7
Oxford PGMDE
The Department of Postgraduate Medical and Dental Education
The Triangle, Roosevelt Drive, Headington, Oxford OX3 7XP
OXFORD DEANERY SUPPORT FOR
SAS DOCTORS AND DENTISTS
BACKGROUND
In 2008 the Department of Health (DH) made available to Deaneries resources to support the further training and professional development of non-consultant career grade doctors and dentists (mainly Staff Grades and Associate Specialists, generally known as SAS Doctors and Dentists, or "SAS Grades" - SASGs). Doctors in this group are those who “have completed the equivalent of at least four years of postgraduate training and who are neither in a Deanery-approved training post nor hold a consultant appointment”. New appointees to these grades are now known as "Specialty Doctors".
The key recommendations of the guidance from NHS Employers are that:
· All specialty doctors should be employed in the spirit of the national contract.
· All specialty doctors should have appropriate clinical supervision.
· Specialty doctors should have access to a minimum of one programmed activity per week to support professional activity, for example, professional development, audit, teaching and research.
· Specialty doctors should have fair and reasonable access to study leave with appropriate funding according to the national contract.
· All employers should apply the minimum requirement of entry to the grade.
· Employers should use the professional development framework for specialty doctors.
· Employers should use the aid for employers when writing a person specification for a specialty doctor post.
· All specialty doctors should undergo an effective appraisal that:
o Ensures the specialty doctor is trained in being an appraisee
o Results in a personal development plan (PDP) with clear achievable objectives
o Identifies the appropriate professional development and study leave to support the maintenance of and development of skills in a planned way, identified through the appraisal process
o Is supported by a portfolio of evidence.
· Experienced specialty doctors should be trained as appraisers.
· Employers should make time available in senior medical staff job plans (including senior specialty doctors) to ensure effective career discussions take place with specialty doctors.
· Employers should ensure specialty doctors are legitimate participants within their professional group within the employing organisation: supported in developing as managers, leaders, trainers and researchers.
· All specialty doctors should be seen as an integral part of the clinical team.
· All specialty doctors should be aware of support networks including the process for doctors who are underperforming.
In the pages which follow, where the term "SAS doctor" appears, it should be taken to include both doctors and dentists, in the grades of Associate Specialists, Staff Grades, and Specialty Doctors (under the new contract). In the Oxford Deanery, we have elected to include those in the grades of Clinical Assistant and Hospital Practitioner, and locums in SASG posts for a duration of over 3 months, among those eligible for support. Trust Doctors, Clinical Fellows, and others in junior non-training posts are not at this time included.
The NHS has not always recognised the need for ongoing education and training for SAS doctors. It is important to recognise that an SAS doctor is often in the post because their training is incomplete. Some SAS doctors aspire to further career progression which will entail them gaining top-up training to an appropriate level. Others wish to remain in the grade, but still require continuing professional development and updating of their skills and knowledge base. This is especially relevant with the imminent introduction of revalidation. Additionally, changes to career pathways following the introduction of MMC are likely to result in greater movement between training and SAS grades in the future.
SAS doctors are experienced and senior professionals in permanent posts working within the NHS. They work across all specialties, both in clinical and non-clinical areas. By tradition they have had a high level of service commitment, but training has not usually been part of the SAS doctor's contract. All too often, continuing professional development (CPD) and Continuing Medical Education (CME) for SASGs has been ignored as well. The new and recurrent funding from the DH seeks to redress this lack, and offer career and professional development support to this important group who have been much neglected in the past.
This support might include arranging secondments to other units to learn new techniques, advising on and supporting CME for SASGs, representing their views to the Clinical Tutor/Director of Medical Education (DME) and other senior Trust personnel, providing leadership and educational support relevant to their needs, advising on further training, involvement in audit and research, and liaising with the Royal Colleges. The funds can also be used to "top-up" the Trust study leave funding to which all SAS doctors should be entitled (and which must be applied for and utilised prior to any grant being made from the SAS Development Fund), to attend courses and meetings.
STRUCTURE
In the Oxford Deanery, an Associate Postgraduate Dean, Mr. John Lourie (, or his successor after 1st. March 2012), has overall responsibility for the delivery of career and professional support for the nearly 500 SASGs working in the 11 Trusts within the Deanery. The actual provision of this support, together with funding on a basis proportional to the number of SAS doctors in each Trust, has been devolved to seven SAS Tutors, who work in the major Trusts in the Deanery (see below).
