Advisory Appointments Committee FAQ

What is an AAC?

An Advisory Appointments Committee (AAC) is a legally constituted interview panel established by an employing body when appointing consultants.

What is the function of an AAC?

The function of an AAC is to decide which, if any, of the applicants is suitable for appointment and to recommend a name or names to the employing body. The overriding aim is to ensure that the best candidate for the job is appointed, that the process is fair and open within current legislation on employment practice and that the candidate is fully trained for the post or meets the requirements in the person specification.

What is the composition of an AAC and who are the panel members?

The core composition of an AAC is governed by statute, which states that the committee shall comprise a group of five members. These are:

• a lay member (normally the chairman of the employing body or another non-executive director);
• the College assessor;
• the chief executive of the employing body (or a nominated deputy);
• the medical director of the employing body (or a medically qualified nominated deputy);
• a consultant, normally from the relevant specialty, from the employing body.

I want to organise an AAC. What is the process or procedure?

Please refer to our AAC flowchart.

Who approves the job description?

Before a consultant post is advertised, a copy of the job description and person specification should be emailed to the College, who request approval from the relevant regional specialty professional advisor (RSPA). If the RSPA works in the same trust in which the appointment is to be made, the job description will be referred to a neighbouring RSPA.

There are exceptions for certain specialties. In Cardiothoracic Surgery, Neurosurgery and Vascular Surgery the process is centralised through the relevant specialty association.

Please email all job descriptions to collegereps@rcseng.ac.uk.

What do I need to do once the job description is approved?

Advertise the post and email collegereps@rcseng.ac.uk to request a College assessor, attaching a copy of the job description and approval. The College will then nominate an assessor for the AAC.

To maximise notification time to find an assessor, we will accept details of a planned AAC as long as the RSPA is in receipt of and is reviewing the job description.

How long is the approval valid for?

The job must be advertised within 12 months of approval (the AAC can take place after this 12 month period if necessary). If the job has not been advertised within 12 months, the trust must seek approval from the RSPA again.

What happens if a job description requires amendment after it is approved?

The RSPA and the College should be notified. If the change significantly alters the content or balance of the post, the job description will need to be approved again and possibly re-advertised.

The job description should not be challenged at the AAC by any member of the committee unless an obvious error has been made and incorrect information given to candidates, or if it appears that it could lead to unlawful direct or indirect discrimination.

Is this for all specialties?

Yes, except for oral and maxillofacial posts, which are arranged by the Faculty of Dental Surgery (FDS) within the College. Please call 020 7869 6806 for further information.

What happens if the job description is not approved?

Lack of approval does not prevent an employer advertising a post nor will it necessarily prevent the College sending a representative to the AAC. However, If concerns are sufficient, the College may withdraw from the appointment process.

In the majority of instances it is the view of the College that participation in the AAC - whether or not the job description has been approved - will allow for continuing dialogue and negotiation regarding the job description and ensures external specialty input into the suitability of candidates.

How much notice do I need to give the College to find an assessor?

Eight weeks, which is the notice period the majority of assessors require to secure leave from their employing Trust.

What happens if we cannot provide that notice?

The College will attempt to find an assessor for NHS Trusts. However, this is on the understanding that it may not be possible and the date may need to be rescheduled.

Foundation Trusts will be asked to reschedule the AAC if they wish to have further College involvement into the appointment and to bear the notice period in mind for the future.The College remains committed to providing assessors for all consultant appointments at Foundation Trusts and believes that the role can enhance the recruitment process. 

Is it essential to have an assessor on the AAC?

Consultant appointments are governed by The National Health Service (Appointment of Consultants) Regulations 1996 and the accompanying Good Practice Guidance (2005).

It is a legal requirement that NHS trusts, primary care trusts and strategic health authorities in England and Wales comply with these regulations. Although the 1996 regulations and subsequent amendments do not specifically apply to NHS Foundation Trusts or ISTCs, the Department of Health recommends that all employing bodies follow them as a matter of best practice. The College supports this position and is happy to find assessors for all AACs.

Will the assessor have the same subspecialty as the post being advertised?

The College will always try to find a suitable subspecialty assessor, however in some circumstances an assessor from outside the subspecialty will be used.

Who is responsible for the shortlisting?

Each member of the committee should be involved in the shortlisting process by assessing candidates against the person specification. All members of the committee have equal say in both shortlisting and determination of suitability. The chairman should ensure that all members of the committee are involved in the shortlisting process and are content with the outcome.

The assessor must ensure that only individuals who are fully trained are shortlisted. This includes adequate training in any subspecialty that is mentioned in either the job advertisement or the person specification. They will also advise whether a specialist registrar is within six months of their expected CCT date or qualifies through the Certificate of Eligibility for Specialist Registration (CESR) route.

