Posts Tagged ‘CEAs’

If you want to keep CEAs, you’ll have to speak up

By Mike Broad - 25th August 2010 10:39 am

I’m guessing that the 2010 round of clinical excellence awards is going to be the most hotly contested yet. Why? Because there’s every chance it could be the last.

CEAs are to be reviewed and the government has questioned their affordability. It follows a near halving in the number of national awards handed out in the 2009 round.

While the review will not be submitted until next summer, you don’t need the powers of Nostradamus to predict the ensuing proposals.

CEAs are set to become like any other modest bonus scheme. Smaller sums will be handed out to more participants and they will become time limited. It’s likely that consultants will have to compete with other health professionals to secure one in a broadened scheme. The big, national awards will be consigned to history and I’d be surprised if the ‘bonuses’ remained pensionable.

The main problem with this is, of course, that CEAs are not some financial frippery aimed at cheering up the odd hard-pressed consultant, but part of the essential terms and conditions of all consultants.

Without them, the government would have had to offer a higher basic salary for consultants in the 2003 contract.

This is what I told a researcher from Panorama the other week when they rang to discuss whether doctors should receive “big bonuses” at the public’s expense. They’re pulling a programme together on the issue of doctors’ pay and I doubt it’ll be supportive.

I also told them that scrapping CEAs will make the government’s job of raising standards in the NHS much harder. While no consultant embarks on a service- or practise-improving project because of the potential to receive an award, there’s no doubt it helps to compensate for the extra work this demands.

There’s also a real risk for the NHS that some consultants will seek to grow their private work instead. Consultants are currently facing a three-year pay freeze and having their SPAs squeezed. Pensions and CEAs are now both subject to high profile reviews and likely to be compromised.

Does the government really believe that a bit of talk about clinical autonomy is going to make up for this, particularly when it wants raised quality and improved outcomes?

The CEA system isn’t perfect but it’s a lot better than it was. It’s more equitable and transparent than ever. If the review concentrated on improving accessibility and ensuring that awards were better linked to ongoing performance then it might even receive professional support. But if it’s just about saving money then I doubt it will receive any (with the possible exception of those who haven’t received a CEA).

There’s an enormous challenge here for the BMA. Can they protect the contract they negotiated? It’s looking difficult. Not only are they going to have to be vocal and vociferous, but they’re going to need the profession to start raising their voices as well.

Who received a national CEA in this year’s round? Read more.

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Review of Clinical Excellence Awards launched

By Mike Broad - 21st August 2010 8:28 am

The government is to review the Clinical Excellence Awards system across the UK with a view to making them more “affordable”.

Health secretary Andrew Lansely has asked the Review Body on Doctors’ and Dentists’ Remuneration to lead the review and it will report by July 2011.

The government says the DDRB will work closely with a range of ‘external stakeholders’, including NHS organisations, the BMA and the independent committees which make awards in the devolved administrations.

Lansley said: “We want to continue to reward and recognise those individuals who give outstanding patient care and go beyond the call of duty, but we must ensure that the system is effective and affordable. The NHS must recognise its responsibilities in the current financial climate as the largest public service in the country and this review will ensure that Clinical Excellence and Distinction Awards are in line with other public sector pay and incentive schemes.

“A more transparent and sustainable awards system will allow the NHS to focus its resources to benefit patients and drive up standards to give us a health service that delivers outcomes among the best in the world.”

CEAs are intended to financially reward consultants who perform over and above the standard expected of their NHS role. They’re given for a range of achievements, from research and innovation through to an outstanding commitment to quality of care and leadership. They are consolidated into pay and are pensionable.

The review will consider the need for incentives to encourage and reward excellent quality of care, innovation, leadership, health research, productivity and contributions to the wider NHS.

There is already a freeze in place on the cash amounts of Clinical Excellence Awards for 2010/11, which was recommended by the DDRB earlier this year. That freeze will continue for 2011/12 and 2012/13.

Consultants did not receive a pay rise for 2010/2011 and are now subject to a two-year pay freeze.

Dr Mark Porter, chair of the BMA’s consultants Committee, commented: “The BMA will engage with this review, which provides an opportunity to highlight the value of award schemes to patient care. These schemes exist to promote quality, efficiency and innovation across the whole NHS, all of which are key aims of the recent health White Paper.

“It is worth noting that Clinical Excellence Award Schemes have already been subject to review in recent years, with the conclusion that they are beneficial to the NHS. The innovative practices and research activity that they encourage not only benefit patients, but also frequently save the NHS money and bring benefits to the economy.”

The number of CEAs handed out nationally was halved in the 2010 round. Only 317 national awards have been given to senior doctors in England and Wales in 2010 in comparison to 601 in 2009.

In 2009-10, the NHS paid £202.2 million to consultants for Clinical Excellence and Distinction Awards, of which 564 consultants received new awards, totalling some £20m. Most of the expenditure on the scheme funds existing awards.

Who received a national CEA in this year’s round? Read more.

Read more on the value of CEAs.

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CEAs are slashed for the highest performers

By Mike Broad - 11th August 2010 4:47 pm

The number of clinical excellence awards handed out nationally has been halved in the 2010 round.

