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Experts seek urgent steps to reverse drop in SAS numbers

College says SAS doctors in paediatrics short by a third

Adrian O'Dowd

Wednesday, 12 June 2019

Numbers of paediatric specialty, associate specialist, and staff grade (SAS) doctors have dropped dramatically and need to increase by at least a third in order to meet demand, according to a newly published report*.

The report from the Royal College of Paediatrics and Child Health (RCPCH) says the number of SAS doctors in paediatrics has fallen steadily over time and now there are only around half (51.9%) the number of SAS doctors compared to 2001.


These senior clinicians were integral to the paediatric workforce, yet often experienced a lack of professional development or meaningful career pathway, said the college, which was likely to have contributed to the current shortage. Many SAS doctors had reported difficulties in accessing training and educational opportunities.

The report is part of a series using RCPCH workforce census data to highlight key areas of the paediatric workforce.

SAS vacancy rates were significant and higher than vacancy rates for consultants, said the college, which had calculated that the number of SAS doctors needed to increase by around a third from 645.9 whole-time equivalent (WTE) to 860.7 WTE, with the largest growth (around 185 WTE) needed in community child health.

The report recommends:

  • Health Education England, Health Education and Improvement Wales, Scottish government, and the Department of Health (NI) include SAS doctors in workforce planning
  • employers develop a career path for SAS doctors with readily available training and development
  • employers make SAS jobs more attractive and not view them as mainly to support failing rotas
  • employers and professional bodies respect doctors’ career choices whether they pursue a training or non-training route
  • Department of Health re-introduce the Associate Specialist grade so that career options and pathways are enhanced.

Dr Simon Clark, vice president for health policy at RCPCH, said: “SAS doctors are a significant and important part of the paediatric workforce and play vital roles in general paediatrics and community child health, yet many report feeling undervalued and overlooked.

“It is time we invested properly in this group of doctors and provided the support, career development, and recognition that they deserve. This will help not only the SAS doctors themselves, but the many patients that they treat.”


*2017 workforce census: focus on Specialty, Associate Specialist and Staff Grade doctors. Royal College of Paediatrics and Child Health (11 June 2019).

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