Section Handbook for College Assessors Role of …...Section Role of the College Assessor Handbook for College Assessors April 2007 35–43 Lincoln’s Inn Fields London WC2A 3PE T:

SectionRole of the College AssessorHandbook for College AssessorsApril 2007

35–43 Lincoln’s Inn FieldsLondonWC2A 3PET: 020 7405 3474 W: www.rcseng.ac.uk

Introduction from Mr Richard Collins 3

A The Role of the College Assessor 4 A1 Rolesandresponsibilities 5A2 Eligibilityandappointment 6A3 Expenses 7

B Statutory Framework 8 B1 Introduction 9B2 Thespecialistregister 11B3 Non-CCTregistration 12B4 CertificateofCompletionofTraining 13B5 Non-UKEuropeandoctors 15B6 Internationaldoctors 16

C The Appointment Process 18 C1 Jobdescription 19C2 Compositionoftheadvisoryappointmentscommittees 21C3 NominatingtheCollegeassessor 22C4 Conflictofinterest 24C5 Selectionofcandidates 25C6 Shortlisting 27C7 Thecommittee 29C8 AbsenceofCollegeassessor 30C9 Theinterview 31

D Sub-specialty Interests and Other Consultant Appointments 32D1 Sub-specialtyinterests 33D2 Seniorclinicalacademicposts 34

Appendices 36 Appendix1: Minimumtrainingcriteriaforappointmenttoa consultantpost 37Appendix2: Suggestedpersonspecifications–consultantsurgeon 39Appendix3: Exemptappointments 41Appendix4: Independentsectorappointments 44Appendix5: Listofusefulcontacts 45Appendix6: Equalityanddiversitypolicy 47

Contents Page�

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Introduction by Mr Richard Collins

Assessors are the College’s representatives on advisory appointmentcommittees(AACs)andaretheonlystatutoryexternalinfluenceonthecommittee.Their role is vital in ensuring that the standards of surgicaltrainingandservicearemaintained.

TheCollegeplacesgreatrelianceonthoseconsultantsurgeonspreparedtoactasassessorsandtheirhardworkandthetimetheydedicatetotherolearegreatlyappreciated.

I recognise that inorder tomeet localneeds, assessorsmay sometimescome under considerable pressure to appoint candidates judged to bebelowthestandardsexpectedbytheCollege.IwishtoreassureassessorsthatinsuchcircumstancestheywillreceivethefullsupportoftheCollege.

TheHandbook for College Assessorswasfirstpublishedin1999.However,sincethen,theDepartmentofHealthguidance–The National Health Service (Appointment of Consultants) Regulations 1996: Good Practice Guidance(2005)–hasbeenupdatedandthescopeofCollegeinvolvementintheappointment of consultant surgeons and specialists to posts outside oftheNHShasbeenwidened.IndependentsectorprovidersnowhavetheoptionofusingtheAACprocessfortheappointmentofconsultants.Thisdevelopmentisimportantasitisameansofmonitoringtheselectionandappointmentofmedicalpersonnelinanindustrythatisexpandingtomeetthedemandsofhealthpolicyandservicedelivery.

Theaimofthissecondeditionistoprovideanup-to-date,comprehensivereferencedocumenttohelpandadviseCollegeassessorswhenundertakingtheirrole.

IwouldliketotakethisopportunitytothankallCollegeassessorsforyourhardworkanddedicationandlookforwardtocontinuingtoworkwithyouallinthefuture.

Richard Collins FRCS Council Lead for AACs

Introduction Page�

SectionAThe Role of the College Assessor

A� Rolesandresponsibilities

A� Eligibilityandappointment

A� Expenses

SectionAThe Role of the College Assessor

A� Rolesandresponsibilities

A� Eligibilityandappointment

A� Expenses

The Role of the College Assessor Page�

A1 Roles and responsibilities

TheCollegehas,asaprimaryresponsibility, theupholdingofthehigheststandards of practice of surgery in all specialties. In order to fulfil thisresponsibility,theCouncilplacesgreatrelianceontheconsultantsurgeonsnominatedtositonAACs.

TheCollegeassessoristheonlystatutoryexternalinfluenceontheAAC.AlongwiththeothermembersoftheAAC,theassessormustensurethatthebestcandidateforthejobisappointedandthattheprocessisfairandopenwithincurrentlegislationandcurrentemploymentpractice.

Selectionmustbebasedonacandidate’sfitness,iequalifications,experienceand,whenrelevant,suitabilityasatrainer.

Itistheresponsibilityoftheassessortoensurethatonlyindividualswhoarefullytrainedareshortlistedandappointed.Thisincludesadequatetraininginanysub-specialtythat ismentionedineitherthejobadvertisementorthepostspecification.

TheroleoftheCollegeassessorparticipatinginindependentsectorAACsisgenerally identical tothat fortheNHS.Thedifferencesareoutlined inappendix4.

Page� Handbook for College Assessors

A2 Eligibility and appointment

CollegeassessorsarenormallyrecommendedbytheirrespectivespecialistassociationandareformallyappointedbytheCollegeCouncil.TheCollegemaintains lists of assessors in each specialty.Assessors will normally befellowsofthisCollege.(Onrareoccasions,wherecircumstancesprecludeaCollegeassessorfromattendingtheAAC,asubstitutemayparticipateintheAACifagreedbytheCollegeCouncilmemberresponsibleforAACs.)

Assessorsmusthavebeentrainedinfairandnon-discriminatoryinterviewingand selection techniques and have received appropriate training in theapplicationofequalopportunitieslegislationtoappointmentproceduresinlinewiththeEqualOpportunitiesCommissionandCommissionforRacialEqualitycodesofpractice.TheCollegeholdsregularequalopportunitiestraining courses, which assessors are highly recommended to attend.However,assessorscanalsoundertaketraininglocally.

AnassessormustbeanestablishedconsultantorhonoraryconsultantintheNHS.Theymusthavebeen inactivepractice foraminimumoffiveyearsandshouldnormallystanddownwhentheyretirefromactiveclinicalNHSpractice.TheCollegemayallowanassessortocontinueactinginthatcapacityforaperiodnotexceeding24monthsfollowingretirementfromtheNHS.

