The Scottish Government

• Robust evidence is available in the literature of best practice approaches to recruitment and selection in non-medical contexts. Specifically in how to effectively carry out job analysis and define selection criteria to assess teamworking, leadership potential, personality, attitude towards work etc.
• In the medical context, at entry into UG and PG medical training, there is some evidence of the value of identifying criteria and piloting relevant selection methods. For example, how to identify and assess potential for attaining clinical competence and non-clinical attributes, given that these are viewed as important criteria for the successful completion of training/future performance.
• There is little national or international documented evidence of senior level medical recruitment practices, nor indeed the criteria for selection.

• There is no evidence of any systematic analysis of job requirements and limited evidence of whether or how non-clinical criteria have been assessed within consultant selection.
• However, stakeholders consistently identified criteria important to assess at this level, although there is no published evidence of the most effective ways of assessing this in this context.

• While extensive academic literature exists on best practice recruitment and selection in other sectors, there is limited evidence of practice in medical recruitment, especially for consultant recruitment.

• Lessons can be learnt from other sectors, but given the unique medical context, care must be taken in application of selection methods within this context.

• Significant opportunities exist for Scotland to be the first to identify relevant selection criteria and methods for consultant recruitment, establishing Scotland's consultant recruitment practice as 'leading edge'.
• The development of appropriate person specifications (reflecting specialty differences and non-clinical criteria) is essential.
• Piloting and validation of methods prior to implementation is essential.

• Scotland needs to attract candidates to apply to posts to improve selection ratio and fill rate of consultant posts.
• Scotland operates a different appointment process to the rest of the UK in that clinical competence is assessed via Royal Colleges in England, not National Panellists as in Scotland.
• One of the future challenges for Scotland is that doctors will exit training earlier and potentially have less experience in their specialty. Those applicants applying straight out of completing their CCT and medical training within Scotland believe they many not be as competitive with those who have held a CCT for years and are already in the system. The challenge is to ensure fair recruitment and selection for all groups.
• A clearer development plan following appointment may be required in the future. Whilst this currently happens in some appointments, given changes to the training of doctors in Scotland, formalised development opportunities identified at interview and feeding this into appointments may be necessary.

• An appointments process and system is required that is attractive to candidates and fits with their needs. In particular in managing perceptions and expectations regarding fairness in appointments and development opportunities post CCT.

• Widening the applicant pool is critical. Advertising is one method, but alone may be insufficient to ensure a wide applicant pool. Improving the accuracy of job description and person specifications can also be beneficial.

• It is possible that the selection ratio may change and so Scotland will need to 'future proof' any process and method of selection to this level.

Theme 1: Recruitment and selection process

• Stakeholder consultation makes clear that the process by which appointments are made is viewed as bureaucratic, inefficient and in need of improvement. There is also evidence to suggest that the effectiveness could be improved. This is not to say there are grounds to suggest the wrong people are being appointed, rather that there are lost opportunities in current practice.

• Improvements are required to the practicalities and feasibility of the appointments process to reduce bureaucracy and enhance efficiency. There are opportunities to improve effectiveness of the process.

Theme 2: Professional standards and quality assurance in recruitment

• There were mixed views on whether National Panellists needed to carry out clinical competence verification and how this is carried out. What is clear is that while the CCT is an important indicator of minimum clinical competence, alone it does not confirm whether a doctor has the experience to safely practice within a particular job context. All stakeholders would welcome a clarification of the role and boundaries of the National Panellists remit, in addition to more structured training for the role. Training of interviewers was also viewed as necessary for the future.

• Clinical competence still needs to be assessed beyond CCT. If National Panellists continue to carry out this role, clarification of their remit, training and added value beyond that of local consultants or senior doctors is required.
• Training of interviewers, particularly Chairs could be improved.

Theme 3: Selection criteria

• Clinical competence was clearly specified on job descriptions. However, all stakeholders believed that improvements could be made to the identification and assessment of other important selection criteria. Common areas included teamworking, clinical leadership, motivation and intention for development of special interests, communication and organisational fit.

• Work to identify the selection criteria for consultants, particularly non-clinical knowledge skills and abilities is required.

Theme 4: Selection methods

• Shortlisting methodology is not currently a major issue as most eligible applicants are invited to interview. All stakeholders support the use of interviews as a method for recruitment at this level. However, many want improvements to the interview (eg number of interviewers, content, criteria, timing, structure, training) to help generate more valuable information on candidates, while reducing bureaucracy and workload. Stakeholders want improved ways of using selection information for development activities for appointed candidates and for feedback to unsuccessful ones.
• There was strong interest in the use of other selection methods (eg presentations, work-based exercises, personality), but most stakeholders were unsure of the evidence and acceptability for their use in this context. Many would like pilots to generate evidence of the validity, reliability and utility.

• Consistent view that the interview could be improved to obtain better information on candidates and utilise panellist time better.

• Interest exists in exploring the use of other selection methods, but evidence is required to gain acceptance/ confidence that alternatives will be an improvement on current methods.

Theme 5: Fairness and diversity

• Attracting an eligible pool of candidates from which to select from was a key issue for many employers. Advertising widely clearly helps, but alone this strategy may not be enough to ensure a suitable applicant pool. Tensions were apparent with stakeholders wanting to retain local talent through the process. Legislation provides requirements to ensure the process is fair, but clearly practice has developed to work around this for organisational and departmental needs. Most recognise that legislation in itself will not change some of this practice.

• Evidence is required to convince many stakeholders of the benefits of ensuring posts are attractive to a wide group of applicants. Detailed and accurate person specifications and job descriptions can enhance this.
• Training in equal opportunities, fairness, and interviewing can help stakeholders to better understand the benefits of attracting a wider pool to individuals, departments and organisations.

Theme 6: Future perspectives

• It was clear across all stakeholder groups that improvement is required to the appointments process. Stakeholders differed to the extent of improvements required, and had some concerns about what was possible in the context of changes to junior doctor selection. However, most felt that clearly opportunities exist to improve the selection process and planning is required now to ensure a robust system is in place to deal with future output from specialty training.

• There is considerable support for improvements but it is clear that any improvements to current practice need to be consider in the context of the current climate following the changes in selection of junior doctors.

• Evaluation of the effectiveness of any appointments process must consider factors other than whether the right person was appointed, whether they are effective in post and are retained. Evaluation of the process is required from multiple stakeholders (eg applicants, HR, interviewers, employers etc) in order to judge success.
• Design of evaluation is important if any improvements take place. This must be agreed in advance with regular reviews and checkpoints to the process.
• Monitoring of selection process is required and reviewed regularly by key stakeholders to ensure best practice is adhered to and to ensure improvements made on basis of evaluation.

• An evaluation design is required if improvements are made. Best practice shows this should include multiple empirical assessments including measures of validity, reliability and the utility of methods and processes.