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Local Clinical Excellence Awards are a substantial part of consultants’ pay; and we’ve just secured an important deal with the Government to ensure this continues to be the case for consultants in England.
The future for Local CEAs was not always certain and the process to settle it has not been a straightforward one. Initially, the then Department of Health had planned to withdraw the existing Local CEA scheme (proposing that they remove all existing awards over a 3 year period) and have also in the past cut funding for local awards by 40 per cent. Equally, we know that some employers have routinely ignored requests to run rounds for new awards. That increasing failure to run rounds meant investment was bleeding out of the consultant pay envelope: that is not reasonable nor is it fair.
As part of our lengthy and protracted action to preserve CEAs we took legal action to unequivocally establish the long term contractual status of Local CEAs. We never take litigation lightly, not least because once you enter into legal proceedings control of the outcome is lost when you ask a third party to settle a case. However, we’ve settled this case out of court with the Government, and in doing so secured the majority of what we hoped to achieve.
So, what is the future for Local CEAs under the agreement which we have reached?
First, we have secured more than £300m in annual funding for LCEAs for the future. There will be a 50 per cent increase in awards than before the agreement - under this new deal, a minimum of 0.3 CEAs will be granted per eligible consultant, compared with 0.2 CEAs as was previously the case.
Second, and crucially, all trusts will be contractually obliged to run award rounds each year. This was an important legal point to establish and was one of the key drivers behind us taking legal action in the first place.
Under the settlement agreement, there is no longer any ambiguity about your contractual right to apply for a CEA. To be clear, as a result of this deal it has been incorporated into your contract.
From April this year, any trust refusing to run an award round will be in breach of their employment contract with you, and the BMA will support members should that occur.
On top of that, all of the CEA funding must now be spent each year. To be clear, that is to say that all of the CEA funding must be spent on CEAs each year and not held back or diverted elsewhere.
Of course, in any negotiation there are some trade-offs; some of which have caused understandable concerns.
While all existing CEAs will be retained and remain pensionable, any awarded from now on will not.
Instead, awards under the new arrangement will be paid as a single lump sum and last between one to three years.
We agreed to this, after much consideration, for two reasons:
Perhaps most importantly, many consultants tell us that they are already hitting the ceiling for annual and lifetime allowances in their pensions. So extra income from CEAs generates large additional tax charges.
But equally, agreeing to this helped to secure some extra funding which will enable more consultants to benefit from LCEAs than are currently able to do so
Consultants wishing to boost their pensions can still do so by purchasing additional pension through the NHS scheme, as is currently the case. But by increasing the consultant-award ratio to 0.3, it means more of us will have extra income from a CEA to make that choice.
Making such decisions is never easy, but all things considered, I believe it was the right decision.
Other concerns have been raised about how awards will be reviewed under the new deal – and what happens to those of us who lose national level awards.
We have secured protection for all existing awards going forward. CEAs have always been subject to review, of course, but that has rarely been applied. So as part of the new arrangement, we have agreed a fair method of review that ensures that existing awards are reviewed and renewed using a nationally agreed methodology and are not simply removed. The review process starts in 2021. And in addition, in almost all cases, national awards will revert to local ones if they are withdrawn.
We will be holding further discussions as part of our talks with NHS Employers about what CEAs will look like post-2021. But until then, this deal has secured the necessary finance, protections and rights to halt the permanent demise of CEAs and allow more of us to benefit from a scheme which rightly rewards your excellent practice in service, leadership, research and teaching.
Rob Harwood, BMA consultants committee acting chair
Find out more about the clinical excellence awards deal in our roadshows in Newcastle, London, Taunton, Birmingham and Manchester in April and May. More details are here
The award scheme is indefensible and a poor use of public money. I am more concerned as a retired member of the profession that my successors should have reasonable increments during their service for their whole career. I agree that retaining the 300million as part of the remuneration of all consultants is desirable and i can see that the new limited life awards do help to spread the money around a bit more. Having been in my time MAC chair and having sat on an LAC and coordinated staff side several times i am aware that the way such awards are made is never fair although it aspires to be. I think that the money could be better used to ensure that interval increments linked to revalidation appraisal and acquisition of further qualifications taken with performance say every five years would be fairer for local awards. The money used for national so-called distinction awards would be better used to fund higher remuneration posts linked to specially funded units like a five or seven year package for a Trust to apply for, for example a professorial post in a specialty so that applicants would be appointed to a high salary scale based on overt excellence and tasked with development or research funded at an international level. Currently ACCEA is about the same as the committee which appoints the members of Tony Blair’s House of Lords. Such a system while acceptable to the Victorians or their predecessors should not exist in the 21st Century and it makes the profession vulnerable to accusations of being in the pocket of the government. I state that I retired with four superannuable discretionary points. I stopped applying while I was MAC chair as I coordinated the LAC and although not an obligation I felt that I should not apply while so involved.
Would there be plans to do this for Specialty Doctors and new Associate Specialists?
Pathetic. The contract states that the consultant / award ratio should be 0.35. To agree 0.3 is no improvement, no victory, and nothing to be proud of. And the new ones are not superannuable and can be removed! - what a sell out. Disgraceful.
CEA scoring committee should be independent of the hospital managment, and be made up purely by the general consultant body. I have raised concerns of unfairness and bullying by some hospital doctors in leadership/managerial positions who sit on the panel - and I know what score they will give me! I find the general attitude of these people appalling.
I did rather well, thank you.
But I am most concerned my successors will not.
All I can suggest is that each consultants assesses their own worth, and works to whatever standard employers deem appropriate for the remuneration they are prepared to offer.
Goodwill regrettably is likely to be the first casualty. So be it. Employer's decision.
As for national awards- iniquitous!
It could be that after some years you will 'only just miss out', but that being so it makes no sense to have done all you did over those years, and for which you will not be remunerated.
Offering your services for free is very altruistic, but surely a financial no no.
You will have to assess your chances and stop 'going the extra distance' unless you can be sure of due reward. Sorry, but that's the logic of the system.
And when is Rob going to stop 'acting' and be appointed the definitive chair of CC?
We don't want actors at a time like this.
No comment on whether these are consolidatable or not. Do you just bumble on having to do more and more to justify a 3000 pound increase for a year, and never go up the scale? Unbelievable that current high level awards have not been capped rather than retained in their entirety. An ‘average’ consultant retiring today could reasonably expect to be on a level 9 local award, an extra £36000 pa pensionable. BMA sellout again
At present, the local CEA awards at level 9 are to be reviewed every 5 years. This point was being re negotiated so that the renewal after 5 years was not necessary. Any agreement reached on this or not?
Aren't these awards cited as part of the reason for the gender pay gap within the UK medical profession? Please correct me if this is not the case.
It's great that people are interested in this topic.
Outstanding clinical awards are now guaranteed. This is good news for clinical studies.