The National Health Service (Appointment of Consultants) Regulations: Good Practice Guidance (2005)states that theassessormustnotbeemployedbytherecruitingTrustandshouId,wherepossible,beemployedbyaTrustgeographicallydistantfromtherecruitingTrust.Inordertoensurethatthisguidanceisfollowed,theCollegewillonlyidentifyassessorsfromoutsidetheTrustandideallynotfromanimmediatelyadjacentTrusttowhichtheappointmentistobemade.

TheappointmentofassessorsiscoordinatedbytheProfessionalStandardsandRegulationDivision.

The Role of the College Assessor Page�

A3 Expenses

MembersofanAACwillbereimbursedtheirexpensesbythehealthcareorganisationholdingtheAAC,includingtravel,hotelaccommodationandother subsistence allowances, in accordance with regulations or rulesestablishedby theemployingbody. It is usual to reimburseon thebasisoffirstclassrailoreconomyairtravel.However,ratesforreimbursementand restrictionsvarybetweenhealthcareorganisations.Assessors shouldconfirm entitlements with the healthcare organisation before theAACevent.

SectionBStatutory Framework

B� Introduction

B� Thespecialistregister

B� Non-CCTregistration

B4 CertificateofCompletionofTraining

B5 Non-UKEuropeandoctors

B6 Internationaldoctors

SectionBStatutory Framework

B� Introduction

B� Thespecialistregister

B� Non-CCTregistration

B4 CertificateofCompletionofTraining

B5 Non-UKEuropeandoctors

B6 Internationaldoctors

Statutory Framework Page�

B1 Introduction

Consultant appointments are governed by The National Health Service (Appointment of Consultants) Regulations 1996andtheaccompanyingGood Practice Guidance(2005).ItisthereforealegalrequirementthatallemployingauthoritiesinEnglandandWalescomplywiththeseregulations,apartfromNHSFoundationTrustsandISTCs.The1996regulationsandsubsequentamendmentsdonotapplytoNHSFoundationTrustsorISTCsalthoughitisrecommendedbytheDHthatFoundationTrustsdofollowthem.In2005aconcordatwasdrawnupbetweentheFoundationTrustNetworkandtheAcademyofMedicalRoyalCollegestoenablethetwoorganisationstoworktogetherontheappointmentofconsultantmedicalstaff.

In late2006,anagreementbetweentheDepartmentofHealthandtheCollege established a framework for independent sector providers toparticipateintheAACprocessfortheappointmentofconsultantsurgeonsto independent sector consultantposts.Theparticipation in theprocessbytheindependentsectorprovidersisvoluntarybutitisexpectedfromaqualityassurancestandpointthattheywillutilisetheprocessandrequestCollegeparticipation.TheprocessfortheindependentsectorprovidersissimilartotheNHSprocessandthedifferencesfortheCollegeassessorareoutlinedinappendix4.

The statute states thataproperly constitutedAACmustbeheld forallconsultantappointments.It isthisAACthatthenrecommendsthenameofthedoctormostsuitablefortheappointmenttotheTrust.However,itisnormal(andacceptable)practicefortheTrusttodelegatethedecisiononappointmenttoitsrepresentativesontheAACinordertoenabledecisionstobemadespeedily.

TheTrustmayappointonlyfrompersonsrecommendedbytheAAC.Theymaynotappointanyonewhohasnotbeenfoundsuitable.Thepostisofferedtothesuccessfulcandidatesubjecttotheresultsofchecksonprofessionalqualifications,acriminalrecordcheckandhealthclearance.Anappointmentmustnotbeconfirmeduntiltheappropriatepre-appointmentcheckshavebeenmade.Ifduringthecourseoftheinterviewitbecomesapparentthatanunsuspectedchronicmedicalproblemmayexistinacandidate,itisnottheroleoftheAACtoinvestigatefurther.Thismattershouldbereferredto

Page�0 Handbook for College Assessors

theTrust’soccupationalhealthdepartmentifthecandidateisthepreferredchoiceand theappointmentof thatcandidate shouldnotbeconfirmedunlessanduntilasatisfactoryreportisobtainedfromthem.

Statutory Framework Page��

B2 The specialist register

The European Specialist Medical Qualifications Order 1995cameintoforceinJanuary1996.TheOrderimplementstheUK’sEuropeanobligationsrelatingtothetrainingofmedicalspecialistsandtothemutualrecognitionoftheirqualifications. Under these arrangements, the General Medical Council(GMC)isrequiredtomaintainandpublishthespecialistregister.ItisnowalegalrequirementforalldoctorstobeontheGMC’sspecialistregisterbeforetheycantakeupasubstantiveconsultantpost.

SpecialistregistrarsareabletoapplyforconsultantappointmentsbeforebeingadmittedtothespecialistregisterprovidedthedateoftheinterviewiswithinsixmonthsoftheirexpectedCertificateofCompletionofTraining(CCT) date.Where this occurs, it is important that College assessorscontactthe JointCommitteeonHigherSurgicalTraining(JCHST)beforetheinterviewstocheckwhetheracandidateiswithinsixmonthsoftheirexpectedCCTdate.ForfurtherdetailsseesectionB4.

Pleasenote, theOrderstates thatacandidatemustbeonthespecialistregisterbutdoesnotdefinewhichspecialtyitmustbein.ThisparadoxhasbeendrawntotheattentionoftheDH.AssessorsareadvisedtousetheirjudgementifthereareproblemsinthisareaandasktheCollegeforadvicewherenecessary.

TheGMChasahelplinethatcanbecontactedon08453573456shouldanassessorwishtocheckwhetheracandidateisincludedonthespecialistregister.ThiscanalsobecheckedthroughtheGMC’sonlinemedicalregisterontheirwebsite(http://www.gmc-uk.org/).

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B3 Non-CCT registration

In2003thegovernment issuedanewstatutory instrument(The General and Specialist Medical Practice (Education, Training and Qualifications) Order 2003),whichcreatedthePostgraduateMedicalEducationandTrainingBoard(PMETB)and reintroducedamechanism,Article14, that allowsdoctorswhoarenot inpossessionofaCCTtoapply foranevaluationof theirspecialist trainingor specialist qualifications, aswell as acquired specialistmedical experienceor knowledgewhereverobtained, todetermine if itis equivalent to aCCT in the specialty inquestion.Article14broadensthe routes through which an individual may apply and allows restrictedregistrationbasedonlimitedareasofclinicalpractice.

