Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers

doi:10.1136/bmj.327.7421.961

BMJ 2003;327:961-964 (25 October), doi:10.1136/bmj.327.7421.961

Paper

Recruitment of doctors to non-standard grades in the NHS: analysis of job advertisements and survey of advertisers

Sabina Dosani, research assistant¹, Sara Schroter, senior researcher¹, Rhona MacDonald, editor, Career Focus¹, Jackie Connor, director, BMJ Careers¹

¹ BMJ, London WC1H 9JR

Correspondence to: S Dosani sdosani{at}bmj.com

Objectives To estimate the proportion of advertised non-consultanthospital posts that do not conform to nationally recognisedterms and conditions of service and to investigate why theseposts exist, who fills them, and what the doctors in such jobsdo.

Design Analysis of job advertisements and a cross sectionalsurvey of advertisers.

Setting Job advertisements in one of the leading UK publicationslisting hospital doctor vacancies (BMJ Careers).

Results Nearly a quarter of non-consultant posts advertisedin the two study periods (23% and 21%) were for non-standardgrade posts. A questionnaire was sent to the medical staffingofficer for each post. Of 430 questionnaires sent out 192 (45%)were returned. 98 trusts said they advertised non-standard gradesbecause there was no more funding from the deanery for approvedposts and 75 because service needs could not be met by doctorsin training grades. In 132 posts (69%) the post holder wouldbe required to do on-call work, and 50 advertisers (26%) requiredon-call duty for 1 in 5 or more frequently, which would conflictwith the European Working Time Directive. 131 advertisers (68%)expected the posts to be filled by doctors from outside theEuropean Economic Area.

Conclusions Non-standard grade posts are mostly being createdto meet service requirements when there is no more funding forstandard training posts and are expected to be filled by doctorsfrom overseas. Doctors in such posts can be more easily exploitedand their careers hindered. The Department of Health's annualcensus should include non-standard grade doctors.

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