It is important that shortlisting does not take place until the College assessor has been nominated. If the shortlisting process does start due to a late nomination of assessor, it is essential that all the details are communicated and a view is sought on the outcome of the shortlisting.

What happens if the assessor cancels prior to the AAC?

Please contact us by emailing collegereps@rcseng.ac.uk or calling 020 7405 3474. Depending on the circumstances, guidance will be provided to try to ensure the AAC can still go ahead.

Who sets the terms of the assessor's travel expenses?

This should be in line with the appointing trust’s policy. The assessor should be made aware of the terms at the earliest opportunity to avoid confusion and encourage advance ticket purchases.

What other appointments does the College deal with?

Honorary and senior lecturer posts. The arrangements for honorary contracts are exempt from the regulations relating to AACs. However, job description approval and a College assessor on the interview panel will ensure that the successful candidate is suitable for training.

What is the minimum requirement for such an appointment?

It is the legal requirement for the proposed holder of an honorary NHS contract (whether paid or unpaid) to be on the specialist register. On occasion, a university may wish to interview candidates for a senior clinical academic appointment from overseas, who are not on the specialist register. In these circumstances, a candidate may be interviewed and an offer made which is subject to the doctor gaining entry to the specialist register.

What if the appointment is for an unpaid honorary post?

Unpaid appointments are exempt where the person to be appointed is to receive no remuneration in respect of the tenure of the post and is:

• a member of the academic staff of a university
• a consultant who is over the age of 65
• a mental health officer who is over the age of 60
• a person who is wholly or mainly engaged in research who requires his or her appointment to the staff of a trust
• a medical practitioner who has been appointed to a post in a hospice which is equivalent to a consultant post in the health service

It is important that a trust proposing to grant an honorary contract satisfies itself as to the practitioner’s competence to carry out the clinical duties required; the employer carries out the same liability in law for the actions of its honorary staff as it does for its paid staff. An honorary appointee must also be on the specialist register.

Do we need the AAC process to appoint a locum?

Locum appointments are exempt provided the employment is for an initial period not exceeding six months and any extension is for a maximum period of a further six months (subject to a satisfactory review by the trust and to consultation with the College).

It is important that trusts have satisfactory procedures in place to ensure that locum consultants are of adequate standard. There should always be assessment of the candidates by an 'appointments' committee, including at least two professional members, one in the specialty concerned. Where a locum is to be appointed at short notice and is not already known to the trust, they should be seen by at least one of the hospital consultants before they are engaged. It is important that references are obtained for all locum appointments, irrespective of the short-term nature of the post.

Wherever possible, trusts should try to appoint locum doctors who hold, or have held, posts of consultant status, or else who have completed specialist training.

What if we are appointing following redundancy?

Where a consultant has been, or is about to be, made redundant from their post by the trust, the latter has a moral obligation to render them the greatest possible assistance with a view to obtaining comparable work elsewhere. Where this is not possible, the trust should apply to the Secretary of State for Health for a certificate recognising that this person has been made redundant from a paid appointment, which has been the subject of a previous AAC recommendation. A copy of this certificate should be given to the consultant concerned. On presentation of the certificate of redundancy, they may be exempted from the AAC procedures, provided an appointment is made within one year of the date of the redundancy.

Are there any other exemptions from the NHS AAC process?

Other exemptions occur where the person to be appointed:

• is transferred from one trust to another as part of a local reorganisation of the health service, without any significant alteration in the duties of the post
• is a consultant transferred within a trust to another consultant post with that trust
• is a consultant transferred to a consultant post with a different trust where the employment of the consultant would otherwise be terminated by reason of redundancy
• is a consultant, working for the Health Protection Agency (HPA), the Defence Medical Services (DMS) or a university, transferred to an NHS post in which the duties are substantially the same as those performed for the HPA, the DMS or the university
• or was a consultant who retired as a consultant and returns to work in the same trust and specialty as one they filled prior to retirement.

What is the role of an RSPA in the appointment process?

The RSPA is responsible for approving consultant and specialty doctor job descriptions in their specialty throughout the region. It will also sit on the panel (or nominate another consultant to do so on their behalf) for the appointment of specialty doctors and will liaise with representatives of the specialty and subspecialty associations in carrying out these responsibilities. The RSPA is expected to keep up-to-date with the specialist association’s guidance in respect of the appointment of consultants.

What does an RSPA look for when approving a job description?

For consultant appointments, it is to ensure that the post contains the proper balance of clinical, academic and managerial activities to be carried out.

The job description should include an assessment of the service needs and future demands of the post, including the possibility of relocation when service arrangements are under discussion, together with all the information relevant to the post and selection criteria, which might include the minimum qualifications, training and experience required. It should also be clear if the post requires a consultant with a particular subspecialty interest.