Three of the Tutors are consultants and four are Associate Specialists, and all have complete autonomy in delivering educational and professional support in whatever way is locally considered most appropriate. Within each Trust, the Tutor has formed a small sub-committee to assist with day-to-day decision-making, and dealing with applications for funding from SAS doctors. For administrative purposes the smaller Trusts in the Deanery (mainly PCTs) are amalgamated with the larger nearby Trusts, who receive a proportional per capita increase in funding allocation (including a nominal amount for administrative support).
A database of all SAS doctors in the Deanery is maintained and regularly updated by the SAS Project Officer, Linda Day, who is based in Milton Keynes. The target grades included in the listing of "SAS doctors" are Associate Specialists, Staff Grades, Clinical Assistants, Hospital Practitioners and Specialty Doctors (under the new contract).
WHO'S WHO IN THE OXFORD DEANERY SAS SUPPORT PROJECT?
John Lourie, Associate Postgraduate Dean for SAS Doctors (who is also responsible for International Medical Graduates) can be contacted at (or his successor after 1st. March 2012)
Linda Day, Project Officer, can be contacted on
The Trust SAS Tutors are:
Berkshire Healthcare NHS Trust (East and West):- Dr. Alison Stewart ()
Buckinghamshire Healthcare NHS Trust (including Stoke Mandeville and Wycombe General Hospitals):- Mr. Govindan Thirumamanivannan ()
Heatherwood and Wexham Park Hospitals NHS Trust (including Berkshire Healthcare NHS Trust (East)):- Miss Pampa Sarkar ()
Milton Keynes General Hospital NHS Trust (including Milton Keynes PCT):- Mr. Shafiul Chowdhury ()
Oxford Health NHS Foundation (formerly Oxfordshire and Buckinghamshire Mental Health) Trust (including Ridgeway Partnership and Oxfordshire PCT):- Dr. Hugh Series ()
Oxford University (formerly Radcliffe) Hospitals NHS Trust (including the John Radcliffe Hospital, Horton Hospital (Banbury), Churchill Hospital, and the Nuffield Orthopaedic Centre):- Dr. Denise Tritton ()
Royal Berkshire Hospital NHS Trust, Reading (including Berkshire Healthcare NHS Trust (West) and West Berkshire PCT):- Dr. Peter Tun ().
OUR AIMS
The goal of the Oxford Deanery SAS Doctors' Support Project is to facilitate the continuing medical education and professional development of these doctors in the ways most appropriate to their individual needs and aspirations. This will always include support to ensure SAS doctors get regular annual appraisals, which to date is by no means universal practice. Some senior SASGs will themselves develop the skills to become appraisers (as a number already have) and so contribute significantly to the educational process. We also wish to offer strong encouragement to SAS doctors to become involved at an appropriate level with management issues, and to gain the appropriate training and skills for this by attending courses, some of which are offered within the Deanery.
SAS doctors should be encouraged to participate in decision-making processes in their department, specialty group and employing organisation. They should look to develop leadership and management skills to enable them to contribute in this way at the most appropriate level.
All SAS doctors should develop a personal portfolio containing information on their activity and experience. The preparation of a portfolio and its use at the appraisal will help support the requirement of the Personal Development Plan for the next period, an important outcome of the appraisal process. This will also form an essential component of the revalidation process. Specific contents will differ with specialty. Clinics attended, procedures completed (solo and working with a consultant), teaching experience, study leave, courses and meetings attended, certificates and audits are valuable information to keep. Most Colleges will have specialty specific logbooks that could be used for part of this purpose.
We also wish to provide support to those doctors wishing to obtain the Certificate of Equivalence of Specialist Registration (CESR) or Certificate of Equivalence of General Practice Registration (CEGPR) via the Article 14 (8) or Article 11 routes respectively.
Of course, careers don't always proceed smoothly, or according to plan, and a wide range of personal and professional factors can adversely affect anyone's progress. These can include periods of mental or physical ill-health, workplace problems such as bullying or intimidation, or simply uncertainty about career progression or choice of specialty. In the Oxford Deanery we have a strong tradition of providing practical pastoral care and support through a variety of mentoring schemes, as well as career guidance and help for "doctors in difficulty" - of whatever nature. These can be accessed by SAS doctors through the Career Development Unit (CDU)(http://www.oxforddeanerycdu.org.uk), based at the Triangle, Roosevelt Drive, Headington, Oxford, via email to . Further information is also available from the Director of the CDU, Dr. John Derry ().
