SAS development

Group of hospital staff

Specialty and associate specialist (SAS) doctors and dentists are a diverse group with a wide range of skills, experience, and specialties.

They work as staff grade doctors, associate specialists, specialty doctors, hospital practitioners, clinical assistants, senior clinical medical officers and clinical medical officers. Ensuring that SAS doctors receive effective development benefits patient safety and employers, as well as the individual doctor. Good patient experience is strongly associated with a motivated and engaged workforce where every individual has the opportunity to work at their full potential.

Investing in development is a step to achieving that which will inevitably better equip these doctors to meet the needs of the service and improve patient care.

SAS doctor development guide

The SAS doctor development guide aims to make sure that this important group of doctors remains fit to practice and develop in their careers. The guide was updated in partnership by the British Medical Association (BMA), British Dental Association (BDA), Health Education England (HEE), the Academy of Medical Royal Colleges and NHS Employers in September 2020. This updated version includes new case studies and updated sections on continuing professional development, autonomous working and extended roles.

This guide has been updated in line with our actions to support the work of the HEE and NHS Improvement guidance Maximising the Potential: essential measures to support SAS doctors which sets out how the NHS can better recognise and support SAS doctors to continue to deliver high quality patient care. It tasks HEE and NHS provider organisations with ensuring that SAS doctors are offered development opportunities linked to service need, their experience and career aspirations.

This updated SAS development guide aims to set out in more detail the ways in which employers can help to meet this commitment. Ensuring that SAS doctors receive effective development will benefit patients, employers, and doctors.

Improving SAS appraisal guide

The Improving SAS appraisal guide aims to support employers to ensure that their SAS employees are able to engage fully with the appraisal process. It includes practical advice based on feedback, ideas and experience from SAS doctors. It also sets out the steps that employers can take to acknowledge and develop SAS doctors’ skills.

Maximising the potential: essential measures to support SAS doctors

The HEE and NHS Improvement (NHSI) March 2019 report Maximising the potential: essential measures to support SAS doctors sets out measures to give SAS doctors access to improved support and better development opportunities. SAS doctors make up 20 percent of the medical workforce but many say they lack workplace support, find it hard to move between specialties, have limited access to training and some have reported bullying.

Through implementation of the shared commitments in the report, HEE along with NHSI, NHS Employers and other partners will work together to improve opportunities for SAS doctors to advance as clinicians and leaders in healthcare, to improve the knowledge of what they do among other healthcare professionals and to promote SAS as an attractive career option.

Securing the future workforce for emergency departments in England

In October 2017, HEE, NHSI, the Royal College of Emergency Medicine (RCEM) and NHS England published a plan to ensure sustainable staffing to meet the growing demands of the future. 

Securing the future workforce for emergency departments in England aims to grow a multi-professional workforce, reduce attrition in medical training and ensure emergency departments in England are attractive places to work.


Dignity at work

Everyone deserves to be treated with dignity and respect at work. Bullying and harassment is not acceptable. A 2015 BMA survey of SAS doctors found that more than a third had experienced bullying, harassment or victimisation at work over the preceding 12 months. Read the survey findings and find out what the BMA is doing to tackle bullying and harassment on the BMA website. You can also find more helpful information on our evidence and tools pages.


Professionalism and Cultural Transformation toolkit

The Professionalism and Cultural Transformation (PACT) toolkit can be used to improve professional attitudes and behaviours in the workplace. The toolkit is based on the principles of work undertaken by Hull University Teaching Hospitals NHS Trust and is designed to support managers to embed the PACT programme in their organisation and includes practical information, advice and solutions. The toolkit encourages staff to ‘make a PaCT’ and take positive steps to improve the culture of the organisation.

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