Policy responses and statements

Name of organisation:

The Scottish Government

Name of policy document:

Consultation on Options for Improvements to the Consultant Recruitment Process

Deadline for response:

15 February 2008

Background: The Scottish Government Health Workforce Directorate is conducting a review of how consultants are recruited. In summer 2006, it was decided to undertake this review of consultant recruitment for the following reasons:

• To check that current recruitment practice was in line with changes to employment legislation. There have been substantial changes to employment legislation and Boards need to minimise the risk of litigation.
• To ensure that current recruitment practice in NHSScotland reflected best practice guidance.
• To consider the implications of reforms to postgraduate medical education introduced under Modernising Medical Careers (MMC) and its impact on the future demand and supply of consultants and any related recruitment issues. It is expected that in the future there will be a greater number of applicants for consultant vacancies in NHSScotland.
• In response to indications from Health Boards that the current system was not working effectively and that the regulations were a substantial policy constraint.
• In response to a British Medical Journal study on obtaining consultant posts, that indicated that certain groups of staff identified constraints in the current process.

COMMENTS ON
THE SCOTTISH GOVERNMENT
CONSULTATION ON OPTIONS FOR IMPROVEMENTS TO THE CONSULTANT RECRUITMENT PROCESS

The Royal College of Physicians of Edinburgh is pleased to respond to this important consultation on consultant recruitment in Scotland.

Effective consultant recruitment is key to the delivery of safe patient care and the optimum use of NHS resources.  Consultants are senior and long-serving staff, and recruitment processes must reflect the risk of poor appointment decisions in terms of quality of patient care, excessive vacancies and the effort to rectify avoidable problems.  The College is aware of examples where poor recruitment decisions have resulted in serious clinical problems, which have been expensive to address, adding to the workload of other team members including managers.  The College considers it is essential that any new procedures continue to be enshrined within regulations to enforce standards and support consistency across Scotland.

Options offered within the Consultation Document

1 Status Quo

The College accepts there are operational difficulties with the current regulations and that change is necessary.  However, more diligent attention to time-tabling and training could address some of the practical problems.

2 Establishing a 2 Stage Process

The College believes that this option would be administratively disproportionate and misses the opportunity to ensure an informed external perspective is available at interview.

3 Allowing NHS Health Boards to exercise autonomy in consultant recruitment

The College believes there are significant risks if Health Boards are allowed complete autonomy supported by guidance only.  External specialist input is necessary at all stages, particularly where the job may be unusual or there are applicants on the specialist register through the CESR route, whose training may not reflect exactly the training offered in the UK.

An external perspective can prevent a hasty decision driven by pressure to appoint or help defend a decision if challenged by an unsuccessful candidate, particularly in single candidate interviews.

There could be considerable duplication of effort as employers develop their own procedures and train panellists and HR support teams.  There may also be competency concerns about external panellists if the level of training across Scotland is left to local discretion.

Recommendation

The College believes that none of the above options is ideal and recommends that the standards for consultant recruitment should be laid out in new regulations.  These should reflect best employment practice and provide for:

• The recruitment of a new group of trained consultants across the specialities to provide an external, objective and informed perspective within an otherwise local interview panel.

• A minimum of 1 external member, reserving the right to require 2 external members for very specialised roles or where there is a significant undergraduate teaching component.

• Clarity of role between local, university and external specialist interview panel members. External panel members should be involved throughout the process from the agreement of the job description to the final interviews.

• Central management of external panel members to ensure that all are active, that they remain fully trained for their role and there is regular turnover.  They should be supported with regular training updates in employment law, interviewing techniques, and equality and diversity law.

• Agreement among employers to release their consultants to serve on external interview panels and to consider these duties as professional leave.

• Improved mapping of the consultant recruitment process to ensure panellists and short-listing/interview dates are identified early, avoiding the delays reported by some employers through unavailability or short notice absence.

• Training for staff within employer HR departments to avoid many of the current operational problems.

• Encouragement for employers to develop evidence-based (and possibly specialty-specific) approaches to assessing the suitability of applicants that complement interviews.  However, the final decision should be taken at a properly constituted consultant appointment panel.

Copies of this response are available from:

Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.

Tel: 0131 225 7324 ext 608
Fax: 0131 220 3939

[14 February 2008]