Tutors for SASG doctors why do we need them

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Tutors for SASG doctors- why do we need them?
Dr Meng Aw-Yong Staff Grade (AS) in Emergency
Medicine Medical Advisor St John
Ambulance Forensic Medical Examiner FASSGEM
President SAS Advisor to London Deanery
Frontier Project
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Objectives

• History of SAS grade
• Issues with SAS grade
• Results from surveys
• SAS tutor do we need them?
• Qualities of a SAS tutor
• A success story
• ABCDE

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Evolution SAS doctors

• Senior Clinical MO
• NCCG SG, AS
• Clinical fellows/Trust grades
• Specialty Grade
• Effects of MMC and EWTD
• Main service providers
• Workforce shortage at middle grade level
• ? Increases in SAS doctors
• Interest now due to DoH money
• Future credentialing?

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Attitudes

• Grades such as the staff grade, have been
  perceived as a threat to standards and a possible
  means of obtaining medical care on the cheap
• Thinking of taking a staff grade post? Buckley
  ,G.BMJ 7120 Volume 315 Saturday 29 November 1997
• Many of them do clinical work that is comparable
  to that of consultants and have an operational
  responsibility for their work but the majority
  of them feel frustrated about their lack of
  career progression and feel that their
  contribution to the NHS is not recognised
• (PWC, 2001).Franklin Oikelome and Geraldine
  Healy HUMAN RESOURCE MANAGEMENT JOURNAL, VOL 17
  NO 2, 2007
• At the root of all this is ..a historical lack
  of adequate workforce planning, with the
  resulting two tier system we have today
• The rise of trust doctors. Stop exploiting them
  and start rewarding their input. Cooper,N.
  Burr,W. Editorial. BMJ 20033279434

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• Why take up SAS post?

• Problems

• Exam failure
• No jobs
• Family life
• Portfolio career
• 9-5 hours no on-calls
• Clinical no management
• Did not fit

• Isolated
• Not respected by ST
• Excluded from management
• Regarded as failed consultant
• No training/funding
• Demoralised
• Bitter

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What are SAS career aims

• Total years in grade 368 years average 5.9 1
• Career aims
• EM 1 AS 2 SG 2
• CESR 38.6 34.7 28.5
• Remain 50.9 57.3 16.1
• Regrade 19.3 81.3 35.5
• TNA FRONTIER - TR
• 1 EM survey 62 doctors Meng Aw-Yong
• 2 BMA survey of SAS training and professional
  development needs I England Sep 2008 HPERU 969
  doctors

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CPD for SAS drs or not.?

• How many hours CPD are you allocated each week?
• AS 2.9 hrs SG 2.8 hrs
• 27/62 had no CPD time at al (MAY) New contract
  1SPa
• On what grounds have you been denied study leave?
  2
• Lack of cover 50.8
• Lack of funding 36.6
• Why are you not able to utilise all allocated
  CPD? 2
• Lack of time 32.4
• Not allocated time 34.1
• Workload/cover 65.9
• Lack of suitable courses 26

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Why do we need a SAS tutor?

• Heterogeneous group
• Widely varying CPD needs
• Not part of the managed trainee network
• Many out of mainstream medicine e.g audiology
• Middle grade workforce issue
• Revalidation and recertification looming
• Independent from clinical director
• Support in relation to development needs
• How and what to access?
• Obtain and protect CPD/Spa time

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Qualities required for SAS tutor

• Be aware responsive to unique/shared nature of
  SASG
• Be abreast of current issues eg MMC, Tooke
  report, credentialing
• Be able to effect change within specialty/trust
• Been there done it
• Be effective
• Be knowledgeable, understand support CESR
  process
• Pastoral support
• Close liaison with Schools and Colleges

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FASSGEM a success story

• Forum for associate specialists and staff grades
  in EM
• Started in 1997 by 2 consultants
• Organise conference annually providing 15 CPD
• Represent 500-800 members
• Incorporated into CEM structure - inclusivity
• Chair - Voting Council member CEM
• Committees - Professional standards, BMA CCSC,
  Simulation, International, Clinical
  Effectiveness, Revalidation Regional Reps
• PMETB - 5 FASSGEM reps
• Shape our future

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SAS tutor an easy guide The ABCDE approach

• A Accessible available. Time.
• Engagement is difficult
• B SAS tutor needs to belief in SAS drs and
  instill belief. Involve SAS in dept/local
  management
• Many are demoralised
• C Communication strategy, College involvement,
  CESR
• Cash DoH limited how recurrent
• D Develop personal skills teaching skills,
  leadership, portfolio
• Obtaining cover
• E Education, enthusiasm promote CPD
• Study leave SAS v ST
• F Frontier one way is it better?

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EVOLUTION OF SAS CHANGING WINDS

• There is a will to integrate SAS and other Trust
  grade doctors into a more coordinated structure
  and give them CPD, study leave and appraisal
  opportunities to provide excellent health
  services that benefit local people requires
  education to be in the middle and in the heart of
  everything that this Trust does

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• Thank you