Only 317 national awards have been given to senior doctors in England and Wales in 2010 in comparison to 601 in 2009.

The ACCEA, which runs the awards scheme, has blamed reduced affordability.

There are 12 levels of CEA with the highest three levels - silver, gold and platinum - being awarded nationally. Level 9, or bronze, can be awarded locally or nationally. A bronze recipient is paid £35,484 a year, silver £46,644, gold £58,305 and platinum £75,796.

CEAs are intended to financially reward consultants who perform over and above the standard expected of their NHS role.

In the 2010 round, the Advisory Committee on Clinical Excellence Awards received 1065 applications for bronze, 820 applications for silver, 183 applications for gold and 138 applications for platinum awards. Of these 317 were given awards, with 189 receiving bronze, 84 silver, 23 gold and 21 platinum.

The highest profile doctor to receive platinum in this round was Lord Ara Darzi, author of the former government’s influential High quality care for all: NHS Next Stage Review Final Report. Another well-known doctor was Jonathan Fielden, the former chair of the BMA’s consultants committee, who received a silver award.

A spokesperson for ACCEA said: “There are fewer awards this year than in the past few years. This is a result of reduced affordability in the light of the fact that fewer consultants have left the scheme - through retirement or for other reasons - than anticipated, reducing the funds for reinvestment as well as wider financial constraints.”

The level of CEA awards were frozen for 2010-2011.

Dr Mark Porter, chairman of the BMA’s consultants committee, said: “This is a matter for regret - it’s highly disappointing that so many talented and dedicated consultants have missed out on awards because of factors entirely beyond their control. The scheme exists to ensure that quality care is promoted across the NHS, not just in a few centres of excellence.

“We have strongly protested on behalf of individual applicants, and will continue to express our belief in the value of CEAs.”

Some trusts have also put pressure on their consultants to forgo their CEAs in order to help local finances. And, in Scotland, there has been a strong campaign to scrap the scheme.

Stephen Campion, chief executive of the HCSA, commented: “CEAs, and their predecessor merit and discretionary points, are an integral and long-standing element of hospital consultants’ salaries and terms and conditions of service.

“They are not ‘performance bonuses’ as some uninformed critics have argued. But we know from the leaked document prepared by the Foundation Trust Network earlier this year that they are seen as a target to cut consultants’ pay in order to save money. That the number of national awards has been slashed by 50% this year on the grounds of affordability raises a number of questions about the integrity of the scheme itself.”

The 2011 round of CEAs will open in September and close on 10 December 2010. The ACCEA says that all consultants currently holding an award who received it in the 2007, 2002, 1997 or 1992 rounds should be ‘reviewing’ in the coming round.

Read a full listing of the 317 doctors who received national awards in 2010.

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Clinical Excellence Awards: a full listing of recipient doctors

By Mike Broad - 10th August 2010 3:25 pm

The ACCEA has halved the number of clinical excellence awards handed out nationally in 2010. Only 317 national awards have been given to senior doctors in England and Wales.

There are 12 levels of CEA with the highest three levels - silver, gold and platinum - being awarded nationally. Level 9, or bronze, can be awarded locally or nationally. A bronze recipient is paid £35,484 a year, silver £46,644, gold £58,305 and platinum £75,796.

Here’s the full listing of doctors receiving national CEAs (alphabetically by region):

