Unfair treatment affecting many SAS and LE doctors, GMC survey

Rudeness, incivility, belittling and humiliation are among the workplace experiences faced by some doctors in Specialty and Associate Specialist (SAS) and Locally Employed (LE) roles, according to a survey by the General Medical Council (GMC).

The regulator has today (Thursday 9 January) published the initial results of its first ever survey of SAS and LE doctors – the one in six UK doctors who are not GPs, consultants nor in training roles.Many doctors see SAS and LE roles as positive choices that provide fulfilling careers. However, the GMC’s survey found that 30% of SAS doctors and 23% of their LE counterparts had been bullied, undermined or harassed at work in the last year, either by colleagues or by patients and their families.

Rudeness and incivility, and belittling and humiliation, were the most common types of undermining behaviour reported. Around one in six respondents reported suffering threatening or insulting comments or behaviour. Where bullying related to protected characteristics* was reported, race was the most commonly-cited factor.

Many doctors replied ‘no’ or ‘not sure’ when asked if they knew how to raise a concern about such treatment.

Charlie Massey, the GMC’s Chief Executive, said:

‘Doctors in SAS and LE roles are a hugely diverse group, and for many it is a positive career choice. It is unacceptable that they, or anyone, should have to experience this type of behaviour. That many of these doctors, who are so crucial to UK healthcare, are being treated this way is shocking. It must change.

‘SAS and LE doctors are a vital part of the UK’s healthcare workforce. Like all doctors they need and deserve working environments that are fully supportive, to maximise their potential to deliver good care to patients.’

The survey found that although almost all SAS and LE doctors have additional responsibilities on top of their day-to-day roles, such as training colleagues, the extra work isn’t always recognised.

A quarter of SAS doctors and nearly a third of LE doctors reported feeling burnt out because of their work.

Mr Massey added:‘Poor working relationships and a lack of support in pressured environments impacts on doctors’ health and wellbeing as well as on patient care. SAS and LE doctors may be more isolated, have less support, and may miss out on opportunities available to doctors in traditional training roles.

‘We know from the recent Fair to refer? report, by Roger Kline and Dr Doyin Atewologun, that poor support and isolation are factors in the disproportionate referrals of black and minority ethic (BME) doctors to the GMC for fitness to practise concerns. Nearly two-thirds of SAS and LE doctors are from BME backgrounds.

'We’re now working with others to explore our findings in more detail. We will use the results to help strengthen the support that is already available, and to identify where more can be done to address the issues raised.’

The GMC’s report Specialty, associate specialist and locally employed doctors survey 2019: initial findings report is available online.