England has a significant SAS and locally employed (LE) workforce. According to the GMC’s workforce report 2022, there were 48,605 SAS and LE doctors in England in 2021. This workforce had grown by a third (32.5%) since 2017. SAS and LE doctors in England are more likely to be male (56%) and to be international medical graduates (58%).

Professor Wendy Reid, Executive Medical Director of Health Education England (HEE), now part of the Workforce, Training and Education Directorate of NHS England, emphasises that while HEE has had no statutory responsibility for SAS doctors, it has been committed to supporting this workforce. Its strategy for SAS doctors is set out in a document that was published with NHS Improvement, Maximising the potential: essential measures to support SAS doctors.

Wendy observes that doctors-in-training increasingly want to take time out from training after a few years, typically as locally employed doctors, often referred to as ‘F3’ or ‘CT3’. Some choose to stay at that level for a prolonged period or permanently, instead of pursuing a career as a consultant or general practitioner (GP). SAS careers offer options for these doctors, with a more focused scope of practice. She is supportive of both SAS and locally employed doctors having access to career development training: “We know that training improves patient care, we know that those in training with opportunities to learn and develop, are productive and more likely to stay in the workforce. All doctors need to feel valued and being part of a system that offers ongoing education and training is key to better healthcare.”

The integrated care boards (ICBs) offer opportunities to use the workforce differently, which could mean local employers asking their SAS doctors to lead areas of work, such as early skin cancer management within a network. Emily Newton-Dunn has carved out a surgical niche in skin cancer. Read her story.

Wendy also advocates learning from general practice. She says, “GPs have accepted this different model, and partners are not better than salaried partners, they’re just different and not valued any less. People are choosing lifestyle and autonomy over power and income.”
For more about the approach to supporting SAS doctors and dentists in England, visit: https://www.hee.nhs.uk/our-work/supporting-sas-doctors

Learn about SAS stories in England:

  • Mr Fuad Abid is an Associate Specialist in General and Vascular Surgery, in Derby, and Associate Postgraduate Dean (SAS)
  • Dr Gauri Sankhe, also in Derby, was the first SAS Advocate in England
  • Miss Sarah Grimble is a Specialty Doctor in colorectal surgery in Nottingham, who became a SAS surgeon after a lengthy career break
  • Miss Emily Newton-Dunn is a Specialist Doctor in Plastic Surgery in Plymouth
  • Mr Husam Ebeid became a Consultant Surgeon in Benign Biliary Gastrointestinal (GI) and Emergency Surgery in London, having completed the Certificate of Eligibility for Specialist Registration (CESR) process