Guidance on Consultant Appointments
Consultant Appointments must be carried out in accordance with the Scottish Government’s General Guidance on Medical & Dental Appointments
Overarching Principles for Consultant Recruitment within NHS in Scotland:
- The consultant recruitment process is owned and determined by the Health Board as the employer.
- The management of and decisions taken regarding the consultant recruitment process is the responsibility of the Health Board.
- It is recognised that externality provides a valuable contribution to the objective assessment of applicants and the role of an External Adviser is included within this consultant recruitment process
Summary Guide
Consultants carry ultimate clinical responsibility for every patient seen under their care. The public is therefore entitled to expect that all consultants will have reached the highest standards of skill and knowledge and this is guaranteed by means of a statutory appointments procedure for recruitment of consultants laid down in regulations. The regulations and supporting guidance were revised in July 2009 (The National Health Service (Appointment of Consultants) (Scotland) Regulations 2009).
While the majority of the actions within the consultant recruitment process, which were previously subject to regulation, now lie with the NHS boards who hold responsibility for the process, some key elements are still subject to regulation and remain under statutory control.
The statutory element includes the appointment of a trained External Adviser from a different NHS board as a full member of the consultant assessment panel: this is intended to ensure the clinical quality of appointed candidates is maintained. The External Adviser will have been trained in selection processes and, with experience of other appointments, can provide advice on the appointment from a different perspective than the local clinical team.
Key Roles within the Recruitment Process
Within the recruitment process it is for the recruiting Board to determine the staff and their roles within the process; however each recruitment process should include the following key roles:
The Board Lead Officer
The Board should identify a Lead Officer to manage an individual recruitment process with support from the HR department. Within the recruitment process it is anticipated that this Lead Officer will often be a medical manager or dental manager, who may, depending on the size of the Board, or the specialty involved, choose to either directly lead the recruitment process or identify who will. Other possibilities for this role include a lead clinician from within the service or the clinical service manager.
Chair
The Chair of the panel has delegated authority from the recruiting Board to make an offer of employment. This authority is contained within the regulations. Boards may choose to appoint the Lead Officer as Chair, or may alternatively choose a senior manager or non-executive director to chair the assessment panel.
External Adviser
The regulations require a single External Adviser is included on the assessment panel for consultant appointments within NHS in Scotland. The role of the External Adviser will be to advise the recruiting Board on each stage in the process, including commenting and advising on the job description, person specification, the selection methodology and participating in the selection process. This External Adviser is identified from the list of External Advisers maintained by the Academy, and must be external, i.e. not employed by the recruiting Board, and must be in the same specialty as the post being appointed to. In rare instances of small specialties it may be necessary to seek an External Adviser from out with Scotland.
The Assessment Panel
The assessment panel is convened by the Board to conduct the candidate assessment. Within this recruitment process, as the Boards determine the selection methodology for appointing to consultant posts, the Assessment Panel is also to be determined by the recruiting Board to best support and facilitate the methodology chosen to assess the suitability of candidates. This assessment may include profiling, aptitude tests or multi-station interviews. The panel must include at least one consultant from the specialty. Where possible that consultant should be from the employing Board.
Depending on the nature of the post and the extent of any undergraduate teaching or training duties the Board may include University representation on the assessment panel and requests for University representatives should be submitted to the Dean.
While there is no set limit on the size of the panel, under the regulations it remains that the panel must include a Chair, with delegated authority from the Board, an External Adviser as outlined above and one other consultant from the specialty
Planning and Advertising a Consultant Post
When recruiting to posts it is advised that the planning for a consultant appointment begins well before the post is to be filled. Consideration should be given to service needs, the amount and level of training that may be required, teaching, supervision of junior staff, continuing professional development, research and any special interests and produce a draft job description and person specification which must be sent to the External Adviser for their advice and comment.
All potential applicants should have access to the job description; the person specification; information from the board with details of arrangements for practice, e.g. units, clinics etc; details of staffing and relevant services covered; where appropriate, information about undergraduate or postgraduate medical/dental teaching; and the relevant TCS including pay. A Job Plan must also be available for the consideration of candidates for appointment to a consultant post.