TheCollegeadvises thatcandidatessubject toArticle14shouldnotbeshortlistedorinterviewedforconsultantpostsinadvanceoftheoutcomeof that process. Part of the process undertaken by the College is theassessmentofthetrainingcarriedoutabroadanditsequivalencetotrainingundertaken in the UK.This is undertaken by an Intercollegiate Panel ofSpecialistAdvisoryCommitteemembersintheappropriatespecialty.Therecommendation is then forwardedtotherelevantCollege forapprovalandsubmissiontoPMETB,thestatutorybodythatformallyrecommendsinclusionontheGMC’sspecialistregister.

ItisalegalrequirementforalldoctorstobeontheGMC’sspecialistregisterbeforebeingabletotakeupaconsultantappointment.

ForinformationonArticle14.4and14.5pleasecontacttheheadofnon-CCTspecialistregistration,JCHST,on02078696256.

FormoreinformationonArticle14seethePMETBwebsite:http://www.pmetb.org.uk/


B4 Certificate of Completion of Training

Given the structured training programme and annual reviews bypostgraduatedeansviatherecordofin-trainingassessment(RITA)process,specialistregistrarswillbeawareoftheirprogressthroughthegradeandwillknowtheirexpectedprogrammecompletiondateandlikelydatefortheawardoftheCCT.Thereisnoreasonwhytraineescannotexplorethepossibilityofpost-CCTcareersassoonas it isclear thataCCTwillbeawardedinthenearfuture.

Whileitisrecognisedthatapplyingforandobtainingaconsultantpostcanbealengthyprocess,traineescannotbeinterviewedforaconsultantpostmorethansix monthsbeforetheirexpectedCCTdate.

Wherepossible, theemployingauthority should include thedateof theinterviewintheoriginaladvertisementforthepost.(SeesectionC3.)

Whenthesuccessfulcandidatewillnotberequiredtotakeupthepostwithin six months, the advertisement and the job description/personspecificationshouldmaketheplannedstartdateexplicit.

TheDH’sGuide to Specialist Registrar Training(1998)setsoutseveralreasonsfornot interviewingcandidatesmorethansixmonthsbeforetheirCCTdate:

AnAACshouldneverbeputinthepositionofhavingtoassessacandidatesignificantlyinadvanceofthecompletionoftraining.

Thosewhotrainspecialistregistrarsshouldnotbeplacedintheinvidiouspositionofassessingtheprogressoftraineeswho,whilehavingmorethansixmonthstrainingtocomplete,havesuccessfullyobtainedaconsultantappointmentontheconditionthattheycompletetraining.

Allpotentialcandidatesmustbetreatedfairlyandequitably.Seriousdifficultiesmayariseinassessingthecomparativesuitabilityforappointmentofthosewhohaveyettocompletetrainingandthosewhoarealreadyonthespecialistregister.

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Itisnotintheinterestsofemployers,traineesortheNHStomakeappointmentstotheconsultantgradesignificantlybeforetrainingiscompletedand,consequently,beforethetraineeisinapositiontotakeuppost.

SpecialistregistrarsapplyingforconsultantpostsshouldincludewiththeirCVaconfirmatorycertificatesignedbytheirpostgraduatedeangivingthedate thathasbeen issued to themby their specialist advisoryorhighersurgical training committee for the completion of training. Ultimately,theAAC must be satisfied that the applicant is sufficiently near to thecompletionoftrainingtoenabletheAACmemberstojudgetheapplicant’ssuitabilityforaconsultantpost.

The Professional Standards andRegulationDivision has suggested to allTrustmedicalstaffingdepartmentsthataspaceforspecialistregistrarstofillintheirexpectedCCTdatebeincludedonthefrontoftheirapplicationforms.

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B5 Non-UK European doctors

TheEuropeanCouncil Directive 93/16/EEC facilitates the freemovementof doctors throughout the European Economic Area (EEA) by layingdown minimum requirements for training and arrangements for mutualrecognitionof qualifications.TheDirectivedoes not stipulate thequality,quantityorcontentoftraining–onlytheduration.

TheGMCspecialistregisterhelpline(08453573456)canconfirmwhetheraEuropeancandidateisonthespecialistregisterorholdsaspecialistmedicalqualification that gives them automatic right of entry to the specialistregister.

The College advises that the person specification for a consultant postshouldstatethatclinicaltrainingandexperienceequivalenttothatrequiredforgainingaUKCCTintherelevantspecialty isessential. (Seeattachedsuggested person specification in appendix 2.) Standards set out in theintercollegiate surgical curriculum could be used to inform this process.Moreinformationisavailableathttp://www.iscp.ac.uk/.


B6 International doctors

AnAACshouldneverbeaskedtoassessthequalityoftrainingundertakenabroadbyanoverseascandidate.Theassessmentofoverseas(non-EEA)trainingand itsequivalencetoUKtraining isundertakenthroughArticle14.(SeesectionB3.)Theintercollegiateassessmentprocessensuresthataconsistentstandardisappliedtoallinternationaldoctors’applications.

InMarch2006theDHannouncedimportantchangestotheimmigrationrulesfordoctors.From3April2006internationalmedicalgraduateswhowishtoworkortrainintheNHSneedaworkpermit.Toobtainaworkpermit,anemployermustshowthatagenuinevacancyexiststhatcannotbefilledbyaUKorEEAgraduate.

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SectionCThe Appointment Process

C1 Jobdescription

C2 Compositionoftheadvisoryappointmentscommittees

C3 NominatingtheCollegeassessor

C4 Conflictofinterest

C5 Selectionofcandidates

C6 Shortlisting

C7 Thecommittee

C8 AbsenceofCollegeassessor

C9 Theinterview

SectionCThe Appointment Process

C1 Jobdescription

C2 Compositionoftheadvisoryappointmentscommittees

C3 NominatingtheCollegeassessor

C4 Conflictofinterest

C5 Selectionofcandidates

C6 Shortlisting

C7 Thecommittee

C8 AbsenceofCollegeassessor

C9 Theinterview

The Appointment Process Page��

C1 Job description

Thejobdescriptionshouldincludeanassessmentoftheserviceneedsandfuture demands of the post, including the possibility of relocationwhenservicearrangementsareunderdiscussion,togetherwithalltheinformationrelevanttothepostandselectioncriteria,whichmightincludetheminimumqualifications,trainingandexperiencerequired.Itshouldalsobeclearifthepostrequiresaconsultantwithaparticularsub-specialtyinterest.