Cheshire & Mersey

Bronze

Arpan GUHA, anaesthetics

Veronica ABERNETHY, medicine

Helen SCHOLEFIELD, obs and gynaecology

Omnia MARZOUK, paediatrics

Sarah COUPLAND, pathology

Imelda BATES, pathology

Terence JONES, surgery

Silver

Robert MOOTS, medicine

James BARRETT, medicine

NJ SHAW, paediatrics

Cheng Hock TOH, pathology

Gold

DN ANDERSON, psychiatry

Platinum

Jonathan RHODES, medicine

East Midlands

Bronze

Janusz JANKOWSKI, medicine

Martin CULSHAW, medicine

Opinder SAHOTA, medicine

Andrew GODDARD, medicine

Guy RUTTY, pathology

Christopher EVANS, psychiatry

Paul BURTON, public health

Richard RICHARDS, public health

John James ENTWISLE, radiology

Mark SIBBERING, surgery

Silver

Mark BATT, medicine

Susan CARR, medicine

Justin KONJE, obs and gynaecology

Irene GOTTLOB, ophthalmology

Christopher HOLLIS, psychiatry

Gold

Christopher O’CALLAGHAN, paediatrics

Platinum

Nilesh Jayantilal SAMANI, medicine

Nicholas JONES, surgery

East of England

Bronze

Aimen Al-Hassani HASSANI, anaesthetics

Alexander MACGREGOR, medicine

Miles PARKES, medicine

Sarah CLARKE, medicine

Roger BARKER, medicine

Jeremy BROWN, medicine

Pawel WARWICKER, medicine

GP CLUNIE, medicine

Ian BEALES, medicine

Vasanti NANDURI, paediatrics

Suzannah LISHMAN, pathology

Christopher HAWLEY, psychiatry

Li Tee TAN, radiology

Elaine SASSOON, surgery

Matthew PORTEOUS, surgery

David JENKINS, surgery

Silver

Kathleen Ann WILKINSON, anaesthetics

Kenneth SMITH, medicine

Robert TASKER, paediatrics

Nicholas WAREHAM, public health

David LOMAS, radiology

Jerome PEREIRA, surgery

Gold

Andrew LEVER, medicine

Clare MARX, surgery

Platinum

Anthony GREEN, pathology

London North East

Bronze

Andranick PETROS, anaesthetics

Susan WRIGHT, anaesthetics

Susan CUNNINGHAM, dental

William ROSENBERG, medicine

Daniel HOCHHAUSER, medicine

Richard SCHILLING, medicine

Perry ELLIOTT, medicine

Anthony MATHUR, medicine

P AURORA, paediatrics

Michael BURCH, paediatrics

GJ LAING, paediatrics

Marco NOVELLI, pathology

PJ SANTOSH, psychiatry

Peter LUNNISS, surgery

Colin HOPPER, surgery

Silver

Alejandro MADRIGAL, medicine

PH MAXWELL, medicine

Chris BOSHOFF, medicine

Nicholas WOOD, medicine

R VINER, paediatrics

Timothy BRIGGS, surgery

Martin BIRCHALL, surgery

Gold

Chris GRIFFITHS, academic GP

Jane Dacre, medicine

London North West

Bronze

J CORDINGLEY, anaesthetics

Marcus FLATHER, medicine

Kevin FOX, medicine

Theresa MCDONAGH, medicine

Melanie CORBETT, ophthalmology

Michael GATZOULIS, paediatrics

Gwen ADSHEAD, psychiatry

N CHATURVEDI, public health

Vassilios PAPALOIS, surgery

Susan CLARK, surgery

Peter CLARKE, surgery

Silver

Duncan MACRAE, anaesthetics

Alison HOLMES, medicine

Timothy AITMAN, medicine

Guduru GOPAL-RAO, pathology

Nicola STRICKLAND, radiology

Gold

Neil POULTER, medicine

Platinum

David WOOD, medicine

AD EDWARDS, paediatrics

Ara DARZI, surgery

London South

Bronze

Platon RAZIS, anaesthetics

Jackie BROWN, dental

Johann Sebastian DE BONO, medicine

S SHARMA, medicine

Jaswinder GILL, medicine

Desmond BARTON, obs and gynaecology

Baskaran THILAGANATHAN, obs and gynaecology

David O’BRART, ophthalmology

David LAIDLAW, ophthalmology

P GRINGRAS, paediatrics

Mark PEAKMAN, pathology

Anthony WIERZBICKI, pathology

Jonathan EDGEWORTH, pathology

Ann YORK, psychiatry

Allison STREETLY, public health

Sujal DESAI, radiology

Barry POWELL, surgery

Silver

Fraser MCDONALD, dental

Martyn THOMAS, medicine

Andrew SHENNAN, obs and gynaecology

AH SULTAN, obs and gynaecology

Anil DHAWAN, paediatrics

JCW MARSH, pathology

Antonio PAGLIUCA, pathology

Philip MCGUIRE, psychiatry

Anthony BOARDMAN, psychiatry

Sube BANERJEE, psychiatry

Gold

Edward BAKER, paediatrics

Paul LELLIOTT, psychiatry

Charles WOLFE, public health

Platinum

PG KOPELMAN, medicine

Stephanie AMIEL, medicine

Anthony DAVID, psychiatry

North East

Bronze

Gerard DANJOUX, anaesthetics

Patrick CHINNERY, medicine

Alison BROWN, medicine

Julia NEWTON, medicine

Mark ROBERTS, obs and gynaecology

Jason WAUGH, obs and gynaecology

Raj NAIK, obs and gynaecology

HJ VORMOOR, paediatrics

Robert PICKARD, surgery

David DEEHAN, surgery

William OWENS, surgery

Silver

Simon THOMAS, medicine

Hock Kim Stephen HINSHAW, obs and gynaecology

Helen FOSTER, paediatrics

Richard MONTGOMERY, surgery

Simon KENDALL, surgery

Gold

Brian MARTINDALE, psychiatry

Platinum

Chandra Mohan KUMAR, anaesthetics

North West

Bronze

Carolyn CHEW-GRAHAM, academic GP

Chris TILL, anaesthetics

Michael PEMBERTON, dental

Paul LORIGAN, medicine

Edward JUDE, medicine

Terence O’NEILL, medicine

Corinne FAIVRE-FINN, medicine

Anthony JONES, medicine

Dorothy TRUMP, medicine

Ludwig NEYSES, medicine

Rhidian BRAMLEY, radiology

