Specialist progression: application & evidence workbook
HTML edition updated 9 September 2026. This is an educational planning aid, not an official application form or individual advice.
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SAS DOCTORS REVIEW / NHS WALES
PRACTICAL WORKBOOK 01
Specialist progression: application & evidence workbook
A structured way to define scope, map capabilities, evidence service need and quality-check the central application.
Independent educational resource
Author: Dr N Aziz
Reviewed: 7 September 2026
How to use it
Write in this workbook before completing the official form or preparing for the panel. The prompts help organise your own evidence; they are not model answers and do not determine eligibility.
Important
The current official all-Wales policy and application form take precedence. Do not include patient-identifiable information or material you are not authorised to share. Seek individual employment, professional, union or legal advice when needed.
SECTION 01
Start with the four-part case
A large portfolio is not automatically a clear application. The panel needs a traceable answer to four distinct questions.
| Question | What to establish | Useful output |
|---|---|---|
Eligibility | Registration, total experience and relevant specialty experience meet the policy. | Dated chronology and calculation. |
Scope | The work, decisions, autonomy, boundaries, accountability and escalation arrangements. | One-page role and scope summary. |
Capability | Sustained evidence meets the official generic capabilities within that scope. | Capability map and evidence index. |
Service need | The service requires the Specialist-level responsibility described. | Separate, objective service-need statement. |
A useful working order
Download and read the current policy, capability framework and form.
Complete the eligibility chronology before collecting a large portfolio.
Define the actual role and scope, including boundaries.
Map each capability using claim - evidence - impact.
Write service need separately.
Discuss the case with the manager and consider SAS advocate support.
Run confidentiality and submission checks, then retain the exact submitted version.
Do not confuse the tests
A doctor may demonstrate capability while service need is disputed, or the service may need higher-level work while capability gaps remain. Write and evidence each finding separately.
SECTION 02
Eligibility chronology
Use month and year. Explain overlaps, career breaks, less-than-full-time work and differently titled or overseas posts. Do not rely on the panel to calculate relevance from a CV.
| Period | Grade / role | Specialty and organisation | FT / LTFT | Why relevant |
|---|---|---|---|---|
Eligibility check
Full GMC or GDC registration with a licence to practise is evidenced.
At least 12 years of medical or dental work since primary qualification is clearly calculated, continuously or in aggregate.
At least six years of relevant specialty experience is mapped. Equivalent relevant work in other grades, including overseas, is explained.
The current Specialist generic capabilities framework has been reviewed.
The contract and policy scope have been checked against the latest official wording.
SECTION 03
Define the role, scope and autonomy
Autonomy is accountable decision-making within a defined scope. It includes recognising limitations and escalating appropriately; it does not mean isolation or consultant equivalence.
ONE-PAGE ROLE AND SCOPE SUMMARY
Current grade, specialty, contract, working pattern and sites
_
Main clinical activities and patient group
_
Decisions made independently
_
Activities requiring discussion, approval or escalation
_
Governance, leadership, education and improvement responsibilities
_
Exact progression request and proposed Specialist scope
_
Autonomy evidence map
Use more than one source for important claims. A job plan shows expected work; activity records show delivery; governance or outcomes show quality; and appropriate corroboration can confirm responsibility and duration.
| Recurring activity | Decision / responsibility | Frequency / duration | Boundary / escalation | Evidence IDs |
|---|---|---|---|---|
Test the wording
Could a reader tell exactly what you decide, for which patients or service, how often, under what governance and when you seek advice? If not, the claim is too broad.
SECTION 04
Capability map: clinical, safety and professionalism
Use the official framework headings in the application. The categories here are working prompts only and do not replace the framework.
| Working area | Questions to answer | Possible evidence |
|---|---|---|
Clinical expertise and autonomy | What complex work and decisions are sustained? What is your scope? How do you manage uncertainty and escalation? | Annotated job plan; duty schedule; non-identifiable activity; outcomes; role description; senior corroboration. |
Patient safety and governance | How do you identify risk, act, communicate, learn and strengthen systems? | Governance contributions; incident learning; guideline or risk work; audit; reflection; documented actions. |
Communication and patient partnership | How do you adapt communication, support decisions and manage difficult or uncertain conversations? | Feedback; pathway material; complaints learning; teaching; appraisal reflection; accessible resources. |
Professionalism and equality | How are integrity, inclusion, boundaries, wellbeing and reflective practice demonstrated? | Appraisal; MSF; CPD; equality work; conduct evidence; development plan; appropriate feedback. |
CLAIM - EVIDENCE - IMPACT NOTES
Capability claim 1
_
_
_
Capability claim 2
_
_
_
Capability claim 3
_
_
_
SECTION 05
Capability map: leadership, education and improvement
| Working area | Questions to answer | Possible evidence |
|---|---|---|
Leadership and teamwork | What problem or goal did you influence? Who was involved? What action and impact followed? | Pathway, rota, MDT, guideline or service leadership; meeting outputs; team feedback; adoption or outcome data. |
Education and supervision | What learning need did you address? What responsibility did you hold? How was quality assessed? | Programme plans; supervision roles; learner feedback; assessments; resources; changes made after evaluation. |
Quality improvement | What was the aim, baseline, intervention, measure, result and next step? | QI records; completed audit cycle; service evaluation; pathway redesign; remeasurement; sustainability evidence. |
Scholarship and wider contribution | What was your contribution and how is the output relevant to the capability or service? | Full citation; author role; presentation; guideline; research; article; adoption, education or service impact. |
What leadership means here
Leadership is not the possession of a title. Show responsibility, influence, judgement and an effect. A concise example should identify the problem, your role, how you engaged others, the decision or change and the result or learning.