Employingbodiesshouldalsoprepareapersonspecificationforeachpost,drawnfromthejobdescription.Theselectioncriteriashouldlistboththeessential anddesirable skills andexperienceneeded toperformthe job,includinganysub-specialtyinterest.Itshouldbenotedthatadoctorlistedonthespecialistregistermayapplyforaconsultantpost inanyspecialtyso it is important that the person specification stipulates that clinicaltrainingandexperienceequivalenttothatrequiredforgainingaUKCCTintherelevantspecialtyisessential.Asuggestedpersonspecificationforaconsultantsurgeoncanbefoundinappendix2.

Theroleoftheregionalspecialtyadviseristocommentontheprofessionalcontentofthejobdescriptioninrelationtoclinical,teachingandresearchwork.Non-professional issues (eg the availability of car parking) do notcomeundertheregionalspecialtyadviser’sremit.

Before the consultant post is advertised, the employing authority mustsendacopyofthejobdescriptionandpersonspecificationtotherelevantregional specialty adviser for approval, with a further copy to the deanery adviser/regional adviser for information.The regionalspecialtyadvisermaywish toconsultwith theappropriate regional sub-specialtynominatedrepresentatives(advisers).Thisistoensurethatthepostcontainstheproperbalanceofclinical,academicandmanagerialactivitiesandthattherearesufficientfacilitiestoenabletheseactivitiestobecarriedout.Theregionalspecialtyadvisershouldbeaskedtocommentonthejobdescriptionandselectioncriteria,inwriting,within three weeks of its receipt. Failure to respond followingconfirmationof receiptof the jobdescriptionwillbeinterpretedasagreement.Iftheregionalspecialtyadviserisduetobeonleaveforasubstantialperiod,arrangementsshouldbemadeforthejobdescriptionstobeconsideredbythedeaneryadviser/regionaladviseroranotherregionalspecialtyadviserinthesamespecialtybutfromaneighbouringregion.


Iftheregionalspecialtyadviserhasdoubtswithregardtothejobdescription,theirconcernsshouldbediscussedwiththemedicaldirectoroftheTrustorindependentsectorproviders.ThismustbedonewithinthreeweeksofreceiptofthejobdescriptionforTrustsorwithinoneweekforindependentsectorproviders.Shoulddifferencesofopinionpersist,theregionalspecialtyadvisershouldrefertheproblemasamatterofurgencytotheCollegeandinform the employing body. In such circumstances, the president of theCollege,ornominateddeputy,shouldrespondwithinthreeweeksandseekan agreed solution.To make the appointment process as fast as possible, it is important that regional specialty advisers respond promptly to requests for approval and deal with any difficulties within the agreed time frame.

Oncetheemployingauthorityhasreceivedtheregionalspecialtyadviser’sapproval, it should send a copyof the jobdescription and the letterofapprovalfromtheregionalspecialtyadvisertogetherwithaformalrequestto the Professional Standards and Regulation Division, which will thenproceedwithnominatingsuitableassessorsfortheAAC.

Onceappointed,theCollegeassessorshouldcontacttheregionalspecialtyadviserforacopyoftheapprovedjobdescription.

Whenagreementhasbeenreachedonthejobdescription,itshouldnotbechanged,norchallengedattheAACbyanymemberofthecommitteeunlessanobviouserrorhasbeenmadeand incorrect informationgivento candidates, or if it appears that it could lead to unlawful indirectdiscrimination.

Ifbyamendingthejobdescriptiontocorrectanerrororanoversightthecontentorbalanceofthepostchanges,theprocessshouldbesuspendedandthe jobdescriptionshouldbere-submittedto theregional specialtyadviserforfurtherapproval.Ifthechangeissignificantthenthepostmayhavetobere-advertised.

TheAACcantakeplace12monthsormoreafterthejobdescriptionhasbeenapproved. Iftheconsultantposthasnotbeenadvertisedwithin12monthsof the jobdescriptionapproval, theTrustor independentsectorprovidermustseekapprovalfromtheregionalspecialtyadviseragain.


C2 Composition of the advisory appointments committees

ThecorecompositionofanAACisgovernedbystatute,whichstatesthatthecommitteeshallcompriseagroupoffivemembers.Theseare:

alaymember(normallythechairmanoftheemployingbodyoranothernon-executivedirector);

theCollegeassessor;

thechiefexecutiveoftheemployingbody(oranominateddeputy);

themedicaldirectoroftheemployingbody(oramedicallyqualifiednominateddeputy);and

aconsultant,normallyfromtherelevantspecialty,fromtheemployingbody.

AnAACmaynotproceedifaquorumisnotestablishedorthereisnota local medical majority. A quorum consists of the core membership.TheCollegeassessorscanthereforeterminateproceedingsbyabsentingthemselves.This does not apply to independent sector providers. (Seeappendix4.)

Employingauthoritiesarefreetoaddadditionalmembersprovidedthereremains a local medical majority and the size of theAAC is kept to aminimum.

UniversityrepresentativesarenolongernecessarilypartofanAAC,exceptwheretheappointmentistoapostthatinvolveseithersubstantialteachingorresearchcommitmentsorboth.

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C3 Nominating the College assessor

The employing authority must contact the Professional Standards andRegulationDivision at least eightweeks before the dateof theAAC inorder to requestanassessor to represent theCollegeat theAAC.Thisperiodofnoticeisessentialtoensurethatthemostsuitableassessormaybenominatedandthattheywillbeavailable.

WhiletheNHSGood Practice Guidance(2005)suggeststhatthedateoftheinterviewshouldbeincludedintheadvertisement,primarilyasanaidtospecialistregistrarswhocanthengaugewhethertheinterviewswillbeheldwithinsixmonthsoftheirCCTdate,medicalstaffingdepartmentsshouldbeawarethatbysettingadateforinterviewtheymayexcludesomeassessorswhowillfinditdifficulttore-arrangepreviousclinicalcommitments.