Timothy WOOLFORD, surgery

Silver

Peter TRAINER, medicine

Mark WOODHEAD, medicine

Cynthia PINE, public health dentistry

Kieran O’FLYNN, surgery

B BRIDGEWATER, surgery

Nigel James BUNDRED, surgery

Gold

Alan JACKSON, radiology

Platinum

Christopher GRIFFITHS, medicine

James Edmond WRAITH, paediatrics

South East

Bronze

Colin SPRING, anaesthetics

Andrew DIBIASE, dental

Lawrence GOLDBERG, medicine

Mark HILL, medicine

David HILDICK-SMITH, medicine

Adam Julian DE BELDER, medicine

Jonathan DUCKETT, obs and gynaecology

FG AH-FAT, ophthalmology

Andrew LAURIE, pathology

Peter RIMINGTON, surgery

HD APTHORP, surgery

Clive PRATT, surgery

Silver

Martin FISHER, medicine

David HOWLETT, radiology

Gold

Kevin DAVIES, medicine

Graham LAYER, surgery

South

Bronze

Andrew Oliver Mungo WILKIE, medicine

David OLIVER, medicine

Anoop CHAUHAN, medicine

Bernard PRENDERGAST, medicine

Robert LEWIS, medicine

Avan AIHIE SAYER, medicine

Mark MIDDLETON, medicine

Ashwani MONGA, obs and gynaecology

Vicky OSGOOD, obs and gynaecology

Robert MACLAREN, ophthalmology

Julie EDGE, paediatrics

Rupert MCSHANE, psychiatry

William GRAY, surgery

Henrik STEINBRECHER, surgery

Paul JOHNSON, surgery

Sunil OHRI, surgery

Silver

Timothy LANCASTER, academic GP

Jonathan FIELDEN, anaesthetics

Diana ECCLES, medicine

Christopher CONLON, medicine

Michael CUMMINGS, medicine

Peter SULLIVAN, paediatrics

Robert Mark BEATTIE, paediatrics

Gold

Peter JOHNSON, medicine

Keith WILLETT, surgery

Peter FRIEND, surgery

Platinum

Iain CAMERON, obs and gynaecology

South West

Bronze

Alastair HAY, academic GP

Frederick ROBERTS, anaesthetics

Jane LUKER, dental

Nabil JARAD, medicine

Wai TSE, medicine

Daniel FLANAGAN, medicine

Elizabeth PRICE, medicine

Julian ABEL, medicine

John FERRIS, ophthalmology

Sarah SMITHSON, paediatrics

Jennifer TYRRELL, paediatrics

Andrew MUMFORD, pathology

David PHILLIPS, public health

Amit BAHL, radiology

Raimondo ASCIONE, surgery

Francis Xavier KEELEY, surgery

Richard WELBOURN, surgery

Silver

J CAMPBELL, academic GP

Timothy COOK, anaesthetics

Elizabeth Anne THORNBERRY, anaesthetics

Andrew LEVY, medicine

David WYNICK, medicine

Tanzeem RAZA, medicine

David MARKS, pathology

Anne MOORE, surgery

Alan BRYAN, surgery

Gold

Jerry NOLAN, anaesthetics

Michael DURKIN, anaesthetics

Platinum

Jonathan SANDY, dental

Neil SHEPHERD, pathology

Wales

Bronze

G FINDLAY, anaesthetics

K BISHOP, restorative dentistry

S ALLEN, paediatrics

G ROBINSON, pathology

L FLIGELSTONE, surgery

B CHADWICK, paediatric dentistry

S HUDDART, surgery

A MOTT, paediatrics

P DUMMER, restorative dentistry

CL HANNA, radiology

N MASANI, medicine

A EDWARDS, GP

Silver

E TREASURE, dental public health

A KEMP, paediatrics

P DURNING, orthodontics

PH JEWELL, medicine

Gold

JAE REES, medicine

West Midlands

Bronze

Robert MCKINLEY, academic GP

Anne-Marie SLOWTHER, academic GP

Paramjit GILL, academic GP

Shashi Bala VOHRA, anaesthetics

Andrew VEITCH, medicine

Sara THORNE, medicine

Philip TOOZS-HOBSON, obs and gynaecology

Khalid KHAN, obs and gynaecology

S SHAH, ophthalmology

Pamela KEARNS, paediatrics

Giridharan RAJARATNAM, public health

Simon BRAMHALL, surgery

Isaac NYAMEKYE, surgery

Paolo MUIESAN, surgery

Silver

David MUTIMER, medicine

George KITAS, medicine

Jeremy KIRK, paediatrics

Helen GOODYEAR, paediatrics

Andrew BRADBURY, surgery

Darius MIRZA, surgery

Gold

Paul DODSON, medicine

Platinum

Frederick HOBBS, academic GP

David ADAMS, medicine

Yorkshire & Humber

Bronze

Alison PITTARD, anaesthetics

Robert CRUICKSHANK, anaesthetics

Martin THORNHILL, dental

Simon LITTLEWOOD, dental

Dennis MCGONAGLE, medicine

Helen FORD, medicine

Basil SHARRACK, medicine

John PUNTIS, paediatrics

Michael THOMSON, paediatrics

Simon CROSS, pathology

JF MORGAN, psychiatry

Wendy BURN, psychiatry

William RAMSDEN, radiology

Andrew GRAINGER, radiology

Timothy HODGSON, radiology

John Gavin MILLER, surgery

Muhammad QURAISHI, surgery

Silver

James MCLENACHAN, medicine

Janette CLARKE, medicine

Christopher HOBBS, paediatrics

Eric KILPATRICK, pathology

Timothy KENDALL, psychiatry

David SEBAG-MONTEFIORE, radiology

Adrian JOYCE, surgery

Christopher MUNSCH, surgery

Gold

Peter BELFIELD, medicine

Platinum

Ian GREER, obs and gynaecology

David John COTTRELL, psychiatry

ACCEA

Bronze

Heidi Ann DOUGHTY, pathology

Gillian LENG, public health

Platinum

SR PALMER, public health

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Trusts pressurising consultants to forgo CEAs

By Francesca Robinson - 8th July 2010 8:50 am

Consultants are being pressurised by some cash starved trusts to forgo their bids for clinical excellence awards, claims the BMA.

