New research highlights the contribution to the National Health Service of a hidden group of hospital doctors. The doctors, who the British Medical association says most people have never heard of, are responsible for more than one in ten operations carried out in Britain each year.The BMA is publishing a dossier today detailing the contribution to patient care of Staff Grade and Associate Specialist (SAS) doctors who, it claims, do not get the recognition they deserve. The research shows that in 2002 an SAS doctor was the senior surgeon present at more than 7,500 weekday daytime operations, or 12 per cent of the total carried out in the UK. It says the latest figures show that, excluding trainees, SAS doctors make up 49 per cent of the Accident and Emergency doctors in England and 23 per cent of the country’s surgeons.
Government figures show there are around 12,500 doctors in the SAS group. Patients cannot be referred directly to them, only to consultants and unlike junior doctors they are not in posts accredited for training. A BMA survey in 2004 found that more than half of the doctors had qualified overseas, those on full-time contracts were working an average 73-hour week, half suffered from low morale and one in five was considering retirement within five years. The BMA and the Commission for Racial Equality have also identified SAS doctors as a professional group whose careers are likely to be blocked because of discrimination.
Today’s dossier, entitled “The Hidden Heroes of the NHS: Time to recognise Staff and Associate Specialist doctors”, says the morale of the group suffers because of a lack of recognition. Mohib Khan, chairman of the BMA’s Staff and Associate Specialist Committee, says it is clear that without the doctors much of the NHS would grind to a halt. “At best patients would wait longer for their treatment, and at worse they would be denied entire services”, he writes in the dossier. They are frustrated, he says, that unlike nurses, GPs, consultants and junior doctors they are generally absent from the political and media debate about health.
The dossier features 25 SAS doctors, including Jan Knight, an associate specialist ophthalmologist in Norwich. She has introduced working practices that have helped to cut waiting times for cataract surgery from nine months to three. Another, Sue Jackson, an associate specialist dermatologist in Liverpool, says the NHS is failing to make the best use of doctors simply because Primary Care Trusts are not aware that they exist.
In a foreword to the dossier, the BMA chairman James Johnson says the doctors are often 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,” he writes.