RCPCH responds to GMC's SAS and LE doctors survey

The GMC today published their first survey of specialty and associate specialist and locally employed doctors. Dr Prakash Kalambettu, chair of the RCPCH’s Staff, Associate Specialist and Specialty Doctor Committee, comments on the findings.

“SAS grade and locally-employed (LE) doctors are an absolutely key part of the paediatric workforce so while it is good to see that many of the doctors in this survey see their roles as providing fulfilling careers, it is disheartening to find that so many feel underappreciated by colleagues and patients.

We know from our 2019 workforce data that paediatric rotas, which are under immense strain, are reliant on SAS doctors.

“The RCPCH data also show that 38% of community paediatricians are SAS doctors. Community paediatrics covers mental health and complex developmental disorders such as autism, which have grown in incidence and are set to rise further. Many safeguarding lead roles are filled by SAS doctors, responsible for protecting the most vulnerable children, such as those who have suffered physical or sexual abuse. Despite this, the number of SAS doctors in paediatrics has halved since 2001.

“Rudeness, bullying or undermining behaviour is unacceptable from anyone and in any workplace.  Working in an over-stretched and under-resourced health service is challenging enough without having to face this sort of treatment and it is hardly surprising that a quarter of SAS doctors and nearly a third of LE doctors reported feeling burnt out because of their work. The lack of career structure or incentives is also leading to poor morale.

“SAS and LE doctors possess a wide range of skills at different levels and support rotas at various tiers. This sometimes causes confusion to employers, staff and also to patients who are often aware of consultants and junior doctors, but not of other experienced senior doctors outside these grades.

“Paediatrics needs staff at all levels. A single medical model of trainees and consultants is unlikely to be viable in the future because of the reluctance amongst national planning bodies to increase training numbers to meet the growing demand.

“The shared commitments and guidance to support SAS doctors set out in Maximising the Potential, published by NHSI and HEE, should be incorporated and implemented in the NHS Long Term Plan in England, and the equivalent child health workforce planning strategies in Scotland, Wales and Northern Ireland.

“We call on the health departments in the four UK nations to follow recommendations from the RCPCH and others to re-introduce the Associate Specialist grade to enhance career options and pathways.”