The new SAS doctor contract

Published: 24/03/2021

The College welcomes the introduction of a new specialty doctor and specialist grade contract in England and Wales. The contract is in the final stages of sign off in Northern Ireland. Scotland is awaiting a Scotland-specific contract, hopefully by the end of 2021.

The 2008 specialty doctor contract was introduced with the intention of streamlining the career structure for doctors not in training or in a consultant post. At the same time, the associate specialist contract was closed to new entrants.

The main changes are:

  • improved pay progression
  • the introduction of a new senior grade to be known as the specialist grade.

This restores an opportunity for career progression and recognition of clinical expertise and seniority, which was removed with closure of the associate specialist grade.

The 2008 contract had an 11 point pay scale that took 17 years to reach the top. The 2021 contract has a five point pay scale and the top can be reached in 12 years of starting as a new specialty doctor. This flatter pay progression is better suited to a career average pension.

Pay progression will not be automatic but will be linked to development of skills and competence. It is expected that local arrangements will be developed based upon satisfactory appraisal and job planning meetings to assess progress.

There are transitional pay arrangements for those who wish to transfer to the new contract. The deal includes a three-year funding agreement.

Progress to the new specialist grade will not be automatic. Employers will decide whether they have a need for such posts and advertise. In a competitive market for experienced anaesthetists, this will be a way for trusts and boards to attract or retain talent. It finally allows those on the pre-2008 associate specialist contract the chance to change jobs without losing recognition of their seniority.

Applicants must have a minimum of 12 years since passing their primary medical qualification and at least six years in a specialty doctor or other SAS post. Specialists will be senior clinical decision makers, able to practise autonomously. They must meet the required generic professional capabilities as well as specialty specific capabilities.

Appointment to a specialist post will involve an advisory appointments committee (AAC) process, as for consultants. At present, the College has no SAS AAC assessors. We will start with the existing consultant assessors and roll out training for SAS assessors.

Dr Lucy Williams
RCoA Council Member

Dr Ashwini Keshkamat
RCoA Council Member


Further reading:

  1. The BMA
  2. NHS Employers