Some bosses have tried to blackmail consultants by warning that nurses may have to be made redundant unless they can save money.

So far consultants have refused to play ball and the few trusts involved have backed down. In another development, NHS Employers has indicated that the current freeze on the level of awards will continue until 2013.

Mr Paul Flynn, deputy chairman of the consultants committee, is warning that if one trust succeeds with this ploy of pressurising consultants then others may follow suit. “This sort of emotional blackmail is a form of bullying. If trusts managed to pull off a stunt like this it would have an appreciable impact on the morale of consultants. They have certainly been trying it on in a few trusts,” he said.

He added that trusts should be using consultants to lead the way in helping them to make sustainable economies. “Consultants have SPAs (supporting professional activities) in their job plans just for this purpose.”

If CEAs were blocked consultant salaries would fall behind on the pay scale and they would end up with lower pensions and would be much worse off in retirement, he said. “There has been a fundamental misunderstanding among some people of what CEAs are - they are part of a consultant’s pay and are awarded for achieving a standard of excellence. They are not like bankers’ bonuses.”

A spokesman for NHS Employers said they had not heard of any cases of trusts trying to dissuade consultants from putting in CEA applications.

Earlier this year a leaked memo from the Foundation Trust Network outlined a proposal for scrapping CEAs in England as part of range of cost cutting measures. But a spokeswoman said this was not their current policy. “Foundation trusts are committed to promoting quality and excellence and would certainly want to retain clinical excellence awards as part of promoting a successful and thriving biomedical sector in the UK,” she said.

The level of CEAs has currently been frozen in England as part of the two year public sector pay freeze imposed by the government.

Bill McMillan, head of medical pay and workforce at NHS Employers, said: “The value of existing clinical excellence awards will remain unchanged during the pay freeze period. We understand that freeze will continue for 2011/12 and 2012/13. The government will now be considering the matter of new clinical excellence awards, in the light of its wider approach to public sector pay.”

Trusts in Northern Ireland were recently called on to increase the number of CEAs handed out. It was revealed at the BMA’s annual representatives meeting that while CEAs are awarded at a rate of 0.3 per eligible consultant in England, in NI they’re given out at a rate of 0.1 per consultant.

Pressure to scrap the system in Scotland continues.

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Hospital doctors’ pay scales for 2010/2011

By Mike Broad - 10th April 2010 4:12 pm

Consultants did not receive a pay rise for 2010/2011. The government also froze the value of clinical excellence awards.

Foundation year doctors, house officers, senior house officers, specialty registrars, specialty doctors, associate specialists and salaried GPs in England received a 1% pay rise from 1 April 2010.

The government turned down a recommendation from the Doctors’ and Dentists’ Review Body that juniors’ pay should increase by 1.5%. Wales adopted the same pay awards to doctors, but juniors in Scotland received the 1.5% pay uplift.

In 2009/2010, all doctors received a 1.5% pay rise.

Consultant salaries 2010/2011

Threshold 1, years completed as a consultant 0, £74,504, period before eligibility for next threshold one year

Threshold 2, years completed as a consultant 1, £76,837, period before eligibility for next threshold one year

Threshold 3, years completed as a consultant 2, £79,170, period before eligibility for next threshold one year

Threshold 4, years completed as a consultant 3, £81,502, period before eligibility for next threshold one year

Threshold 5, years completed as a consultant 4, £83,829, period before eligibility for next threshold five years

Threshold 6, years completed as a consultant 9, £89,370, period before eligibility for next threshold five years

Threshold 7, years completed as a consultant 14, £94,911, period before eligibility for next threshold five years