We must ensure that we look to advertise details of vacant posts widely which will include the use of the NHS Scotland online job portal www.jobs.scot.nhs.uk , medicaljobs.scot.nhs.uk and where necessary other online professional job portals and journals e.g. BMJ ( British Medical Journal ) .
Eligibility for appointment and specialist register
On successful completion of specialty training, doctors are awarded a certificate of completion of training (CCT), allowing them to practice across Europe as recognised ‘specialists’. The GMC recommends CCT holders for inclusion on the specialist register, which it administers. The specialist register includes the names of all CCT holders together with those of other eligible specialists, and shows their specialty and, if requested, any particular field of expertise within it. Eligible specialists are defined as:
- European Economic Area nationals holding recognised specialist qualifications
- Overseas nationals holding specialist qualifications that are deemed equivalent to the CCT
- Doctors who have followed academic or research training paths, resulting in a level of knowledge and skill consistent with NHS consultant practice in that specialty.
From 1 January 1997 it has been a legal requirement for all doctors to be on the GMC’s specialist register before they can take up a consultant appointment.
In the case of consultant dental posts, individuals must be a registered dental practitioner or a fully registered medical practitioner. However, trainees may explore the possibility of post-CCT careers as soon as it is apparent that a CCT will be awarded in the near future. Consequently, SpRs and StRs are able to apply for a Consultant appointment provided the expected date of award of their CCT (or recognised equivalent, if outside the UK) falls no more than six months after the date of interview for the consultant post. The consultant assessment panel must also be satisfied that the applicant is sufficiently near to the completion of training to enable them to judge the applicant’s suitability for a consultant post.
Membership of the Assessment Panel
The assessment panel is convened by the appointing board to conduct the candidate assessment. This assessment may include profiling, aptitude tests or multi-station interviews. The panel must include at least one consultant from the specialty. Where possible that consultant should be from the employing board. Depending on the nature of the post and the extent of any undergraduate teaching or training duties, the board may include university representation on the assessment panel. While there is no set limit on the size of the panel, under the regulations the panel must as a minimum include a Chair, with delegated authority from the Board, an External Adviser and one other consultant from the specialty.
External Adviser
The regulations require that a single External Adviser is included on the assessment panel for consultant appointments within the NHS in Scotland. The role of the External Adviser is to advise the recruiting board on each stage in the process, including commenting and advising on the job description, person specification, the selection methodology and participating in the selection process. This External Adviser is identified from the list of External Advisers maintained by the Academy of Royal Colleges and Faculties in Scotland, and must be external i.e. not employed by the recruiting board, and must be in the same specialty as the post being appointed to. In rare instances of small specialties it may be necessary to seek an External Adviser from outside Scotland.
All newly appointed External Advisers undergo training before they are included on the adviser list, and if reappointed to the list again, should undergo refresher training.
This training is coordinated by NHS Education for Scotland and includes:
- detailed training on equality and diversity issues;
- refreshers on specialty training curricula and assessment methods used;
- updates on selection methodology and tools that have been used successfully;
- the option to shadow an External Adviser and observe the process, although it should be emphasised that observers will play no role in the recruitment process.
Process
Under the regulations, recruiting boards will appoint a Chair for the assessment panel. The Chair will hold delegated authority to offer the post on behalf of the board once the panel has considered the candidates.
Boards should draw up a policy on the use of visits as part of the employment process and communicate this policy to all applicants. Visits are intended to inform the applicant regarding the department and the requirements of the post. Depending on the nature of the post the policy on visits should look to offer applicants an opportunity to visit the department and meet with key staff. The option of a visit, and the timing of such a visit, should be determined by the board, and should be made available to all applicants at the same point in the recruitment process.
Once the assessment panel has made a decision on which candidate(s), if any, should be offered the post, the Chair and the Recruitment Service will then take responsibility for offering and contracting with successful candidates .
All members of the assessment panel hold equal responsibility for raising concerns at any stage within the recruitment process with the Chair. In these instances, it is for the Chair to assess these concerns and to determine whether or not to proceed with the recruitment process. If the decision is taken to proceed to appointment, the Chair should note the concerns raised and indicate the basis on which the decision to proceed was taken. If the Chair decides not to proceed, this decision is reported back to the board, outlining the basis on which this decision was taken. It is for the board to decide on next steps and whether to re-run the process.
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