Employing bodies should also prepare a person specification for each post, drawn from the job description. The selection criteria should list both the essential and desirable skills and experience needed to perform the job, including any subspecialty interest. It should be noted that a doctor listed on the specialist register may apply for a consultant post in any specialty so it is important that the person specification stipulates that clinical training and experience equivalent to that required for gaining a UK CCT in the relevant specialty is essential.

For other grades' appointments, the RSPA is primarily notified of - and shown the job description of - every non-training, non-consultant grade proposed in their specialty in the region. This is to ensure that the College guidelines regarding such appointments are followed.

What is the expected time for a job description approval?

The RSPA should comment on the job description and person specification, in writing, within 15 working days of its receipt.

Failure to respond following confirmation of receipt of the job description will be interpreted as agreement. If the RSPA is due to be on leave for a substantial period, they should ensure that the necessary processes are in place to notify employing authorities of their absence in order that arrangements can be made for job descriptions to be considered by an alternative RSPA.

Can an RSPA approve a job description for an appointment taking place within his/her own trust?

No, if the RSPA works in the same trust in which the appointment is to be made, the job description should be referred to the appropriate RSPA in a neighbouring region. The College can provide the names and addresses of the relevant RSPAs in the surrounding regions. Please contact us on 020 7869 6219 or email collegereps@rcseng.ac.uk.

Are there any other instances when an RSPA is asked to approve a job description from a different region?

If an RSPA becomes unavailable or the post is vacant then the employing body is referred to another neighbouring RSPA.

Are there special arrangements in some specialties?

Yes, consultant JDs for either Cardiothoracic Surgery, Neurosurgery or Vascular Surgery must be reviewed centrally by the relevant specialty association. As with any other specialty, please email the job description to the College at collegereps@rcseng.ac.uk.

What is the role of a College assessor?

College assessors play an important role in ensuring the fair and transparent appointment of consultants. In particular, they:

• take part in the shortlisting process ensuring that best candidates for the job are shortlisted according to the selection criteria stated on the job description and person specification;
• ensure shortlisted candidates are on the GMC specialist register or the date of interview must be within six months of the candidate’s expected CCT date or qualify via the CESR route;
• provide a fair and impartial contribution towards the shortlisting and appointment process within current legislation and employment practice.

Please read our Handbook for College Assessors for more information.

How do I become a College assessor?

Find out about the College assessor application process. 

What happens once I apply for the position?

Your application will be considered by the College and if approved your name will be forwarded to College Council for ratification. You will then be invited to attend a one-day training course that covers both theoretical and practical aspects of equality and diversity as well as interview techniques.

What are the essential person specification criteria to become a College assessor?

A College assessor must:

• be an established consultant or honorary consultant in the NHS
• have been in active practice as a substantive consultant for a minimum of five years
• be a fellow of The Royal College of Surgeons of England (RCS)
• have taken or be willing to undertake equal opportunity and diversity training

NB: If you are not a member of the RCS, you can join through the ad eundem route. This is where College Trustees grant a FRCS ad eundem to those who have taken their fellowship exam at another college. This would require a fellow of this College to recommend you in writing for the FRCS ad-eundum.

Please email us at collegereps@rcseng.ac.uk for more details.

How am I selected to attend an AAC?

The College will contact you as and when we receive a request from an employing body within your specialty. College assessors are selected based on the location of the AAC, the specialty (or subspecialty) as well as your availability and notice period. We will initially try to find someone from the immediate surrounding regions, but will broaden our search if initially unsuccessful. RSPAs might be asked to assist if a College assessor is not available.

What happens once I agree to sit on an interview panel?

The College sends a confirmation email with information about the appointment including contact details of the medical staffing. You will be contacted by the employing body to confirm your attendance as well as your involvement in the shortlisting process and to outline the trust's expenses travel policy. The trust is responsible for paying all expenses relating to the AAC and all claims should be submitted to them directly.

What happens if the job description has not been approved for the AAC I am attending?

The College will send you an email confirming the discussions that have taken place regarding the job description and recommend you contact the RSPA to discuss ahead of the interviews. The objective of your role on the committee remains unaltered.

What happens if I don’t agree with the employing body on the shortlisted candidates?

If the employing body insists on shortlisting a candidate whom the assessor has deemed as lacking the necessary qualifications for appointment, then the assessor should discuss this with the medical director of the employing body and inform the College. You may also contact the RSPA and/or the College if there are concerns about the job description or the appointment process.

What do I need to do once the AAC is over?

Once the AAC has made its decision, please use the feedback form to inform us of the name and GMC number of the candidate(s) who has/have been appointed. Please also notify the College should any problem arise during or after the AAC.