Threshold 8, years completed as a consultant 19, £100,446

Clinical excellence awards for consultants

Level 1 £2,957

Level 2 £5,914

Level 3 £8,871

Level 4 £11,828

Level 5 £14,785

Level 6 £17,742

Level 7 £23,656

Level 8 £29,570

Bronze/Level 9 £35,484

Silver/Level 10 £46,644

Gold/Level 11 £58,305

Platinum/Level 12 £75,796

More on Clinical Excellence Awards

Trainee salaries 2010/2011

Grade FHO1

Point minimum, no band £23,533, 1C band (20%) £26,895, 1B band (40%) £31,377

Point 1, no band £25,002, 1C band (20%) £28,574, 1B band (40%) £33,336

Point 2, no band £26,470, 1C band (20%) £30,251, 1B band (40%) £35,293

Grade FHO2

Point minimum, no band £27,798, 1C band (20%) £33,358, 1B band (40%) £38,918

Point 1, no band £29,616, 1C band (20%) £35,540, 1B band (40%) £41,463

Point 2, no band £31,434, 1C band (20%) £37,721, 1B band (40%) £44,008

Grade StR

Point minimum, no band £29,705, 1C band (20%) £35,646, 1B band (40%) £41,587

Point 1, no band £31,523, 1C band (20%) £37,828, 1B band (40%) £41,133

Point 2, no band £34,061, 1C band (20%) £40,874, 1B band (40%) £47,686

Point 3, no band £35,596, 1C band (20%) £42,716, 1B band (40%) £49,835

Point 4, no band £37,448, 1C band (20%) £44,938, 1B band (40%) £52,428

Point 5, no band £39,300, 1C band (20%) £47,160, 1B band (40%) £55,020

Point 6, no band £41,152, 1C band (20%) £49,383 1B band (40%) £57,613

Point 7, no band £43,003, 1C band (20%) £51,604, 1B band (40%) £60,205

Point 8, no band £44,856, 1C band (20%) £53,828, 1B band (40%) £62,799

Point 9, no band £46,708, 1C band (20%) £56,050, 1B band (40%) £65,392

Specilty doctor salaries 2010/2011

Scale value minimum, £36,807, period before eligibility for next pay point one year

Scale value 1, £39,955, period before eligibility for next pay point one year

Scale value 2, £44,046, period before eligibility for next pay point one year

Scale value 3, £46,239, period before eligibility for next pay point one year

Scale value 4, £49,398, period before eligibility for next pay point one year

Scale value 5, £52,546, period before eligibility for next pay point two years

Scale value 6, £55,764, period before eligibility for next pay point two years

Scale value 7, £58,983, period before eligibility for next pay point two years

Scale value 8, £62,201, period before eligibility for next pay point three years

Scale value 9, £65,419, period before eligibility for next pay point three years

Scale value 10, £68,638

Associate specialist salaries 2010/2011

Scale value minimum, £51,606, period before eligibility for next pay point one year

Scale value 1, £55,754, period before eligibility for next pay point one year

Scale value 2, £59,901, period before eligibility for next pay point one year

Scale value 3, £65,378, period before eligibility for next pay point one year

Scale value 4, £70,126, period before eligibility for next pay point one year

Scale value 5, £72,095, period before eligibility for next pay point two years

Scale value 6, £74,665, period before eligibility for next pay point two years

Scale value 7, £77,235, period before eligibility for next pay point two years

Scale value 8, £79,805, period before eligibility for next pay point three years

Scale value 9, £82,375, period before eligibility for next pay point three years

Scale value 10, £84,948

Read the full pay scales.

Dispute over pay awards for hospital doctors

The government takes pay advice from the Doctors’ and Dentists’ Review Body (DDRB) before announcing the pay awards in April. The pay body was set up in 1971 and its reviews are supposedly independent. It has, however, been repeatedly criticised for favoring the government’s position over that of the profession.

The pay body considers the need to recruit, retain and motivate doctors; regional variations in labour markets; the funds available to the health departments in the UK; the government’s inflation target, and the overall strategy that the NHS should place patients at the heart of all it does. It also takes account of the economic and other evidence submitted by the government, staff and professional representatives.

In 2008/2009, the pay increase to doctors’ national pay scales was 2.2%, as recommended by the review body. In contrast, in January 2008, the Retail Price Index - an accurate measure of inflation - stood at 4.1%. The BMA advised pay increases of between 3.6% and 4.3% for the different groups it represents.

In recent years, the media have been less than sympathetic to the pay claims of the medical profession, and the value of GP pay rises in particular have come under scrutiny.

In 2009/2010, the pay increase to doctors’ national pay scales was 1.5%, as recommended by the review body. The BMA criticised the pay body report for lacking clarity on how the figure was arrived at, given that both the NHS Employers’ and Health Department’s evidence suggested a 2% pay rise for doctors was affordable.

The BMA claimed that the evidence appeared to have been discounted and the pay body drew its own conclusions on the affordability of the doctors’ pay round.

In 2010/2011, health secretary Andy Burnham overruled advice from the pay body, which recommended a pay rise for trainees of 1.5%, instead offering 1%. He called on consultants to show leadership over pay restraint.

Burnham said: “These pay uplifts are a good deal for the government and the NHS. In tough times, this package targets the pay rises we can afford to make where they can do most good for patients.”

The BMA had urged the review body to remain independent of government and recommend a 2% pay uplift for 2010/2011.

BMA chairman Dr Hamish Meldrum said: “Many doctors have already undergone pay freezes or sub-inflation pay rises in recent years and today’s announcement will mean a pay freeze for the most highly experienced senior doctors.

“We are particularly disappointed that the Government, in choosing to interfere with the pay review body’s recommendations, has not fully taken into account the financial pressures on junior doctors in their first years of postgraduate training - who have average debts of £22,000.

“It is interesting that the government accepted in full the salary increases recommended for MPs, yet chose to penalise dedicated and hard-working doctors who strive to lead and deliver improvements in care whilst working in exceptionally challenging circumstances.”

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Renewed call to scrap consultants’ CEAs

By Francesca Robinson - 25th March 2010 7:23 pm

New pressure to scrap NHS consultants’ clinical excellence awards has come from former GP and Scottish MSP Dr Ian McKee who has been running a sustained campaign against the scheme.

