1. SAS DOCTORS IN 10 YEARS TIME Dr Ramana Alladi

2. 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

3. STATISTICS RCOA CENSUS 2004 Total Number of SAS doctors 1243 AAGBI Postal Survey SAS doctors 527

4. SAS DOCTORS Clinical Assistants Associate Specialists Staff Grade Doctors Trust Grades Hospital Practitioners

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. SAS SURVEY 2005 AAGBI Many are performing consultant duties 70 % have post-graduate qualifications 50 % have > 10 yrs experience 43 % have English or Irish fellowships 75 % work full-time and 25 % part-time

12. 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

13. 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

14. 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

15. 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

16. 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

17. SUGGESTIONS Creation of a Specialist grade 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

18. Role of AAGBI and Linkman SAS Committee and representation AAGBI Glossy on Guidelines for SAS doctors Guidance on contractual and educational issues

19. 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

20. FUTURE PMETB New Contracts Availability of training and training jobs for SAS doctors Changes in accreditation Dependant on Resources!

21. Finally There is a need There is a demand There is a pool So the numbers will definitely increase

22. IN 10 YEARS !? Two-tier structure to make career progression easier increased morale better motivation better reward for skilled work

23. 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

24. 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

25. Thank you Dr Ramana Alladi