The College suggests that medical departments indicate the week inwhichtheyexpecttheinterviewstotakeplace.Thiswouldalleviatesomeof the problems that have been encountered in identifying an assessor,particularlyinsomeofthesmallerspecialties.IftheTrustorindependentsectorprovider isableto informtheCollegeof theproposed interviewdate before the job description has received approval, the College willendeavourtoallocateanassessorandthenamewillbereleasedoncetheapprovalhasbeenreceived.

OncetheProfessionalStandardsandRegulationDivisionhasreceivedtherequesttogetherwiththejobdescriptionandtheregionalspecialtyadviser’sapprovalletter,thedepartmentwillproducealistofpossibleassessorsfromthedatabase.IftheTrusthasgivenatleasteightweeksnoticeoftheAAC,theProfessionalStandardsandRegulationDivisionwillattempttosecurean available assessor. If theTrust hasprovided thedepartmentwith lessthaneightweeksnotice,theTrustwillbeprovidedwithalistofassessorstocontactthemselves.

Whileeveryendeavourwillbemadetofindasuitablesub-specialtyassessor,insomecircumstancesconsiderationmightbegiventoassessorsoutsidethesub-specialty.

InordertoensurethattheNHSGood Practice Guidance(2005)isfollowedandthatassessorsareappointedwhoaregeographicallydistantfromthe


Trustmakingtheappointment,theCollegewillonlyidentifyassessorsfromoutside theTrust and ideally not from an immediately adjacentTrust towhichtheappointmentistobemade.


C4 Conflict of interest

It is inevitable that a College assessor will occasionally find themselvesrequiredtodecideontheapplicationofacandidatewhoisknowntothemandforwhomtheymayhaveevenprovidedareference.

In these circumstances, the assessor should declare their knowledgeor interest so thatothermembersof thecommitteemay take this intoaccount.Theassessormustbecarefulnot to showbias. In theeventofcloserpersonalties,anassessorshouldasktobeexcusedfromservingandanalternativeassessorshouldbesought.

Canvassingforsupportofanyapplicantforaconsultantpostisprohibited.


C5 Selection of candidates

MembersoftheAACwillbesentallapplicationsreceivedbytheemployingauthority togetherwith the jobdescriptionandselectioncriteria shortlyaftertheadvertisedclosingdate.Theremustbeareasonableexplanationforanyapplicationsreceivedaftertheclosingdate.

Applicantsshouldbeaskedtocompleteastandardapplicationformsothatbasicinformationisavailabletocommitteemembersinastandardformat.ThisdoesnotprecludesubmissionofapersonalCVandtheCollegewouldexpect that aCV for all candidateswouldbe available for the selectionprocess.

Theshortlistingprocessmustbecarriedout,evenifthereareonlyasmallnumberofcandidates.ItisessentialthattheCollegeassessortakespartintheshortlistingprocess.IndependentsectorprovidersmaychoosenottoinvolvetheCollegeassessorintheshortlistingprocess.(Seeappendix4.)

Inordertobeshortlisted,acandidatemustappearontheGMC’sspecialistregister or the date of the interviewmust bewithin sixmonths of thecandidate’sexpectedCCTdate.It should be noted that appearance on the specialist register does not necessarily mean that a candidate is suitable for shortlisting.

Applicantsorprospective applicants shouldbe able to visit the relevantunitandmeetsomeoftheirprospectivecolleaguesbeforetheAACholdsitsinterview.Theopportunitytomakesuchvisitsshouldbedrawntotheattentionofthecandidates,whoshouldbeprovidedwithalistofrelevantcontacts suchas themedicaldirector, chiefexecutiveandotherofficers.However, thestatusofsuchvisitsshouldbemadeclear toapplicantsorprospectiveapplicantsandnoofferorpromiseofsuccessintheapplicationshouldbemade.Suchvisitsformnopartintheselectionprocess.

Since January1997 ithasbeena legalrequirementforalldoctorstobeontheGMC’sspecialistregisterbeforetakingupaconsultantpost.(SeesectionB2.)


Thecommitteeandcandidates shouldbe fullyawareof theprocess forselection and interview. Where the employer wishes to use selectiontechniquesinadditiontointerview,allAACmembersshouldbeinformedinadvanceandbeappropriatelyskilledinusingthesetechniques.


C6 Shortlisting

Each member of the committee, including the lay member, should beinvolved in the shortlisting process by assessing candidates against theperson specification.All members of the committee have equal say inboth shortlistinganddeterminationof suitability.ThechairmanandchiefexecutivesofTrustsdonothave thepowerof vetoover shortlistingorrecommendations made by members of theAAC on the suitability ofcandidates for appointment as consultants.The chairman should ensurethatallmembersofthecommitteearecontentwiththeshortlist.

It is important that shortlisting does not take place until the CollegeassessorhasbeenappointedtositontheAACatanagreeddate.(Fortheindependentsector,seeappendix4.)

Inordertoovercomedifficultiesofscheduling,theAACchairmanmaywishtoconsidersettingupateleconferenceduringwhichshortlistingmighttakeplace.

Whenshortlisting,thechairmantakesintoaccounttheviewsexpressedbyallmembersofthecommitteetodeterminesuitability.TheadviceoftheCollegeassessorismostimportantatthisstageastheycanadvisewhetherdoctorsstillinspecialistregistrarpostsarelikelytobeawardedtheirCCTwithinthefollowingsix-monthperiod.Theyarealsoparticularlyfittedtojudgewhether the applicant has appropriate experience commensuratewiththerequirementsofthepost.

IftheTrustinsistsonshortlistingacandidatewhotheassessorhasdeemedaslackingthenecessaryqualificationsforappointment,theassessorshoulddiscussthiswiththemedicaldirectoroftheTrustandinformtheCollege.Iftheproblempersists,adviceshouldbesoughtfromtheCollege.

The assessormay feel it is appropriate to contact the regional specialtyadviserand/ortheCollegeifthereareconcernsaboutthejobdescriptionortheappointmentprocess.

InordertocheckwhetheraspecialistregistrariswithinsixmonthsoftheirexpectedCCTdate,theassessorshouldcontacttheappropriateSpecialistAdvisoryCommittee(SAC)officethroughtheJCHST.


Candidatesforpoststhatrequireaparticularsub-specialtyinterestshouldonlybeshortlisted if theyhavebeentrainedatanadvanced level inthesub-specialty.

