This paper has been drawn up primarily to assess the issue of accountability when a specialist registrar (SpR) is undertaking elective work when the consultant nominally responsible (referred to below as the primary consultant) is absent. In the event of an untoward incident, the organisational role of the trust would come under scrutiny, as would the individual role and actions of the primary consultant, the supervising consultant (referred to below as the nominated consultant) and the SpR. Paragraph 4 also addresses the situation of non-consultant career grade staff.
Paragraph 5 addresses the situation of SpRs and non-consultant career grade staff undertaking nonoperative duties. Pre-registration House Officers and inexperienced senior house officers (SHOs) must not undertake any operative procedures without direct supervision by more senior staff. The only exception would be the case of an experienced SHO acting as a registrar with the full knowledge of the appropriate clinical director,when the guidance set out in section 2 would apply.