Deal to reform clinical excellence awards agreed

The out of court settlement, announced today, reveals changes to the local awards scheme, which is worth £300m.

Trusts will continue to run annual awards rounds but new points will be time limited for between one and three years, non-pensionable and paid annually by lump sum.

Existing awards will remain pensionable but will be subject to review from 2021.

NHS Employers said the changes were in line with the Review Body on Doctors’ and Dentists’ Remuneration’s recommendations from 2012, which suggested a move towards a scheme that rewarded consultants for their current performance rather than historical actions.

NHS Employers said time limited awards would “help to increase the accessibility of awards”.

However, the Hospital Consultants and Specialists Association rejected the deal, dismissing it as “half-baked”.

From April 2021, variations to the local CEA scheme may be introduced by the employer in consultation with staff. Future performance payments will continue to be non-pensionable and time limited.

Consultants will continue to have access to the national reward scheme and reforms will be introduced with consultation and subject to agreed protections for existing award holders.

Danny Mortimer, chief executive of NHS Employers, said it was right that consultant colleagues were “properly recognised”.

“This clarifies the immediate future of local clinical excellence awards for consultants and prepares the ground for further negotiations on wider consultant contract reform and a fully revised clinical excellence awards scheme,” Mr Mortimer said.

“This is an important step towards the longer term aim of establishing a local awards scheme more closely aligned with local service priorities,” he added.

Robert Harwood, acting BMA consultants’ committee chair, said the union has secured the necessary funding to ensure the annual award rounds continue.

He said: “Securing protection for the future of the local CEA scheme is a significant achievement, given some employers have not been running local award schemes in recent years and investment has been declining.

“We think this is good news for consultants. From April 2018, new awards will be non-pensionable and non-consolidated but the total number of awards available each year will increase, making it more likely that consultants who demonstrate excellence will be rewarded.”

The HCSA said signing up would involve forfeiting negotiating rights over a new scheme from 2021 and would allow trusts to individually change local clinical excellence awards. It said it fears this would divert doctors towards “narrow trust objectives”.

The union called for the current scheme should remain in place and be fully implemented until the revised consultant contract as a whole is agreed.

HCSA President Ross Welch said: “This is a half-baked and hastily constructed scheme that will have unforeseen consequences for the profession.”

“It would be a neglect of our duty to members to sign up to a plan that gives carte blanche to NHS trusts to effectively do as they like in three years’ time without reaching a national agreement on what a replacement scheme will look like,” Professor Welch said.

In 2012, the DDRB recommended changes to the CEA scheme to link awards better to annual performance and appraisal.

Under the proposals, local clinical excellence awards would be awarded annually while national awards would be limited to a maximum of five years.

It also suggested awards be non-pensionable and treated as part of the consultant’s salary, with national awards capped at £40,000 and local awards at £35,000.

The Department of Health and Social Care has wanted to see the awards become time limited for more than five years.

The changes announced today are part of wider negotiations between NHS Employers and the BMA over changes to the consultant contract.

In February, HSJ revealed ministers wanted a deal that would end automatic pay progression for consultants who would also lose their right to opt out of non-emergency work at weekends. No current consultant will have their salary reduced under the deal.

Consultants would be paid on a two point pay structure that “significantly” reduces the time taken to reach the top pay scale, leading to a more attractive basic pay.

The deal could be agreed later this year but it will go to a ballot of not just consultants, but also speciality doctors and junior doctors at ST3 registrar level and above.