Trusts are urging the government to scrap clinical excellence awards.
NHS Employers, their representative organisation, has told the Doctors’ and Dentists’ Review Body in a submission that CEAs should end or be significantly reformed. The DDRB is currently conducting a review of CEAs for the government with a view to making them “more affordable” and will report next summer.
The submission also says that if reformed, the CEA process should include stronger employer control over decisions on pay and reward at a local level.
It admits that employers are divided over the continuance of CEAs. Some accept there is benefit in having a system which rewards outstanding contributions by doctors. “There is broad agreement amongst employers that the current financial and policy framework is not fit for purpose,” it says.
Employers say the awards should not be pensionable, protection should end and any available money – as a result of the reform – should be redistributed directly to employers, to use as part of their pay and reward system.
Stephen Campion, chief executive of the HCSA, commented that the current debate brings the role and function of hospital consultants into a sharp focus.
He said: “NHS Employers seem to imply it wants consultants to work exclusively to meeting the objectives of NHS trusts. The question has to be asked about whether government, and indeed the public, want consultants to act also in the wider interests of the NHS.
“Consultants play a key role in developing professional standards, research, teaching and training. We would hope NHS Employers agree and that any DDRB recommendation will similarly recognise that consultants should be encouraged to work in the national NHS interest. Its narrow view is one that threatens the development of medical practice rather than encourages it.”
Employers also expressed concerns about whether the awards truly award excellence, the requirement to spend an allocated proportion of the pay bill regardless of the number and quality of applicants, the portability of the awards to other employers, the value of the awards and the dominance of the system by doctors.
NHS Employers is calling for a scheme that provides organisations with the flexibility to reward consultants in a way that is integrated into local systems and needs.
The government has already sought to reduce the number CEAs handed out to doctors in the 2011 round prior to the DDRB’s review findings.
In the draft guides for the 2011 round of CEAs from the Advisory Committee on Clinical Excellence Awards, the government agency that administers them, the ratio used to calculate the minimum level of investment for employer based awards has been reduced from 0.35 to 0.2 per eligible consultant.
CEAs have effectively been scrapped in Northern Ireland, pending the review, and distinction awards stopped in Scotland.
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