McKee, who represents the Scottish National Party (SNP), has already persuaded Scottish Health Minister Nicola Sturgeon to freeze the awards for consultants in Scotland and to write to all other UK health secretaries suggesting a UK-wide review.

Now he has called on the Scottish government to be ready to go it alone in reforming CEAs.

There have also been calls from the Foundation Trust Network for CEAS to be stopped in England. The proposal was outlined in a paper discussing a range of cost cutting measures leaked last month to the public sector union Unison.

McKee has attacked what he calls an “insidious bonus culture” for consultants. The freeze on CEAS will save the Scottish government £2m this year.

He told the SNP’s spring conference that health ministers in the UK had failed to tackle CEAs for fear of incurring the wrath of consultants and the BMA.

He said: “Why don’t we eventually get rid of these awards altogether or start a new scheme that rewards genuine exceptional merit for all health workers, not just doctors.”

Paul Flynn, deputy chair of the BMA’s consultants committee, said CEAs were an integral part of doctor’s pay and were linked to improving the quality of care for patients and McKee had not put forward any good argument for abolishing them.

“If they are looking for ways to economise in the health service the BMA will be happy to suggest plenty of other ways they can make more effective cuts without affecting the morale of one of the most important parts of the workforce.”

He said the BMA was not concerned about McKee’s attacks because most people accepted that CEAs were a valuable part of consultants’ remuneration.  

“I don’t think there is an overwhelming move against them. This is just pressure from small groups who have been looking at the scheme and not taking a terribly wide view of it and not understanding the value it gives to the health service.

“We would, however, prefer it if everybody accepted that CEAs are a worthwhile part of doctor’s remuneration.”

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Leak reveals plans to slash consultant ‘costs’

By Mike Broad - 10th February 2010 1:41 pm

Foundation trusts want to stop clinical excellence awards; slash SPAs for existing and newly appointed consultants; cap pensions for higher earners and remove pensionable items; and freeze increments on incremental pay progression.

These are the provocative proposals of a leaked Foundation Trust Network (FTN) paper, which is part of the influential NHS Confederation. It’s a response to the health secretary Andy Burnham’s commitment, in December, to exploring with unions “whether we could offer frontline staff an employment guarantee locally or regionally in return for flexibility, mobility and sustained pay restraint”.

The leaked paper, obtained by public sector union Unison, seeks to identify areas for savings, warning that NHS funding could be worse that currently predicted. Flexibility and mobility are being sought because of the intention to move up to 40% of activity from secondary care into community services.

Certain proposals within the document are underlined in red. These indicate key priorities including freezing increments on incremental pay progression for two to three years; stopping CEAs; and, reducing SPAs for newly appointed consultants to one “to enable them to develop clinical skills”.

Other non-red line proposals include capping the pensions of those earning over £100,000, and removing pensionable items such as CEAs and London weighting. On programmed activities, foundation trusts are urged to reduce SPAs for existing consultants from 2.5 to 1.5 or 1 if possible. 

The FTN also calls for the NHS to make it clear that not every trainee will be offered employment from now on.

Stephen Campion, chief executive of the HCSA, said: “This leaked document shows how the boom years have turned to bust. What we need is a lot more honesty and a lot less secrecy.

“The tragedy of the NHS at the moment is that ministers are fuelling public expectations in the run up to a general election whilst NHS management is trying to figure out which services and staff they must cut to balance the books. In a service that has always depended on trust and goodwill, this paper may well destroy more than money can buy.”

In response to the health secretary’s question on being able to offer staff an employment guarantee, the FTN is non committal. It says: “The group believed that the flexibilities outlined above were now a requirement for managing the fiscal realities but that even with these it would not be possible to give job guarantees.

“In reality many of the factors that will determine the shape of future health and social care services are not under the control of providers but will be determined by commissioning decisions around pathways and competition in service provision.”

The BMA has circulated advice to its local negotiating committees on the FTN paper, describing the proposals as a ‘serious threat to the terms and conditions of service’.

While reassuring LNCs that it is a speculative discussion paper and not policy, the BMA says LNCs should not negotiate on the issues and oppose them where necessary.

On CEAs, the union says: ‘Cutting CEAs would mean a major cut to overall consultant remuneration and will impact on pensions. It must be opposed firmly in all trusts. We suggest that where this is proposed, the LNC should decline to negotiate any changes until they are negotiated nationally.’

On SPAs it says: ‘The 2003 contract makes it clear that consultants should be allocated appropriate SPA time in their job plans to enable them to carry out a range of non-clinical duties. As such a blanket reduction of SPA is inappropriate as job plans must be agreed with individual consultants.’

There are 125 foundation trusts in the NHS, representing about half of all acute trusts.

Read the leaked Foundation Trust Network’s document in full.

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FTN paper on cutting consultant’s terms & conditions

By Mike Broad - 1:15 pm

This is the full text of the Foundation Trust Network (FTN) document leaked to Unison and then run originally in The Guardian:

1. Introduction

In July 2009 FTN undertook a survey of members to examine their priorities for reform of the agenda for change programme. In light of the QIPP programme and the economic realities facing the NHS over the next several years, with a number of member organisations we re-visited the topic of workforce flexibilities as a key part of foundation trust strategies for managing risk and service reconfigurations.

