Intended for healthcare professionals


Work of staff grade doctors does not get proper recognition

BMJ 2006; 332 doi: (Published 16 February 2006) Cite this as: BMJ 2006;332:383
  1. Oona Mashta
  1. London

    Some hospital doctors are not getting the recognition they deserve, despite carrying out more than one in 10 of the United Kingdom's operations every year, a BMA report says.

    The BMA wants to highlight the contribution made by staff grade and associate specialist (SAS) doctors to the care of patients and the running of the NHS.

    The BMA's report found that in the UK in 2002 there were 7545 weekday daytime operations—12% of the total number carried out—in which the senior surgeon was an SAS doctor.

    The report said that this group of doctors accounts for almost half (49%) of accident and emergency doctors in England, once trainees are excluded, and around a quarter (23%) of its surgeons.

    The BMA's research shows that more than half of these doctors qualified overseas and that those with full time contracts work an average of 73 hours a week. Unlike junior doctors, however, SAS doctors are not in accredited training posts and therefore cannot advance to consultant level.

    The BMA and the Commission for Racial Equality have identified SAS doctors as a group whose careers are likely to be blocked because of discrimination.

    There are currently about 12 500 such doctors in the UK.

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    Meng Aw-Yong, a staff grade doctor, has dealt with injuries from riots at football matches

    Morale among this group of doctors has suffered because of lack of recognition by politicians, patients, and fellow medical staff alike, says the BMA's report.

    Mohib Khan, chairman of the BMA's Staff and Associate Specialist Committee, wrote: “It is clear that without SAS doctors much of the NHS would grind to a halt. At best patients would wait longer for their treatment, and at worst they would be denied entire services. Hence the frustration of the 12 500 doctors in the SAS group that—unlike nurses, GPs, consultants, and junior doctors—we are generally absent from political and media debate about health.”

    The report calls for better recognition and highlights the work of 25 doctors in the group. One is Meng Aw-Yong, a staff grade accident and emergency doctor in London and a crowd doctor for football clubs who has helped deal with the worst football riots in the country since the 1980s.

    Also featured is Jan Knight, an associate specialist ophthalmologist in Norwich, who has introduced efficient working practices that have helped her trust to cut waiting times for cataract surgery from nine months to three months.

    The BMA is currently negotiating a new contract for SAS doctors, and one of its key aims is better recognition for the group.

    In the foreword to the report the BMA's chairman, James Johnson, says: “Despite their often Herculean contribution to patient services, SAS doctors are frequently marginalised and denied the plaudits they deserve.

    “They were the last group of NHS workers to see their pay and working practices reviewed, and there still is insufficient recognition for their achievements—both within the NHS and outside. Day in day out, across the UK, SAS doctors are working phenomenally hard to keep NHS services running.”

    The Hidden Heroes of the NHS: Time to Recognise Staff Grade and Associate Specialist Doctors and the related research report are at

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