South West Public Health Training Programme

Policy for Acting up to Consultant role

Policy Statement

This policy aims to clarify the guidelines for senior Specialty Registrars to act up into a Consultant post at the end of their training.

Acting Up and Locum Consultant

The period of acting up should not be confused with undertaking a locum consultant post. By undertaking a period of acting up training, the trainee will be moving into an established, Faculty-approved consultant post and will continue to receive regular educational supervision. A trainee who is acting up should not use the term ‘locum consultant’ to describe their acting up position.

A Specialty Registrar cannot undertake a period of acting up in the post-CCT period of grace. Trainees in their period of grace wishing to undertake a time-limited period of working into a vacant consultant post will need to resign from the rotation, relinquish their NTN and be appointed by the employing organisation as a locum consultant.

To retain access to the Period of Grace, a trainee must complete their period of ‘Acting Up’ before their CCT date. A registrar must not resign from the training scheme prior to taking up the acting up post.

Trainees can apply for consultant posts 6 months before the end of their training, but cannot take up a consultant post until they get a CCT and finish training.

It must be made clear that Registrars do not need to have a period of ‘acting up’ experience to be able to achieve leadership opportunities and skills.

Application notice for acting up

Specialty Registrars wishing to act up should apply to the Head of School and Training Programme Director at the earliest possible opportunity and at least 3 months prior to the intended acting up period. This notice period may only be waived in exceptional circumstances and in agreement with the Head of School and TPD. Where the 3 month rule is to be waived then all other procedural requirements mentioned below must still be in place. It is recommended that Registrars keep the training programme team updated informally via email as soon as discussions about acting up opportunities take place. This does not replace the need for the formal application process to be completed once an ‘acting up’ position is secured.

Principles of Acting Up

Specialty Registrars who are within six months of their anticipated CCT are eligible to ‘Act Up’ as consultants, for up to a maximum period of three months. Trainees may only Act Up into a vacancy arising in an existing Consultant post (i.e. a pre-existing post where the consultant has left / is away). Newly created (as yet unfilled) Consultant posts are not suitable for Acting Up purposes.

Specialty Registrars will retain their National Training Number (NTN) during the period of Acting Up and must not resign from the training scheme prior to taking up the acting up post.

When in post the term ‘Acting Up’ and not ‘Locum’ must be applied.

A Registrar whose annual review of progress is deemed unsatisfactory or with unmet objectives/competences will not be granted permission for a period of Acting Up. Trainees who have unmet objectives or competencies still outstanding in their final year are not eligible to apply for a period of acting up. When a Specialty Registrar has had all learning outcomes signed off by their educational supervisor then the Head of School and TPD will approve whether the Specialty Registrar can commence a period of acting up if the opportunity arose. The Educational Supervisor should inform the Head of School and TPD that all learning outcomes have been achieved. The trainee must continue to have educational supervision during the acting up period. This may be with the pre-existing supervisor or, for the duration of the acting up period, responsibility may be transferred to another supervisor on the scheme that is more local to the acting up post. This needs to be specified in advance and agreed with both supervisor(s) and the Head of School and TPD.

A trainee can act up for a maximum of 3 months (pro rata for flexible trainees), provided the conditions relating to the post and supervision within this policy are met.

Before commencing an ‘Acting Up’ period Registrars must obtain formal approval and apply for Out Of Programme from the Head of School, Training Programme Director and Associate Postgraduate Dean. The mechanism to request approval is to complete an application form available from the Severn Postgraduate Medical Education website.

Registrars can act up for a maximum of 3 months towards their training and need to apply for OOPT prospectively to do this, getting Faculty approval and using standard Severn PGME processes. An educational supervisor is still required. When completing the application it must be made clear who will be supervising the Registrar during the Acting Up – they are still a trainee and cannot undertake Consultant level work without direct Consultant supervision still being available in an appropriate way.

Any ‘Acting Up’ opportunity will only be approved within the HESW region. Registrars will not receive approval to Act Up within another Region.

On occasions where more than one suitable candidate wishes to act up into the same post then the Head of School and Training Programme Director will discuss a suitable selection process with the Employing Organisation based on the needs of the Specialty Registrar and the suitability of the post and suitability of the Registrar.

Acting up payments

In an acting-up post the trainee receives their salary for in-hours work (i.e. the acting up post) from the lead employer Trust but this would usually be at the bottom point of the consultant salary scale. On-call payment would come via the training programme in the usual way. On-call arrangements must be mutually agreed prior to the commencement of the acting up post. Employing Organisations will be expected to pay the difference between Registrar’s current salary and bottom point of the Consultant salary scale.

October 2015