual appraisal. However all Specialty doctors and Associate Specialist are still responsible to a named Consultant Psychiatrist.
Despite not being in a training grade, Specialty doctors 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).
What do SAS Doctors do?
Whilst a great portion of SAS Doctors time is directed towards patient care (clinical duties), they too may fulfil senior leadership and management roles, within their organisations as well as nationally. Additionally SAS doctors engage in the following activities:
- Teaching and training (of others)
- Research and Academic work
- Service development and modernisation
- Committee work
- Representative work
SAS Doctors working hours
Working hours can vary according to the post but a standard full-time working week will be based on a Job Plan containing ten Programmed Activities (PA). A minimum of one such PA (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:
- Continuing Professional Development
- Local clinical governance activities
- Formal teaching
- Job planning