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Flagship Wales programme

Build a clear case for Specialist progression.

A practical route through eligibility, defined scope, evidence, service need, panel preparation, outcomes, appeal and reapplication under the all-Wales policy.

Recognition, not recruitment

This route assesses whether existing practice and service need meet the policy. It is not competition for an advertised vacancy.

Two findings

Capability and eligibility must be demonstrated. Service need must also be addressed as a distinct question.

Scope matters

Describe the real role precisely. Defined or partial autonomy can be relevant; it should not be inflated into consultant equivalence.

01 · Use the guide

Work from the decision backwards

The panel should not have to infer the case from a large portfolio. Build a short, traceable argument that answers four questions: are the formal requirements met; what is the doctor’s current scope; where is each capability evidenced; and why does the service require Specialist-level work?

1Eligibility

Can the registration and experience requirements be checked from dates and roles?

2Capability

Does current, triangulated evidence show sustained practice at the required level?

3Scope

Are autonomy, boundaries, accountability and escalation described accurately?

4Service need

What work does the service require, and where is that need objectively shown?

Do not submit confidential clinical material.
Use proportionate, non-identifiable summaries or authorised documents, and follow local information-governance rules. This guide contains no individual cases or internal employer material.
02 · Eligibility and role

Establish the formal foundation first

The May 2025 policy applies to existing and new Specialty Doctors in NHS Wales on the 2008 or 2021 contracts. Check the current policy before acting; the criteria summarised here should be evidenced rather than merely asserted.

  • RegistrationFull GMC or GDC registration with a licence to practise.
  • Overall experienceAt least 12 years of medical or dental work since the primary qualification, continuously or in aggregate.
  • Relevant experienceAt least six years in the relevant specialty in Specialty Doctor or closed SAS grades. Equivalent relevant work in other grades, including overseas, may be counted.
  • Generic capabilitiesEvidence that the Specialist-grade generic capabilities are met within the role’s defined scope.

Make the chronology checkable

Use month and year, grade, specialty, employer or country, full-time or less-than-full-time status, and a short relevance note. Explain overlaps and breaks. For overseas or differently titled posts, describe the duties and level rather than assuming the title translates directly.

Specialist is a distinct grade

Do not frame the case as proof that the role is identical to a consultant post. Show the Specialist capability, responsibility and scope being requested, including its boundaries.

03 · Scope and autonomy

Describe what autonomous practice actually looks like

Autonomy is not working without colleagues or never asking for advice. It is the accountable exercise of judgement within a defined scope: assessing information, making and implementing decisions, managing uncertainty, recognising limits and escalating appropriately.

Relevant activityWhat the evidence should clarify
Independent clinics or listsWhich patients or procedures, decisions made, frequency, complexity, oversight and escalation.
Assessment and treatment planningWhat you decide, what requires discussion, how risk is managed and where responsibility sits.
On-call or urgent workSeniority of decisions, stabilisation, admission or discharge decisions and access to advice.
Pathway or MDT responsibilityYour authority, contribution to decisions, follow-through and effect on care.
Procedural or technical practiceScope, competence, outcomes, governance and the circumstances requiring assistance.

Use triangulation, not a single assertion

An annotated job plan shows what is expected; a non-identifiable activity summary shows what happens; governance or outcome material shows quality; and an appropriate senior statement can confirm the level and continuity of responsibility. Together they are stronger than a generic reference.

Stronger wording

“I independently assess and manage the defined patient group in two scheduled clinics each week, including treatment decisions within the agreed pathway. The job plan, activity summary and clinical lead statement evidence this. I escalate specified high-risk presentations under the documented protocol.”

Avoid

“I am fully autonomous and work like a consultant.” Absolute claims hide scope, boundaries and evidence, and may create avoidable questions about safety or equivalence.

04 · Capability evidence

Turn experience into an assessable portfolio

The official generic capabilities framework is the authority. The working headings below help organise evidence; they do not replace its wording. For every claim, identify the evidence, date, your contribution and the impact.

