Guidance for the employment of medical and dental consultants

There is information on the Department of Health's website to be used by NHS Trusts and other employers when making appointments to consultant posts. 

It provides good practice guidance on the NHS (appointment of consultants) Amendment Regulations 2004 (Statutory Instrument 2004 No. 3365). 

Please note that primary care trusts and strategic health authorities (SHAs) were abolished by the Health and Social Care Act 2012. The Department of Health has confirmed that the appointment of consultants regulations do not apply to clinical commissioning groups (CCGs). 

NHS foundation trusts are not covered by the consultant appointment regulations however may wish to follow the standards to ensure a robust recruitment process.

The Academy of Medical Royal Colleges (AoMRC) and the Foundation Trust Network (FTN) have agreed a concordat regarding the role of the medical royal colleges in the recruitment process for consultants to posts in NHS foundation trusts.

Appointment to public health posts

Employers should ensure that advertisements for consultant grade posts in public health are clear about any component which requires the post holder to be a registered medical or dental practitioner.

It is generally accepted that most of the duties of a public health consultant post can be done by a person who either is, or is not, a registered medical or dental practitioner. If through custom and practice a post holder has given, for example, medical advice then this should be recognised in the individual's job description. 

If a post is advertised which requires a post holder to be a registered medical or dental practitioner then the job description should clearly justify this. If a post is advertised which could be filled either by a registered medical or dental practitioner or otherwise because only a minority component of the post requires this and the employer would utilise other arrangements to cover this function e.g. giving medical advice - then this component should nevertheless be clearly identified in a job description when filled by a registered medical or dental practitioners.

Registered medical or dental practitioners in a post including these functions will appropriately be placed under the terms and conditions of service for NHS medical and dental staff rather than Agenda for Change.

Clarification on foundation trusts hiring consultants not on the specialist register.

Specialist registration is not a legal requirement for appointment to consultant posts for foundation trusts.  However, FTs must still satisfy themselves that the doctor is competent to undertake the requirements of the post. This of course should be rigorously ensured for all consultant appointments in all trusts, even where the doctor is on the specialist register, as their entry to the register is to some extent a snapshot of a particular point in time and not proof of specific current clinical competences. 

It is our view that FT employers should continue to appoint doctors who are on the specialist register if possible, but that there may be specific circumstances where a doctor clearly meets the requirements of a consultant post but due to issues such as e.g. their pattern of subspecialty training and practice overseas, they would not have met the requirements for the old CESR registration process. In these situations, if the doctor is appointed we would also recommend that the trust and the doctor consider whether the new portfolio pathway could provide a mechanism for them to enter the specialist register. Changes to how doctors demonstrate the standard required for specialist and GP registration.