WHAT ARE YOUR NEEDS?
The British Medical Association (BMA) Staff and Associate Specialists Committee can be contacted on . They have produced a ‘Statement of Principles and Priorities for the Allocation of the Additional Funding for the Training and Professional Development of SAS Doctors’ (www.bma.org.uk) where further information is available. The Association also undertook a survey of SAS doctors’ training and professional development needs in England through their Staff and Associate Specialists Committee and a report was published in September 2008, which identified the five “most wanted” training opportunities identified by SAS doctors:
- Top up training (for CESR/Article 14)
- Training secondments
- Management training
- Specialist clinic or theatre placements
- Postgraduate qualifications.
A questionnaire survey undertaken in the Oxford Deanery a few months after this BMA survey produced broadly similar results.
WHAT IS AVAILABLE IN THE OXFORD DEANERY?
Support
We have 7 SAS Tutors in place, and your first contact if you are an SAS doctor seeking professional or career support or advice should be with your SAS Tutor. Quarterly meetings of the SAS Tutors and SAS Trust representatives are held in Oxford, chaired by the Associate Dean, at which plans are discussed to utilise the funding to help the professional development of SAS doctors and dentists in the Deanery.
A significant number of SAS doctors around the Deanery receive funding every year for various educational projects including courses and further training. Remember - the funding is there - come and get it!
Courses and Meetings
Educational courses are regularly organised by individual Trusts, and more are planned, both at a Deanery level, and locally. In the latter case doctors from other Trusts will usually be very welcome to attend where space is available.
The first Oxford Deanery SAS Doctors' Development Day was held in September 2009 at Milton Hill Conference Centre, near Abingdon. The themes of the meeting were Appraisals, Portfolios and Revalidation. The meeting was very well attended and attracted many positive comments. Since then, equally successful Development Days have been held in February and October 2010, and May and October 2011. The themes covered have included: gaining the CESR via Article 14, and credentialing for SAS doctors, Leadership, Management and Team-working for SAS Doctors, Mentoring and Pastoral Care, and Educational Supervision.
Some of the other courses already held or to be held shortly include:
Mentoring Skills Workshops at Wycombe General Hospital
SAS Doctors Convention at Milton Keynes Hospital
Career Progression Workshop at Wexham Park Hospital
3-day Leadership Course in Milton Keynes
Blended Learning Leadership Course at the John Radcliffe Hospital, Oxford
Mentoring Course, John Radcliffe Hospital
Educational Supervisors' Courses, and Team-Building Away-Days, at both Milton Keynes and Wycombe General Hospitals
Effective Appraisal Workshop at Wycombe General Hospital
Communication Workshop at Wycombe General Hospital
Human Factors Awareness Training Courses in all Trusts
Appraisal, Job Planning and Personal Development Plans at Milton Keynes Hospital
Appraisal for Revalidation for SAS doctors at Royal Berkshire Hospital
Doctors as Leaders; Organisational Leadership, and The Individual as Leader at Royal Berkshire Hospital
and others………
A pilot Coaching Project for SAS Doctors is also in preparation and will run during 2012, in collaboration between the Oxford and Wessex Deaneries. For further details please contact Dr. Suri Dhanoa ().
"What's On" and the OXSAS Newsletter
All the above meetings and courses are detailed in the "What's On" information sheet which is sent out regularly to all SAS Doctors on the database. Our other means of communication is the OXSAS Newsletter. Six issues of this newsletter have come out so far; if you aren't receiving this, or "What's On", it means we haven't got a functioning current email address for you, so please contact Linda Day () about this today, and tell your friends.
Other Courses and Meetings
The Oxford Deanery SAS Development Project has also contributed to several national meetings, including three meetings of the National Association of Clinical Tutors, the Inaugural Joint Royal Colleges SAS Conference, and meetings at the London and Wessex Deaneries. The Associate Dean attends the meetings of COPSAS, the grouping of Associate Deans and SAS Leads responsible for SAS Doctors' CME/CPD support around the UK (see below).