Charter for Locally Employed Doctors in the UK Health Service

Abstract

Locally employed doctors have been described along with their compatriots as 'the lost tribe' compared to their peers who are either in formal training, consultant, or general practitioner posts. Over the lastdecade, considerable progress has been made in improving the recognition, value, and respect given to doctors in Specialty, Staff Grade or Associate Specialist (SAS) roles with harmonised contracts, working conditions and support available. The vast majority of the cohort of over 127,000 doctors in the SAS-LED category as per the UK medical register (GMC 2022 dataset) continue to be lumped with their SAS historicalcounterparts yet have a very different experience. These LEDs are unsung and unheard and remain voiceless in the UK NHS medical staff, yet continue to provide service in delivering high-quality healthcareto the nation.
 This Charter is ambitious in its aspiration and aims to deliver the 'Gold Standard' for all LEDs. It was developed following a prolonged exercise of listening to the experiences of many LEDs within themembership of BAPIO across its affiliated organisations and social networks. It is unique in being developed and written by LEDs and IMGs early in their careers or by those transitioning to more establishedsenior and autonomous roles. So it is grounded in the reality of lived experiences and ambitious in setting the bar at an equal level with other doctors in the UK NHS.
 The LED Charter offers ten practical recommendations for implementation by all NHS employing organisations. Most of the principles of equality and inclusion described in this Charter should be embraced by the medical royal colleges, education and training agencies (i.e. Health Education England) in their committees and processes to provide a voice to this 'lost tribe'.