Leadership is not a luxury 

28th January 2026, Rob Fleming

Leadership is not a luxury – welcoming FMLM support for the SAS Six

The SAS Collective is delighted to welcome the Faculty of Medical Leadership and Management (FMLM) into the fold, as they announce their support for the SAS Six campaign.

For too long, the conversation around medical leadership has suffered from a persistent blind spot. We have historically operated under a hierarchy that suggests medical leadership is only the remit of consultant colleagues, when this is not the case. This has not been the case for a very long time. Leadership is a skill set, a mindset, and—most importantly—a necessity for the sustainability of the NHS.

Breaking the "SAS ceiling"
 

The FMLM's support carries a recognition that the barriers preventing SAS doctors from leading are often structural, not personal. While some SAS doctors are already achieving their leadership potential, others find their aspirations stifled rather than supported.

SAS doctors are frequently viewed as the workhorses of the department—valued for their clinical output but bypassed when it comes to strategy and governance. Finding the time and budget for leadership development shouldn't feel like an undercover mission, but it often does. It’s time to move past the idea that you need a specific badge to head a department, chair a committee, or lead a transformation project. SAS doctors need parity of access to the professional development required to become leaders, and then the opportunity to use these skills.
 

​SAS may have the tools to fix systems in which they work

We aren't asking for these opportunities as a "thank you" for hard work. We are asking because we may well have the tools to help fix the systems in which we function. SAS doctors offer a unique perspective, and it comes with long-term institutional memory. We often see what works, what fails, and where the waste occurs. To deny a SAS doctor a seat at the leadership table isn't just a slight to the individual—it is a failure to utilise vital departmental intelligence.

With the FMLM's backing, we are calling on Trusts to stop seeing SAS leadership as an "extra" and start seeing it as an essential investment. The SAS Six is a blueprint for a modern, inclusive, and effective medical workforce, and we would encourage employers to use it.

If we want an NHS that survives the next decade, we need every skilled leader working to their ability—regardless of their contract type.

The days of the 'invisible' SAS doctor are over. It's time to trade the shadows for the boardroom.