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SAS DOCTORS IN 10 YEARS TIME. Dr Ramana Alladi. ROLE OF SAS DOCTORS. Large section of Medical work force in Anaesthetics First line cover to ITU’s and Maternity departments On-call and out of hours work District General Hospitals. STATISTICS. RCOA CENSUS 2004
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SAS DOCTORS IN 10 YEARS TIME Dr Ramana Alladi
ROLE OF SAS DOCTORS • Large section of Medical work force in Anaesthetics • First line cover to ITU’s and Maternity departments • On-call and out of hours work • District General Hospitals
STATISTICS • RCOA CENSUS 2004 • Total Number of SAS doctors1243 • AAGBI Postal Survey • SAS doctors527
SAS DOCTORS Trust Grades Associate Specialists Clinical Assistants Hospital Practitioners Staff Grade Doctors
CURRENT POSITION • 30 % over 50 yrs of age • 45 % between 40-50yrs of age • Large percentage will leave NHS in 10 yrs • Leaves a BIG GAP in the service
INCREASING NUMBERS • Phasing out of SHO jobs • Introduction of Foundation years Training • De-recognition of Registrars’ jobs in DGHs • Trainee hours are cut further • Consultant hours are down to 10 sessions • Foundation doctors fail to get on to the run through the grade with MMC
NEED FOR SAS IN NHS • To fulfil service needs • To make up for shortage of Consultant applicants • To cope with increasing demands for anaesthetic services
WHO JOINS SAS GRADE? • By Choice • Not keen on consultant responsibilities • Not keen on post-graduate exams or failed to get through • Committed to the specialty and have experience • Wish to work part time
WHO JOINS SAS GRADE? • Gap in service • Too old and too experienced to join SpR grade • Not short listed • Other interests in life and family commitments
SAS SURVEY 2005 AAGBI • 40 % work 13 sessions 32 % work 11 sessions • 65 % do 1 in 4 weekdays on-call 50 % do 1 in 4 weekends on-call A major part of work is cover for ITU and Maternity
SAS SURVEY 2005 AAGBI • Many are performing consultant duties • 43 % have English or Irish fellowships • 70 % have post-graduate qualifications • 50 % have > 10 yrs experience • 75 % work full-time and 25 % part-time
MAIN ISSUES FACING SAS DOCTORS • Wide variation in job plans with no guidelines for sessional allocation • No pathways for Career Progression • No established mechanism for up-grading from Staff grade to Associate Specialist
AMBITION FOR FUTURE • 30 % - Will be in the same job • 20 % - Will re-enter training programme to become a consultant • 25 % - Up-grade to Associate Specialist
IMPLICATIONS • There is a need for this grade • There is a need for improvement of working conditions • There is a need for incentive and recognition of work and increasing work load • Can cause disillusion among SAS doctors
SAS ISSUES • Carrying out independent work but no independence • Work commitment is not commensurate with age, qualifications and experience • Foundation Drs fail to get on to the run through grade • Not experienced enough to qualify as Staff Grades
SUGGESTIONS • Definite guidelines on job plans specific to Anaesthetics • Establishment of career pathways for completion of CCST • Supernumery jobs, day release courses, in-job training and assessment,allocation of jobs for SAS doctors exclusively
SUGGESTIONS • Creation of a Specialistgrade e.g. Europe • Limited or modular accreditation to be a specialist through assessment of competency • Increasing involvement in teaching and training • Creation of single spine with a two-tier system
Role of AAGBI and Linkman • SAS Committee and representation • AAGBI Glossy on Guidelines for SAS doctors • Guidance on contractual and educational issues
Role of Linkman • Encourage SAS colleagues to join the Association • Be sensitive to the needs and problems of SAS members of the department • Involve them in all the departmental activities e.g., teaching, audit and training • Identify SAS doctors that are enthusiastic and encourage and assist to complete CCST
FUTURE • PMETB • New Contracts • Availability of training and training jobs for SAS doctors • Changes in accreditation • Dependant on Resources!
Finally • There is a need • There is a demand • There is a pool • So the numbers will definitely increase
IN 10 YEARS !? • Two-tier structure to make • career progression easier • increased morale • better motivation • better reward for skilled work
IN 10 YEARS !? • Work of staff grades better recognised • Foundation years trainees do not diminish the role of SAS doctors • Allow to transfer to the appropriate point for those who wish to return to training
IN 10 YEARS ?! • New Contract • Enhanced status of SAS group of doctors • Improvement in pay • Improvement in terms and conditions • Implementation in April 2006 • A national contract • Tackle discrimination
Thank you Dr Ramana Alladi