Helmy Mashaly Mid Yorkshire Hospitals NHS Trust Introducing National Training Scheme for SAS doctors. Will it be the ultimate solution we are waiting for? Helmy Mashaly Mid Yorkshire Hospitals NHS Trust

Training: Development: is the process of learning the skills that you need for a particular job or activity. Development: is the process of growth or new information, the systematic use of scientific and technical knowledge to meet specific objectives or requirements

Introduction SAS doctors constitute a significant proportion of all NHS clinicians The issue of work recognition has been raised for a substantial period of time No practical solution has been proposed The lack of assessment of the progress of SAS doctors has led to inefficient usage of expensive resources resulting in significant financial losses Introducing a training scheme could be the foundation for progression and autonomy Such a scheme could benefit patients and NHS trusts in addition to SAS doctors

Background “What is not documented is not done” At the present time there is no documented evidence of SAS doctors individual progression The appraisal process was an important step but it is not a replacement for robust assessment and certification

Aim To highlight the importance of a training/development programme for SAS doctors To look at the financial and health care gains from applying such a scheme To assess the feedback from SAS doctors in relation to introducing training programme

WORK RECOGNITION LACK OF ASSESSMENT

Demoralisation and deskilling Lack of work recognition Demoralisation and demotivation Loss of interest De-skilling (surgical specialities)

Loss of resources for NHS Lack of assessment Under utilisation Financial loss for the trust

Survey Questionnaires were sent to SAS doctors across the Yorkshire and Humber region The questionnaire covered; the type of duties undertaken job satisfaction training received application for CESR thoughts about a formal training scheme

Questionnaires Initials /GMC no. (optional) NHS Trust How many years you have been working as SAS doctor? <5 5-10 10-20 >20 Are you satisfied with your job duties? Very satisfied Satisfied Less satisfied Do not know Are you receiving training? Yes To some degree No Are you applying for CESR? Thinking about it Successful Would recognised training would help applying for CEASR? What do you think of training scheme for SAS doctors? Very important Important Equivocal Not important

View on training scheme Results View on training scheme

Results This showed a lack of enthusiasm throughout the SAS doctors. Many doctors were dis-satisfied with the lack of training and felt pressured to undertake junior duties. Many others do not trust that there will be change to their situation

Proposed scheme 5 points in parallel to the trainees programme: SAS G1: Doctor who have the knowledge and able to demonstrate some wide basic experience in their specialty. SAS G2: Doctor who is able to show specialty skills and motivated to be subspecialised in certain area under close supervision SAS G3: Doctor who wants to advance in certain area/areas needed for day to day work and has sufficient experience to work safe under supervision SAS G4: Doctor who can work independently and are confident of their knowledge and skills but need further development of their skills SAS G5: Doctor who is able to practice at consultant’s level but need a period of supervision before starting autonomous practice

Enrolling assessment Should it be voluntary? Who would do it? Time table planning What point should SAS doctor starts How long for each stage (annual) Annual formal assessment Certificate of competence Recognition and supervision by the deaneries

NHS gains Filling senior positions for less pay Improving SAS doctors job satisfaction Maintaining high standards in patient care Improving NHS image by addressing the unfairness to SAS doctors Increased recruitment and retention of SAS doctors Improving overall patient safety

Conclusion The ultimate solution for the issues facing SAS doctors is to engage them in a recognised training/development process This will result in significant improvements for the benefit of the patients and the NHS It will benefit SAS doctors and improve their morale hence their production Considering the rising cost of litigation, training may have an impact on reducing litigation

Conclusion Successful valid outcome depends on well structured programme, transparent process and standardised assessment Completing this programme should be recommended for the application for CESR Final certification would result in productive autonomous work

References 1- University Hospital Southampton NHS Foundation Trust. SAS grade doctors, [internet] 2014 [Last updated 2016 December 28] Available on line from: http://www.uhs.nhs.uk/Education/Informationforstaff/Doctors/SAS-doctors/SASDoctors.aspx 2- BMA. 2014 UK Medical Workforce Briefing [internet] 2015 May [Last updated 2016 June 30] https://www.bma.org.uk/news/2014/january/survey-reveals-level-of-sas-doctors-autonomy 3- Health and Social Care Information Centre (2015). NHS Workforce: Summary of staff in the NHS: Results from September 2014 Census Medical and Dental, Non-Medical and GP censuses. Website. May 2015. http://www.hscic.gov.uk/catalogue/PUB16934/nhs-staf-2004-2014-over-rep.pdf https://www.collinsdictionary.com/dictionary/english/training 4- Available on line from: http://www.businessdictionary.com/definition/development.html 5- Available on line from: http://www.yourdictionary.com/development

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