Less women are receiving clinical excellence awards suggesting female consultants are falling victim to discrimination.
Managers’ magazine HSJ claims the Advisory Committee on Clinical Excellence Awards – which runs the scheme – has submitted a report that reveals a marked reduction in the proportion of new awards given to women.
The evidence, submitted to the Doctors’ and Dentists’ Remuneration Body, also shows that nearly 60% of NHS consultants are currently in receipt of a clinical excellence award, at a total cost of more than £380m – although the numbers of awards given and their cost has fallen.
CEAs, which are awarded to doctors who work above and beyond their contractual commitments, have been under review since August 2010 and have been subject to a series of un-negotiated cuts. Their future is now part of the ongoing consultant contract negotiations.
The number of national awards has been limited to 300 since the review started when, in 2009, 601 national awards were made to doctors in England and Wales.
Furthermore, the ratio used to calculate the minimum level of investment for employer-based awards was reduced in 2011 from 0.35 to 0.2 per eligible consultant, making it much harder to secure a local CEA.
The ACCEA report reveals women received 16% of the awards in 2012, down from 24% the previous year. Women make up approximately 31% of the consultant population, according to 2012 Department of Health data.
Women are significantly less likely to apply for an award than men, making up just 17% of applicants. For the first time in five years female applicants are less likely to succeed than men at obtaining the highest levels of awards, the committee’s report says.
The review of the CEA scheme by the doctors’ pay body recommends a reduction in the overall value of awards. It says that national awards should be available to a maximum of 10% of consultants and be capped at £40,000 a year, £35,000 less than at present. Local awards should be available to 25% of doctors and be capped at £35,000 a year.
Currently CEAs are awarded on top of a doctor’s regular salary, are pensionable, and paid until retirement. The review recommends CEAs are awarded for no more than five years nationally and one year locally and should not be pensionable. Although Health Secretary Jeremy Hunt has said at the time he is prepared to accept the pensionability of future national awards.
Among local employer-based awards, men are more likely to receive the higher level of award than their female colleagues, the ACCEA report says.
The advisory committee says this data suggests “that employer based awards are heavily skewed by gender, with women being much more poorly recognised than men to an extent that raises concerns about discrimination”.
Fourteen per cent of awards went to consultants from minority ethnic backgrounds – a group which accounted for 16.5 per cent of applications.
The top three national awards worth between £58,305 and £75,796 are held by just 457 consultants, 1% cent of the total. Meanwhile, 4,327 consultants (11% of the total) hold a level 1 award, the lowest level, worth £2,957.
In total £380.7m worth of awards were being paid out each year, as of October 2013. The national awards element made up £177m in 2012, significantly lower than its height of £203.5m in 2011, a fall the committee suggests is mainly due to the retirement of senior consultants in receipt of the top level awards.
Dean Royles, chief executive of NHS Employers, commented: “I think this really does lend weight to having more local discretion on the application and criteria for CEAs. People often mount a spurious argument that you need national involvement to ensure fairness and yet here is clear evidence of it not working for women and not working for people from BME backgrounds.”