There is now widespread recognition that:  

• Cash will reduce in service (15-20 billion) with no third year commitment from treasury to even flat cash - so the situation could get worse than currently predicted.

• Non-pay costs are rising faster than general inflation and NI contributions at around £500m.

• The commissioning aim will be to take 30-40% activity out of secondary sector.

• There is no allowance in tariff for pay - so real reduction in funding pay bill that will not be made up by using natural wastage.

• Even using full natural wastage only produces 2.9% but will not give the shape of workforce and skill mix required to sustain patient services in new configurations.

• Redundancies are likely to be needed with the best case option being local voluntary agreements.

2. Changes Foundation Trust Employers Wish DH to Pursue

Below is the list of changes foundation trusts want to see to workforce conditions in order to sustain patient services together with an indication of the key priorities (Red Line - note that Hospital Dr has italicised these instead):

• Reform to the need to seek Treasury approval for voluntary redundancy schemes

• Negotiate redundancy payments in 12ths to ensure that the duty to mitigate losses can be implemented if employment achieved quickly in another NHS body. This would create an incentive to move quickly.

• Reduce the number of pay points on A4C Bands (Red Line).

• Change Schedule k so that staff members are not able to opt back in to Agenda for Change having accepted local arrangements.

• Freeze increments on incremental pay progression for 2/3 years. Then change increments to two points - one for learners one for experienced staff (Red line).

• Agency staff - refresh the guidance and PASA agreements to drive down unreasonable costs of agency staff. Recognise that some agency (1%) will be needed. DH to review immigration requirements as these have had considerable impact on availability of quality, medical locums.

• Sick pay - 6 months full/6 months half pay unlikely to be able to negotiate change. So, local robust sick management needed. However, change sick pay so that plain rates are paid for sick pay (Red Line).

• Either abolish or extend the time (7am to 10pm) for plain rate payment on basis that many staff chose to work nights (Red line).

• End permanent injury allowance and potentially temporary injury allowance.

• Make clear NHS will not be able to offer employment to every trainee – national review of commissions.

• Tackle regulatory demands for continual expansion of statutory training: plus DH to create more e-learning products.

• Stop clinical excellence awards (Red line).

• New consultants - reduce SPAs for newly appointed consultants to enable them to develop clinical skills - suggested 9/1 (Red Line).

• Existing Consultants - reduce SPAs from 2.5 to 1.5 or 1 (if possible).

• Pensionable items - review all including London rating and CEAs.

• Stop recruitment & retention premium for all staff.

• Cap pensions for higher earners (over £100k: easier to do as part of a whole public sector review of pensions) and look at removal of other pensionable items such as London weighting and CEAs.

3. Agreed Foundation Trust Network Position on Guarantees

In our working group there was some discussion of how FTN should respond on behalf of the foundation trust community to any request for guarantees on jobs. The Group believed that the flexibilities outlined above were now a requirement for managing the fiscal realities but that even with these it would not be possible to give job guarantees. In reality, many of the factors that will determine the shape of future health and social care services are not under the control of providers but will be determined by commissioning decisions around pathways and competition in service provision.

The statement below was approved:

“Foundation Trusts do not believe that, in the economic climate and given the system and reconfiguration challenges they are facing, it will be possible to offer any guarantees that compulsory redundancies will not be required. However, all Foundation Trusts will want to fulfil their responsibilities as good employers in supporting staff to find suitable alternative employment in partnership with the local health economy as a whole.”

FTN January 2010

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Time to answer the West Lothian question

By Stephen Campion, HCSA chief executive - 15th January 2010 4:38 pm

What price devolution? The ‘West Lothian question’, whether Scottish MP’s in Westminster should have the right to vote on legislation that only affects England, has yet to be satisfactorily answered.

But the controversy sparked by a member of the Scottish parliament with a petulant bee in his bonnet about wanting to do away with rewarding excellence in medical practice, saw Nicola Sturgeon, Scottish health secretary quoted as saying: “CEAs are outdated and should be reformed on a four-country basis to avoid undermining the competitiveness of any one country when recruiting consultants.”

I simply cannot follow that logic. Why is it then that Scotland has decided social care should be free in that country, but not advocated it on a “four country” basis? Why is it that Wales has abandoned car parking charges whilst others in the UK are forced to pay punitive fees to visit their local hospital? Is that really fair on a “four country basis”?

And, incidentally, why is it that Wales decided to amend the “old” contract rather than adopt the one in place in the other three countries - albeit with minor differences? Many in the other three countries are now wishing they could do the same. Even though the Wales contact is not perfect, it is less open to the flagrant abuses that are being seen elsewhere in the UK.   

Either a policy that is good enough for one country should be applied across the UK - or we have genuine devolution where devolved parliaments do what they believe is right for that country and, crucially, be accountable to those they represent for whatever legislation they introduce.

Come on! Politicians can’t have it both ways! If the Scottish health secretary really wants to antagonise consultants in Scotland then that is her decision - and risk the consequences. But to hide behind the cloak of saying that to do so would undermine the competitiveness of her own country, and should therefore be a UK initiative, makes the concept of devolution a mockery.

If Nicola Sturgeon really believes she is onto a winner then that is her decision, but why should England, Wales and Northern Ireland carry her political risk?

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