01
Clinical expertise and autonomyWhat decisions do you make, within what scope, and with what accountability?
  • Annotated job plan, duty schedule and role description
  • Regular independent clinics, lists, reviews or treatment decisions
  • Non-identifiable activity summaries showing complexity and frequency
  • Examples of judgement, risk management and proportionate escalation
  • Current senior corroboration that describes responsibility—not only competence
02
Leadership and teamworkingHow do you influence people, coordinate work and improve the service?
  • Leadership of a pathway, rota, MDT function, guideline or service workstream
  • Actions taken to resolve a problem and engage colleagues
  • Responsibility for supervision, induction, mentoring or team development
  • Meeting records or outputs showing your contribution and follow-through
  • Evidence of an effect on access, flow, safety, culture or staff experience
03
Safety and governanceHow do you recognise risk, learn and help the organisation deliver safer care?
  • Clinical governance, incident-learning or mortality-review contributions
  • Audit, guideline, protocol or risk-register work
  • Non-identifiable examples of recognising, escalating and managing risk
  • Evidence of candour, reflection and changes made after feedback
  • Participation alone is weaker than a clear contribution and outcome
04
Quality and service improvementWhat did you improve, how did you test it and what changed?
  • QI aim, baseline, intervention, measures, results and sustainability
  • Completed audit cycle or an honest explanation of the current stage
  • Service evaluation, pathway redesign or reducing unwarranted variation
  • Your individual contribution where the work was shared
  • Outcome data, remeasurement, adoption or credible learning from an unsuccessful test
05
Education and supervisionWhat responsibility do you take for others’ learning and safe development?
  • Planned teaching linked to learner or service need
  • Supervision, assessment, feedback or mentoring responsibilities
  • Learner feedback and changes made in response
  • Educational resources or programmes you designed
  • Evidence that learning affected confidence, capability or practice
06
Professionalism and wider contributionHow do you show sustained, reflective and inclusive senior practice?
  • Appraisal, CPD and multisource feedback
  • Communication, shared decision-making and equality considerations
  • Research, presentations, publications or articles with your contribution stated
  • College, professional, regional or national work relevant to the role
  • A development plan showing insight; Specialist practice does not mean development has ended

Audits, QI and publications: show relevance, not volume

For an audit, record the standard, baseline, your role, action, remeasurement and learning. For QI, include the problem, aim, measures, tests of change, result and sustainability. If the project is unfinished or did not improve the result, say so and explain the next step. Honest learning is stronger than relabelling incomplete work.

For a publication, article, presentation or research output, provide a concise citation, your contribution and the capability it supports. It may evidence scholarship, education, leadership or improvement, but it does not by itself prove clinical autonomy.

05 · Evidence system

Use claim → evidence → impact

Claim

Name the capability, responsibility or service need precisely.

Evidence

Give a stable evidence number, date and exact location.

Impact

Explain the effect, judgement demonstrated and any limitation.

A useful evidence index might contain: evidence number; document title; date or period; capability or service-need claim; exact page or section; what it demonstrates; and confidentiality check. Give files meaningful names and avoid attaching the same item repeatedly.

Weak

“I lead the service.”

Better

Names the workstream, role, action and supporting record.

Strong

Adds the outcome, duration, corroboration and limits of the claim.

Evidence should be current enough to describe present practice, but an older item may remain relevant where it shows sustained experience. Explain why it still matters.

06 · Complete the application

Prepare in Word; submit with control

The official Word version is a useful working copy. Draft, review and cross-reference the full case there before transferring it to the central online form. Confirm that the online questions and attachment requirements have not changed.

  1. 1
    Write a one-page role summary

    State grade, specialty, contract, working pattern, defined scope, main responsibilities, boundaries and the progression requested.

  2. 2
    Set out eligibility with dates

    Make the 12-year and six-year calculations transparent. Explain relevant overseas, non-standard or overlapping experience.

  3. 3
    Answer capability by capability

    Use claim–evidence–impact. Choose the best evidence rather than copying the CV or uploading an unstructured portfolio.

  4. 4
    Give service need its own section

    Describe required work, frequency, responsibility and consequences. Do not rely on capability evidence alone or personal aspiration.

  5. 5
    Address concerns openly

    If support was declined or evidence is incomplete, state the issue and respond with evidence, clarification or a specific development plan.

  6. 6
    Run a submission audit

    Check filenames, links, dates, page references, permissions, confidentiality and consistency. Save the submitted version and confirmation.

07 · Service need

Keep workforce need separate from personal capability

A doctor may be capable but still face a disputed service-need finding. Conversely, a service may need higher-level work while the panel identifies capability gaps. The application should therefore contain a distinct, objective service-need statement.

Describe the work

Recurring activity, responsibility, patient pathway, frequency, complexity and operational dependency.

Show current delivery

Job plan, rota, activity record, pathway document, outcomes or appropriate corroboration.

Explain the consequence

How the work affects access, continuity, safety, capacity, flow or resilience.

Address alternatives

Why this is Specialist-level responsibility in the defined scope, rather than merely workload volume or seniority.

Important policy point.
The all-Wales policy states that where a doctor is already working wholly or partially at Specialist clinical-responsibility level, this is sufficient evidence of service need. Show the relevant work precisely and refer the panel to the current policy wording.

If someone says “there is no service need”

Ask which element is disputed. Is the work not required, not at Specialist level, not sustained, or not evidenced? Respond to that reason using service data and defined responsibilities. Keep the tone professional. Lack of an identified budget alone is not a policy reason for refusal.

08 · After submission

Know what should happen next

01

Prepare away from the portal

Use the official Word form as a working document. Build the chronology, scope summary, capability answers and evidence index before pasting into the online form.

02

Discuss with the manager

Ask for a constructive, criterion-based meeting. A SAS advocate may attend. Take a concise evidence summary and record agreed actions.

03

Record support or concerns

If supported, the manager helps complete the form and statement. If not, request written, criterion-focused reasons and a development plan within the policy process.

04

Submit centrally

Submission is permitted with or without manager support. Keep an exact copy, attachments, submission date and confirmation. That date matters if progression is accepted.

