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BMA response to the Department of Health's consultation document, 'Choice and opportunity': Modernising medical careers for non-consultant career grade doctors

November 2003

• The consultation document is available on the Department of Health's website
• Read the BMA press release issued on 6 November 2003 'Improving career prospects for staff and associate specialists here.

The BMA welcomes the Department of Health’s Choice and Opportunity consultation document with its recognition of the problems currently faced by the staff and associate specialist group of doctors and dentists, and its many positive recommendations to resolve these problems. It is essential that the SAS group receives proper recognition, career progression and autonomy within defined boundaries, and we look forward to working with the Department to take this forward.

Our specific comments on the 14 recommendations are set out in the right hand menu. In addition, we would like to make the following three important points:

Principles
We support the key principles of reform set out in paragraph 10 of the consultation document, and suggest the following additional key principles:

• any new contractual arrangements resulting from this review must be agreed with the BMA and implemented nationally;
• no new non-standard grade posts (such as trust grade posts) should be created.

Implementation
The BMA’s Staff and Associate Specialists Committee (SASC) has been given delegated authority from BMA Council to negotiate for all doctors in the SAS group. We hope, therefore, that the Department will agree appropriate mechanisms with us to negotiate the practical plan set out in paragraph 17. As stated above, we welcome the proposals set out in the consultation document, but the recommendations do require more detail and discussion before finalisation. We want to work with the Department to ensure that the proposals are implemented to the benefit of doctors and their patients.

We would also welcome confirmation that we will be involved in the development of the criteria and methodology for the assessment of competencies. SAS practitioners must be involved in the assessment process itself as the BMA’s SASC has a positive contribution to make and we want to work with the Department to identify any difficulties at the earliest possible stage.

In addition, it would be helpful to receive a draft timeframe for negotiations on the new career structure and terms and conditions of service for the SAS group of doctors.

Devolution
The review should apply to all four countries, not just to England. Major differences in the structure of the new grade or its terms and conditions of service between the nations could result in the migration of practitioners across borders, potentially affecting patient care. It would also be simpler for all concerned to have a unified system. We therefore call for the negotiations to implement the reforms and the new terms and conditions of service to take place between the UK SASC and the four Health Departments. Such negotiations must commence as early as possible.