IftheCollegeassessorconsidersthatacandidateisnotsuitablytrainedforthepost,theymustinformtheTrustandtheCollegeinwriting.


C7 The committee

The function of theAAC is to decide which, if any, of the applicants issuitable for appointment and to recommend a name or names to theemployingbody.Theoverridingaim is toensure that thebestcandidateforthe job isappointed,thattheprocess is fairandopenwithincurrentlegislationonemploymentpracticeandthatthecandidateisfullytrainedforthepost.TheAACmaynotrecommendforappointmentacandidatewhomithasnotinterviewed.Exceptionally,candidatesmaybeinterviewedbyvideo-oraudio-linkwhentheycannotbephysicallypresent.However,acandidateinterviewedinthiswaymustnotbegivenanunfairadvantageordisadvantageoveracandidateinterviewedface-to-faceanditisimportantthattheAACissatisfiedastothecandidate’sidentity.

AACsshouldalwaysmakeaclearrecommendationofthemostappropriatecandidate.Intheeventofanequalityofvotes,thechairmanshallnothaveanysecondorcastingvoteandnoapplicantshallbeconsideredsuitableforappointmentunlessamajorityofthecommitteeconsidersthemtobeso.Therecommendationdoesnot,however,needtobeunanimousandnomemberoftheAAChasarighttovetoanappointment.

Selectionmustbebasedsolelyonthecandidate’sfitness,iequalifications,experienceandotherqualitiessetoutinthepersonspecificationforthepost.MembersoftheAACshouldmakecontemporaneousnotesoftheproceedingsandthereasonsforacceptingorrejectingcandidates.Individualmembersofthecommitteecanbequestionedbythecourtsofemploymenttribunals (who may order the production of contemporaneous notes)aboutthereasonwhyaparticularcandidatewasacceptedorrejected.Inanyothercontexttheproceedingsofthecommitteeareconfidential.

If an unsuccessful candidate seeks feedback on the reasons for non-appointment, they should be advised to contact the chairman of thecommittee.


C8 Absence of College assessor

IfanappointedassessorbecomesawarebeforeanAACthattheywillbeunable to attend for reasons outside their control, ie sickness or courtattendance, the assessor should contact the Professional Standards andRegulationDivisionattheearliestopportunity.(Fortheindependentsector,seeappendix4.)

Ifpossible,theassessorshouldinformtheCollegeofadeputytoundertakethe role of assessor on their behalf.Where an assessor is not able toidentifyareplacement,theProfessionalStandardsandRegulationDivisionwillattempttoidentifyareplacement.Ifthisdoesnotprovepossible,theAACwillhavetobedeferred.

In theevent that an assessor is taken ill on thedayof anAACor is insome other way prevented from attending, the Professional StandardsandRegulationDivisionwillseekdetailsoftheremainingmembersoftheAACwithaviewtoidentifyinganothermemberofthealreadyconvenedappointmentspanelwhomightundertaketheroleofassessoronbehalfof the College and who might safeguard the College’s interest in theappointment. It may also be possible that the regional specialty advisercouldactastheCollegeassessorinthisinstance.

IfitisnotpossibletoidentifyanothermemberoftheAACtoundertakethistaskandanotherindividualsuitabletotheCollegecannotbeidentifiedlocally,theAACwillhavetobedeferred.

It may be necessary to appoint an individual who is not geographicallydistantfromthepostasassessor.

Eventssuchasthosedescribedaboveshouldhappenonveryrareoccasions.Each casewill be consideredon itsownmerits and adecision taken inconsultationwiththeCouncil leadforAACsastothemostappropriatewaytoprogress.


C9 The interview

ItisimportanttoestablishattheoutsetwhetherthecommitteeisactingasanAACforlaterformalappointmentbytheemployingauthorityorasanappointmentscommitteewiththepowertomaketheappointmentatthetime.

Ifthecommitteeisactingasanappointmentscommitteeand,intheopinionoftheCollegeassessor,itappearsthatanappointmentisabouttobemadeof a candidate who does not meet the standards expected and to besafeguardedbytheCollege,thentheassessorcanpreventtheappointmentonly by leaving the committee before a decision is made, so renderingthecommitteenon-quorateandinvalid.(Fortheindependentsector,seeappendix4.)

If an unsuitably trained candidate for the advertised post is called forinterview the assessor should inform the chairmanof their reservationspriortothe interview. If the interviewstillproceeds,theassessorshouldleave the committee before a decision is reached and so prevent anyappointmenttakingplace.

In addition, if at interview information becomes available that was notavailablebefore,theassessorshouldinformthechairmanthattheinterviewshouldnotcontinue.

Incasessuchasthese,theCollegeassessorshouldwrite immediatelytothepresidentoftheCollege,thechairmanoftheAAC,thechairmanoftherelevantTrustorhealthauthorityandthechiefexecutiveoftherelevantTrustorhealthauthoritytoexplainwhattranspired.

IftheCollegeassessorconsidersthatacandidateisnotsuitablytrainedforthepost,theymustinformtheTrustandtheCollegeinwriting.

SectionDSub-specialty Interests and Other Consultant Appointments

D1 Sub-specialtyinterests

D2 Seniorclinicalacademicposts

SectionDSub-specialty Interests and Other Consultant Appointments

D1 Sub-specialtyinterests

D2 Seniorclinicalacademicposts

Sub-specialty Interests and Other Consultant Appointments Page��

D1 Sub-specialty interests

Posts that require a consultant with a particular sub-specialty interestshouldmakeclear that requirement inboth the jobdescriptionandtheadvertisementforthepost.

Candidates applying for thepost shouldonlybe shortlisted if theyhavebeentrainedatanadvancedlevelinthesub-specialty.

Trustsmaybevulnerable to litigation fromcandidatesdiscouraged fromapplyingifacandidateisappointedwithadeclaredinterestinasub-specialtythatdiffersfromthesub-specialtyofthepostadvertised.


D2 Senior clinical academic posts

ThearrangementsforhonorarycontractsareexemptfromtheregulationsrelatingtoAACs.However,theCollegewillonlyrecogniseaconsultantasatrainer(includingseniorclinicalacademicposts)ifaCollegeassessorhasbeenamemberoftheappointmentscommitteeandhasagreedthattheindividualissuitableasatrainer,andtheCollege’sregionalspecialtyadviserhasapprovedthejobdescription.