Audit, QI and publications
Call an audit an audit. Give the standard, baseline, action, remeasurement and learning.
For QI, include aim, measures, tests of change, results and sustainability. An unsuccessful first test can still show insight if presented honestly.
For publications and articles, provide a citation, your contribution and the capability supported. Do not assume the title proves relevance.
Team projects require an individual contribution statement. Avoid claiming the entire outcome as your own.
SECTION 06
Build the evidence index
Use stable evidence numbers and meaningful filenames. Every major claim should point to an exact document, page or section and explain what it demonstrates.
| ID | Document / period | Claim supported | Exact location | Relevance / limitation | IG check |
|---|---|---|---|---|---|
E01 | [ ] | ||||
E02 | [ ] | ||||
E03 | [ ] | ||||
E04 | [ ] | ||||
E05 | [ ] | ||||
E06 | [ ] | ||||
E07 | [ ] | ||||
E08 | [ ] | ||||
E09 | [ ] | ||||
E10 | [ ] |
Evidence quality review
| Quality | Ask | Action |
|---|---|---|
Relevant | Does it directly support this claim? | Remove material that merely adds volume. |
Current | Does it describe present practice? | Explain continuing relevance of older evidence. |
Sustained | Is this a pattern rather than an isolated event? | Use evidence across an appropriate period. |
Triangulated | Does another source corroborate a major claim? | Combine role, activity, outcome and attestation where proportionate. |
Attributable | Is your contribution clear? | Separate team achievement from your action. |
Proportionate | Is the amount necessary and readable? | Index, label and remove duplication. |
Confidential | Is sharing authorised and non-identifiable? | Follow employer information-governance rules. |
GAPS FOUND BEFORE SUBMISSION
Gap, capability or disputed point
_
_
Action, support and responsible person
_
_
Evidence to produce and review date
_
_
SECTION 07
Write the service-need statement
Capability does not automatically prove service need. Describe the required work objectively, including any Specialist-level responsibility already delivered wholly or partly.
SERVICE-NEED CASE
What Specialist-level work does the service require?
_
_
How often and over what period is it delivered or required?
_
_
What clinical responsibility and judgement does it involve?
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_
What objective records show the activity and dependency?
_
_
What is the effect on safety, access, continuity, capacity, flow or resilience?
_
_
If need is disputed, exactly which element appears to be in dispute?
_
_
Policy point
The May 2025 all-Wales policy states that existing wholly or partially Specialist-level clinical responsibility is sufficient evidence of service need. Quote or cite the current official wording rather than relying on this summary.
Avoid weak substitutes
Length of service alone is not service need.
High workload alone does not establish the level of responsibility.
Personal aspiration is legitimate but is not workforce evidence.
Budget alone is not a policy reason for refusal, but the application should still demonstrate the work and need.
SECTION 08
Manager discussion and form writing
| Before the meeting | During the meeting | After the meeting |
|---|---|---|
Bring the policy, role summary, capability map and service-need note. Decide whether to ask a SAS advocate to attend. | Ask which criteria are agreed, disputed or require more evidence. Keep capability and need separate. Record actions. | Confirm agreed points. If support is declined, request criterion-focused written reasons and a development plan within the policy process. |
Write for a reader who does not know the role
Use headings that mirror the official form and framework.
Put the conclusion first, then evidence it.
Use dates, numbers and defined responsibilities where appropriate.
Cross-reference evidence IDs consistently.
Acknowledge limitations or gaps; never overstate autonomy or outcomes.
Explain abbreviations and local role titles.
Keep the manager's position accurate and attach or transcribe it as required.
Submission remains possible
The all-Wales policy route permits an application with or without manager support. Lack of support should be addressed factually, not hidden or turned into a personal dispute.
SECTION 09
Final submission audit
| Check | Complete |
|---|---|
Current policy, capability framework and form versions checked | [ ] |
Eligibility chronology and calculations are transparent | [ ] |
Role and scope summary states decisions, boundaries and escalation | [ ] |
Every capability claim uses claim - evidence - impact | [ ] |
Service need has a separate evidence-based statement | [ ] |
Manager support or written concerns are recorded accurately | [ ] |
Evidence index uses stable IDs, dates and exact locations | [ ] |
Patient-identifiable and unauthorised material excluded | [ ] |
Attachments open, filenames are meaningful and duplication removed | [ ] |
The final online text matches the reviewed working copy | [ ] |
Exact submission, attachments, date and confirmation retained | [ ] |
Support arrangements and contact details recorded | [ ] |
FINAL NOTES
The strongest three points in the case
_
_
The two questions the panel is most likely to ask
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_
Any evidence available on request and who can authorise it
_
_
SECTION 10
Official sources and disclaimer
HEIW SAS education and development support
https://heiw.nhs.wales/education-and-training/sas-doctors/
Independent guidance
This workbook is a general educational aid. It is not an official NHS Wales document, does not establish eligibility or guarantee an outcome, and is not a substitute for the current policy, application form, individual judgement or professional advice.
No confidential cases, individual applications, employer-internal material or unpublished service information are used in this workbook.