05

Employer and panel review

The central route passes the form to the employer. A panel can accept, seek information or invite discussion. No applicant should be rejected without an interview.

06

Receive and analyse the outcome

Check whether the decision addresses capability and service need separately, which evidence was accepted, any gaps, support offered and the effective date.

07

Develop, appeal or reapply

Use the route that fits the written reasons. An appeal needs an identifiable error or disputed finding; development and reapplication may be the better response to a genuine gap.

5 working daysPolicy route for written reasons when manager support is declined
20 working daysFor the employer to identify the assessment panel
20 working daysFor applications to be considered after the panel is convened
20 working daysTo lodge an appeal after the written outcome
1 week beforeAppeal written submissions due before the hearing
15 working daysFor the appeal decision after the hearing

These timings summarise the May 2025 policy. Check the current document and confirm the calculation with the relevant employer team.

09 · Panel preparation

Answer the question, evidence the judgement, then stop

The panel may need clarification even where the written case is strong. Prepare six or eight evidence stories—not a script for every possible question. Each should be usable in about two minutes.

1Scope

Set the context and your responsibility.

2Evidence

State what you did and where it is verified.

3Judgement

Explain the decision, risk and boundaries.

4Impact

Give the result, learning and limitation.

Difficult questions are invitations to clarify

  • “You are not fully autonomous.” Define the actual decisions made independently and the appropriate escalation arrangements.
  • “There is no service need.” Ask what is disputed, then use current responsibilities and service evidence—not length of service.
  • “Your scope is narrow.” Explain depth, continuity and boundaries without claiming the whole specialty.
  • “Evidence is missing.” Acknowledge it, identify available verification and do not bluff.
  • “How is this different from a consultant?” Explain the Specialist scope and recognise the consultant role’s potentially wider accountability.
  • “What is your gap?” Show insight, safe management and a specific development plan.

Take an indexed copy of the application, policy, evidence summary and concise notes. Protect confidentiality. Listen to the full question, answer it directly and avoid lengthy background that forces the panel to interrupt.

10 · Outcomes

Read the finding, not just the result

01

Capability met · service need met

Progression to Specialist grade. The job plan is then aligned to the role; this should not unduly delay implementation.

02

Service need met · capability gap

A supported development plan should address the named gaps, with evidence and review points, followed by reapplication.

03

Capability met · no immediate need

The policy describes workforce and operational action to identify a suitable Specialist post within a reasonable time.

04

Neither condition met

Detailed reasons and feedback should show what was not demonstrated. The doctor can build evidence and revisit the route if circumstances change.

Two safeguards worth knowing

No doctor should be rejected without being invited to an interview, although the panel may accept without interview. If accepted, the progression date is the date the form was submitted; job-plan discussion should not unduly delay implementation.

11 · Appeal and reapplication

An unsuccessful decision is not permanent

First obtain the detailed in-person and written feedback. Separate disagreement from an appeal ground. A useful appeal identifies a procedural error, incorrect policy interpretation, material evidence that was overlooked or a conclusion not supported by the reasons. Map each disputed point to the policy and evidence; avoid personal allegations.

Appeal may fit
  • A required step appears not to have been followed.
  • The decision uses a criterion not found in the policy.
  • Material submitted evidence appears not to have been considered.
  • Capability and service need were conflated or reasons are internally inconsistent.
Development and reapplication may fit
  • The feedback identifies a genuine capability or evidence gap.
  • Practice is developing but not yet sustained or corroborated.
  • Service circumstances may change.
  • A clearer portfolio could address the reasons without disputing the process.

Convert feedback into a controlled plan

For every gap, record the required capability, development activity, supervisor or support, evidence to be produced, review date and completion measure. Use appraisal and job planning to secure agreed opportunities. The policy may support development for up to two years where appropriate.

An appeal must be lodged in writing within 20 working days of the written outcome. The independent appeal panel includes an appropriate senior clinical lead, the SAS advocate and senior HR representation. Written submissions are due one week before the hearing. If upheld, implementation is backdated to the original submission date.

Seek support earlySAS advocate · SAS tutor or HEIW support · trade union or professional association · trusted senior colleague · employer HR or medical workforce team
Interactive preparation

Test the case, then practise the panel

Choose an exercise. Each question gives immediate feedback and a practical next action. Answers stay in this browser and are not submitted to this website.

Readiness check · 1 of 12
Eligibility
Which is the best first check before preparing a full application?
Choose the best response.

Important: This is an educational self-check. It does not predict an employer panel decision, establish eligibility or replace the official policy, form, professional advice or your own judgement.

12 · Authoritative sources

Use the current official documents

Important disclaimer

Independent guidance—not an official decision tool

This resource provides general educational information. It is not issued or endorsed by NHS Wales Employers, a health board, the BMA, NHS Employers or HEIW; it does not establish eligibility, guarantee progression or replace the current policy and application form. Employment circumstances and evidence require individual judgement. Check current official sources and seek appropriate professional, union, HR or legal advice where needed.