Te Whatu Ora consulted us on an Early Draft Proposed Approach: Advance offers for Fellows. We strongly supported the proposal to test and introduce advance offers for Fellows. RACS has for some time been advocating strongly for measures to ensure doctors can commit to specialist surgical fellowship training whether in Aotearoa or overseas, knowing they have secure roles at the end of this time within Aotearoa. Retaining and reattracting Fellows is a key part of the strategy to build a sustainable surgical workforce within Aotearoa. It will also maximise the return on our investment in training, reducing the loss to other health systems. We expect a significant benefit of the proposal to be Fellows accepting SMO positions in regional and rural hospitals where recruitment is most challenging.
We agreed with the overall proposed approach to formalising the process for advance offers, the rigorous approach proposed, and the early consultation with colleges before consulting more widely.
However, we conveyed some concerns and suggestions:
- Achieving a sustainable surgical workforce will be significantly dependent on the availability of budgeted positions (FTE) within Hospital and Specialist Services. To enable successful implementation, the budget for new positions in the relevant year must be a pre-condition, not a constraint. There is a clear need in some areas to increase FTE to provide appropriate capacity.
- Making advance offers by moving resource from current positions, with SMOs choosing to reduce their position, job share, or commit to a retirement date, has been successful informally, and could be formalised.
- Consideration should be given to offering less than 1.0 FTE positions as advanced offers or enabling Fellows to access less than 1.0 FTE.
Of the three options proposed:
- Our clear preference was Option One: An advance job offer of a specified role in a specified location within a region as likely to be the greatest incentive for trainees to commit to returning from a specialist surgical Fellowship.
- Option 2. An advance job offer for a specified role at an unspecified location within a region is a much less of an incentive and should be improved by specifying some locations if possible.
- Option 3. An invitation to join the National SMO Talent Pool may capture the interest of a new Fellow but is not an incentive for returning post Fellowship.
Read submission (PDF 197.85KB).