Advisory Appointment Committees (AAC)

Planning a new or replacement consultant or specialty doctor post

The following information has been designed as a guide for trust medical staffing departments when planning appointments.

The RCP has a statutory role to play in the appointment of consultants. The Department of Health (DoH) website has useful guidance on this subject.

• NHS (Appointment of Consultants) Good Practice Guidance, January 2005

Job descriptions

Before posts are advertised medical staffing departments should send job descriptions for consultant and specialty doctor posts to their local regional office for comments/advice.

• Browse UK regions for regional office contact details.

RCP guidance on job descriptions/job plans and setting up an AAC for consultant posts

Appointment criteria

It is a legal requirement for all doctors to be on the GMC’s specialist register before they can take up a consultant appointment. Specialist registrars who have CCT dates no more than 6 months from the date of an AAC may apply and be interviewed. It is advisable that all other categories of doctors should be on the specialist register before being considered for a consultant appointment by an AAC.

Consultant job descriptions

Regional advisers must be given an opportunity to comment on draft job descriptions and selection criteria before an advertisement is placed. This is to ensure that the post contains the proper balance of clinical, academic, research and managerial activities and that there are sufficient facilities to enable these activities to be performed. Job plans should include time for CME and details of office accommodation and secretarial support.

Please refer to the following for more information:

• Checklist for consultant job descriptions  - available to download below
• Consultant physicians working with patients: the duties, responsibilities and practice of physicians, 5th edition – includes information that can help with consultant job plans.
• A guide to consultant job planning - available to download below.

The NHS Employers organisation and the British Medical Association (BMA) have worked together to produce A guide to consultant job planning. This guide emphasises the need for consultants and managers to work closely together to meet their shared responsibility of providing the best possible patient care within the resources available to them. The guidance doesn’t change any of the current features of the consultant contract or the terms and conditions, but does offer guidance so that the flexibilities contained within the contract are used effectively.

Setting up an Advisory Appointments Committee (AAC) for a consultant appointment

Once the job description has been agreed with the regional adviser the post can be advertised and an AAC set up.

The NHS (Appointment of Consultants) Regulations 1996 (amended 2004) states that an external representative from the relevant college or faculty should be included in the core membership of an AAC. Medical staffing departments should e-mail or post their requests for nominations of RCP representatives to the RCP at least 6 weeks before the AAC date together with a copy of the regional advisers approval.  A set of up to 10 nominations will be provided by e-mail and post.

Please note RCP college representatives are full members of an AAC and should be included in the short listing process. 

The 1996 Regulations do not apply to NHS foundation trusts although they can follow them if they so choose. However, the Concordat (available to download below) between the Foundation Trust Network and the Academy of Medical Royal Colleges (AOMRC) agree that independent professional medical advice has an important role to play in the ability of foundation trusts to make the best possible consultant appointments. The RCP places great importance on the advisory role provided to foundation trusts with a named AAC representative service. Please contact the RCP to take advantage of this service.

Further guidance for NHS foundation trusts on the process for approval of job descriptions and AACs is available to download below.

Specialty doctor appointments

The specialty doctor grade was introduced on 1 April 2008, and replaced the staff grade. The grade provides a secure and satisfactory career in hospital medicine for doctors who do not wish, or for various reasons are unable to complete, training for consultant status, or who do not wish to accept full consultant responsibility.

Please refer to the NHS guidance on employing and supporting specialty doctors below.

Job content

Posts should be constructed so as to appeal to UK as well as overseas graduates who desire jobs with restricted working hours and responsibility. It is advised that a detailed job description should be approved by the appropriate RCP regional adviser, with stringent attention being paid to ensure that the work is of a level commensurate with the grade; that it is within a defined specialty/subspecialty; that sessions are provided for CPD; and that it does not involve a poorly defined ‘general’ commitment.  The essential need for adequate consultant supervision is emphasised, including overseeing education and career development.

Minimum standard for entry

For a doctor to be eligible to apply for a specialty doctor post they must demonstrate that they have a minimum of four years (or equivalent) postgraduate training in the UK (or equivalent EEA training) of which a least two years training must be in the relevant specialty or a recognised equivalent training. This is defined as the successful completion of the Foundation Programme, followed by either successful completion of specialty or core training levels one and two or recognised equivalent, or being able to demonstrate achievement of the necessary equivalent competences.

Continuing professional development

Employers should ensure that doctors are able to participate fully in the continuing medical education programmes organised by medical royal colleges and professional organisations. It is important that doctors in the grade are able to maintain and develop their skills.

Consultant supervision

Practitioners are by and large, senior hospital doctors, but ultimate clinical responsibility for the patients they treat rests with the relevant consultant. Individual doctors will display a range of clinical skills that will change with time, it is important that an appropriate level of consultant supervision is provided. The degree of direct supervision will depend on a number of factors, including skills and experience. It is important that doctors know to whom they are accountable and it is essential that the consultant responsible for their work develops a mechanism for regular appraisal.

AACs

As a matter of good practice the RCP recommends that trusts appointing to this grade should include a RCP college representative on the AAC.

Please contact the RCP to request a college representative.

Academic posts with honorary consultant status

The RCP would strongly advise universities wishing to appoint to senior academic posts with honorary consultant status to seek comments/advice from RCP regional advisers on the clinical component of job descriptions. It should be noted that holders of honorary contracts cannot fill paid NHS consultant posts without fulfilling the provision of the regulations. Universities should also bear in mind the great importance attached by the profession to the inclusion of a RCP representative on AACs for senior clinical academic staff.

Further information and advice

AACs
Royal College of Physicians
11 St Andrews Place
Regent’s Park
London NW1 4LE

Email: aac@rcplondon.ac.uk