Anaesthetic Workforce Census 2025 – SAS and Locally Employed Doctors
The RCoA’s SAS and Locally Employed Doctors report sets out key findings from the RCoA 2025 Census on the working lives of specialist, associate specialist and specialty (SAS) doctors and locally employed doctors (LEDs) working in anaesthesia. It explores their demographics, how they work, their motivations and career intentions, and the training and support available to them.
Summary of key findings
- In the UK, there were 2,182 SAS doctors and 2,272 locally employed doctors (LEDs) working in anaesthesia.
- Numbers of SAS doctors have gone up from 1,635 in 2020, an increase of 33%. Numbers of LEDs have also likely increased but lack a comparable baseline.
- Specialty doctors are the largest group of SAS doctors working in anaesthesia in the UK, with 1,624 working in anaesthesia, constituting 74% of the SAS workforce.
- The anaesthetic workforce is mostly permanently employed, particularly among consultants (93.6% permanently employed) and SAS doctors (88.0%), with limited numbers on fixed-term or external/agency locum contracts.
- In contrast, LEDs are predominantly employed on fixed-term contracts (81%), with only a small minority holding permanent roles (15%).
- The proportion of doctors who gained their primary medical qualification (PMQ) in the UK varies considerably by anaesthetic staff group. 56% of LEDs gained their PMQ in the UK versus 44% who gained it abroad. Among SAS doctors as a group, 41% gained their PMQ in the UK versus 59% who gained it abroad.
- Within SAS doctor grades, 60% of specialist doctors gained their PMQ in the UK, compared to 39% of specialty doctors and 24% of associate specialist doctors.
- By way of comparison, 93% of AiTs gained their PMQ in the UK and 80% of consultants.
- Almost six in ten SAS doctors (59%) in our sample reported they practised autonomously, while 41% work under supervision.
- According to clinical leaders and college tutors, the most commonly reported level at which LEDs were working was Stage 2 (ST4–5) equivalent (37%), followed by Stage 1 (CT1–3) equivalent (31%) and then Stage 3 (ST6–7+) equivalent (28%).
- Overall, the proportion of SAS doctors who said they were in the role through choice was 43%.
- Breaking the results down by contract shows this figure to be 37% for specialty doctors, but higher for specialist and associate specialist doctors, at 64% and 65% respectively.
- Among those who reported choosing their role, better work–life balance was the most common motivator, selected by 79% of those in the role through choice, alongside more direct clinical care (45%), reduced governance (34%) and lower levels of stress (33%).
- 44% of LEDs had applied for a specialty training post before entering their role.
- Demand for progression is high. 38% of SAS doctors and 63% of LEDs were actively studying, training, or building a portfolio to access a more senior role at the time of the survey. A further 30% in each staff group were planning to work towards a more senior role at some point.
- Only 24% of SAS doctors and 4% of LEDs intended to stay in their current roles indefinitely, without taking active steps to access a more senior role.
- 6% of SAS doctors and 39% of LEDs had an active application in for specialty training at the time of the survey. A further 15% of SAS doctors and 29% of LEDs were planning to make an application in the next two years.
- 30% of SAS doctors and 36% of LEDs were working towards completing the portfolio pathway at the time of the survey, with a further 11% and 8% intending to work towards it at some point.
- Among specialty doctors, interest in the more senior specialist contract is high. 72% reported wanting to access it at some point.
- However, there are barriers to accessing the specialist contract. Nearly half of specialty doctors (49%) said they would like to move contract and have been in their post long enough, but still had not been able to do so.
- Only half of SAS doctors (51%) reported having an SAS advocate in their Trust or Board.
- Transition pathways for LEDs to become SAS doctors after two years of service (a key ask of the “SAS Six” campaign) were reported by only 27% of college tutors. A further 16% said such transition was possible, but only after more than 2 years.