It isthelegalrequirementfortheproposedholderofanhonoraryNHScontract to be on the specialist register, paid or unpaid.Onoccasion, auniversitymaywishtointerviewcandidatesfromoverseaswhoarenotonthespecialistregisterforaseniorclinicalacademicappointment. Inthesecircumstances,acandidatemaybeinterviewedandanoffermadewhichissubjecttothedoctorgainingentrytothespecialistregister.Theuniversityandthecandidatemustbeclearthatanhonorary(unpaid)NHSconsultantcontract cannot be issued until the candidate has been enteredon thespecialist register.Providing theappointment ismadeunderaprocedureanalogous to that for hospital consultants, an additionalAACprocedurewillnotbeneededwhenthehonorarycontractisawarded.Ifthehonorarycontract is tobepaidby theTrust, a secondAACproceduremust takeplace.Exemptionmaybesought fromtheSecretaryofState forHealthfollowingapplicationtotheNHSExecutiveunderregulation5(1)(g)ofThe National Health Service (Appointment of Consultants) Regulations 1996.

Universities are advised to seek legal advicewhenmaking a conditionaloffertoacandidatewhomustobtainentrytothespecialistregisterbeforetheycantakeuptheappointment.Theuniversityandthecandidatemustbeawarethatanhonoraryconsultantcontractcannotbeawardedifthecandidateisnotrecommendedforinclusiononthespecialistregister.

Page��

Appendices

Appendix1:Minimumtrainingcriteriaforappointmenttoaconsultantpost

Appendix2:Suggestedpersonspecifications–consultantsurgeon

Appendix3:Exemptappointments

Appendix4:Independentsectorappointments

Appendix5:Listofusefulcontacts

Appendix6:Equalityanddiversitypolicy

Appendices

Appendix1:Minimumtrainingcriteriaforappointmenttoaconsultantpost

Appendix2:Suggestedpersonspecifications–consultantsurgeon

Appendix3:Exemptappointments

Appendix4:Independentsectorappointments

Appendix5:Listofusefulcontacts

Appendix6:Equalityanddiversitypolicy

Appendices Page��

Appendix 1: Minimum training criteria for appointment to a consultant post

1. FromJanuary1997alldoctorstakingupaconsultantpostmustbeontheGMC’sspecialistregister.

2. Postgraduatemedicaleducation iscurrentlyundergoingmajorreformlargely driven by the Department of Health’s Modernising MedicalCareers (MMC) project and the Intecollegiate Surgical CurriculumProject.Duringthetransitionphase,thecurrenttrainingstructurewillcontinuetoexistbutassessorsshouldfamiliarisethemselveswiththeproposed new structures under MMC and the surgical curriculumproject. More information is available at http://www.mmc.nhs.uk/ andhttp://www.iscp.ac.uk/.

3. Theintercollegiatesurgicalcurriculumisbasedonaneducationalmodelofstagedprogression,witheachstageunderpinnedbyexplicitstandards.Thisprovidestheframeworkfordeliveringcompetence-basedtrainingandassessment.

The curriculum deliberately adopts an approach that affirms theimportanceof professional andeducational values, andprivileges theconceptofprofessionaljudgement.Itisunderpinnedbytheprinciplesofpromotingcareofthesurgicalpatientandensuringthatsuchcareisdeliveredsafely.

4. ThecurriculumisstillevolvingandwillbesubjecttochangeuntilAugust2007. FromAugust 2007 therewill be a standards-based curriculumandallspecialtieswillhaveacompetence-basedsyllabus.TheawardoftheCCTwillbebasedonsatisfactorycompletionofcompetenciesandtrainingperiodswillbeindicative.

5. UntilAugust 2007, appointment to aType 1 higher surgical trainingprogramme leading to the award of the CCT is conditional uponthe successful completionof basic surgical training and the awardoftheCertificateofCompletionofBasicSurgicalTrainingorequivalent.Appointmenttoahighersurgicaltrainingprogrammewillbe inopencompetitionbyaproperlyconstitutedappointmentscommittee.


Theprincipleofhighersurgicaltrainingisthattraineesshouldenteraperiodof training in the gradeof specialist registrar, by appointmentto posts that have been inspected and approved for training by theappropriateSAC.

6. TheCCTisawardedoncompletionofadefinedperiodofstructuredtraining and assessment and passing the intercollegiate specialtyexamination.RecommendationwillthenbemadebyPMETBforentrytotheGMC’sspecialistregister.

Appendices Page��

Appendix 2: Suggested person specification – consultant surgeonR

EQU

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Page40 Handbook for College Assessors

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Appendices Page4�

Appendix 3: Exempt appointments*

*The National Health Service (Appointment of Consultants) Regulations: Good Practice Guidance(2005)

The statutory instrument lists appointments exempt from the need toadvertiseandtobeselectedbyanadvisoryappointmentscommittee.

Honorary contracts

Unpaidappointmentsareexemptwherethepersontobeappointedistoreceivenoremunerationinrespectofthetenureofthepostandis:

amemberoftheacademicstaffofauniversity;

aconsultantwhoisovertheageof65;

amentalhealthofficerwhoisovertheageof60;

apersonwhoiswhollyormainlyengagedinresearchthatrequireshisorherappointmenttothestaffofaTrust;

amedicalpractitionerwhohasbeenappointedtoapostinahospicewhichisequivalenttoaconsultantpostinthehealthservice.

ItisimportantthataTrustproposingtograntanhonorarycontractsatisfiesitself as to thepractitioner’s competence tocarryout theclinicaldutiesrequired;theemployercarriesoutthesameliabilityinlawfortheactionsofitshonorarystaffasitdoesforitspaidstaff.Anhonoraryappointeemustalsobeonthespecialistregister.

Locum appointments

LocumappointmentsareexemptprovidedtheemploymentisforaninitialperiodnotexceedingsixmonthsandanyextensionforamaximumperiodofafurthersixmonthsissubjecttoasatisfactoryreviewbytheTrustandtoconsultationwiththerelevantCollege.

i)

ii)

iii)

iv)

v)

Page4� Handbook for College Assessors

ItisimportantthatTrustshavesatisfactoryproceduresinplacetoensurethatlocumconsultantsareofadequatestandard.Thereshouldalwaysbeassessmentofthecandidatesbyan‘appointments’committee,includingatleasttwoprofessionalmembers,oneinthespecialtyconcerned.WherealocumistobeappointedatshortnoticeandisnotalreadyknowntotheTrust,theyshouldbeseenbyatleastoneofthehospitalconsultantsbeforetheyareengaged.Itisimportantthatreferencesareobtainedforalllocumappointments,irrespectiveoftheshort-termnatureofthepost.

Whereverpossible,Trustsshouldtrytoappointlocumdoctorswhohold,orhaveheld,postsofconsultantstatus,orelsewhohavecompletedspecialisttraining.

Moredetailedguidanceisgiveninthecodeofpracticeontheappointmentand employment of Hospital and Community Health Services locumdoctors,issuedbytheNHSExecutiveinAugust1997.

Appointments following redundancy

Where a consultant hasbeen,or is about tobe,made redundant fromtheirpostby theTrust, the latterhasamoralobligationtorender themthegreatestpossibleassistancewithaviewtoobtainingcomparableworkelsewhere.Wherethisisnotpossible,theTrustshouldapplytotheSecretaryofStateforHealthforacertificaterecognisingthatthispersonhasbeenmade redundant from a paid appointment, which has been the subjectof anAAC recommendation; a copy should be given to the consultantconcerned.Onpresentationofthecertificateofredundancy,theymaybeexempted fromtheAACprocedures,providedanappointment ismadewithinoneyearofthedateoftheredundancy.

Other exemptions for the NHS AAC process

Otherexemptionsoccurwherethepersontobeappointed:

Appendices Page4�

istransferredfromoneTrusttoanotheraspartofalocalreorganisationofthehealthservice,withoutanysignificantalterationinthedutiesofthepost;

isaconsultanttransferredwithinaTrusttoanotherconsultantpostwiththatTrust;

isaconsultanttransferredtoaconsultantpostwithadifferentTrustwheretheemploymentoftheconsultantwouldotherwisebeterminatedbyreasonofredundancy;

isaconsultant,workingfortheHealthProtectionAgency(HPA),theDefenceMedicalServices(DMS)orauniversity,transferredtoanNHSpostinwhichthedutiesaresubstantiallythesameasthoseperformedfortheHPA,theDMSortheuniversity;or

wasaconsultantwhoretiredasaconsultantandreturnstoworkinthesameTrustandspecialtyasonetheyfilledpriortoretirement.

NBIfanexemptappointmentismadewithouttheagreementofaCollegeassessor,theappointeemaynotberecognisedasatrainerbytheCollege.To be recognised as a trainer, the appointee must be on the specialistregisterandapprovedasatrainerbytheCollegeassessor.

>

>

>

>

>

Page44 Handbook for College Assessors

Appendix 4: Independent sector appointments

TheAACprocessfortheappointmentofnon-NHSconsultantsisbasedontheprocessusedfortheNHSbuttherearesomechangestotheoverallroleoftheCollegeassessorintheprocess.

Thedifferencesare:

Shortlisting:TheCollegeassessorisnotrequiredtoparticipateintheshortlistingofcandidates.However,theemployingindependentsectorprovidermustprovidetheCollegeassessorwithcopiesoftheshortlistedcandidates’CVsbeforetheAACpanelconvenes.

Interviewofcandidates:TheCollegeassessorroleistoensurethattheprocessofappointmentisfairandthatthebestcandidateisselected.TheCollegeassessorcannotvetoaproposedappointment.However,iftheCollegeassessorhasconcernsabouttheproposedappointment,thenthoseconcernsshouldbeaddressedinwritingtothehealthcareorganisation,theCollegeandthemedicaldirectoroftheDepartmentofHealthcommercialdirectorate.Itwillbethemedicaldirector’sresponsibilitytoliaisewiththehealthcareorganisationconcernedtoaddresstheissue(s)raised.

UnavailabilityofCollegeassessor:IfaCollegeassessorisunabletoattendduetounforeseencircumstancesornoassessorisavailable,theAACwillproceedwithoutCollegerepresentation.Collegerepresentationisnotmandatory;however,intheeventanassessorisunabletoattend,theyshouldcontacttheAACcoordinatorintheCollegeandtheindependentsectorproviderconcerned.

>

>

>

Appendices Page4�

Appendix 5: List of useful contacts

The Royal College of Surgeons of England

Forenquiriesregardingconsultantsurgeonappointments,AACregulations,jobdescriptionsandcontactdetailsofCollegeassessorspleasecontact:AAC coordinator(02078696203)

Forenquiriesregardingregionalspecialtyadviserspleasecontact:Regional representatives’ administrator(02078696203)

Joint Committee on Higher Surgical Training

Forenquiriesregardingcandidates’CCTdates,mediatedentrycandidatesandoverseascandidatesapplyingforentrytothespecialistregister,pleasecontacttheSACsecretaryfortherelevantspecialtyasdetailedbelow:

ENTsurgery 02078696249

Plasticsurgery 02078696242

Neurosurgery 02078696251

Paediatricsurgery 02078696249

Generalsurgery 02078696245

Urology 02078696252

Traumaandorthopaedics 02078696247

Cardiothoracicsurgery 02078696251

http://www.jchst.org/

Page4� Handbook for College Assessors

General Medical Council

Specialistregisterhelpline: 08453573456

Department of Health

http://www.doh.gov.uk/

Intercollegiate Surgical Curriculum Project

http://www.iscp.ac.uk/

Modernising Medical Careers

http://www.mmc.nhs.uk/

Postgraduate Medical Education and Training Board

http://www.pmetb.org.uk/

Appendices Page4�

Appendix 6: Equality and diversity policy

TheRoyalCollegeofSurgeonsofEnglandhasresponsibilitiesunderthedomesticandEuropeanequalitylegislationtoactwithoutdiscriminationinall itspracticesandarrangements.

TheCollege’sequalityanddiversitypolicysetsouttheCollege’scommitmenttoequalopportunities and theencouragementof diversity.Thedocument canbefound in full on theCollegewebsite (http://www.rcseng.ac.uk/publications/docs/equality_diversity.html).

Page48

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SectionRole of the College AssessorHandbook for College AssessorsApril 2007

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