The BMA has reached agreement with the Department of Health and Social Care, NHS Employers and the HCSA to extend the interim arrangement of schedule 30 of the 2003 terms and conditions of service for a further year, until 2022, in the form of equal distribution of funds between eligible consultants for what would have been the 2021 local CEA (clinical excellence awards) round.

In 2018, the BMA agreed an interim arrangement with the DHSC and NHS Employers regarding the local clinical excellence award scheme for England.

This secured the funding for CEAs within the consultant paybill; funding that the government had threatened to remove completely – including removing CEAs from existing award holders.

This interim agreement was for a three year period to allow time for a new successor scheme to be negotiated. Originally this agreement was due to come to an end on the 31 March 2021, but given the unprecedented events of the last 12 months, the BMA, NHS Employers, DHSC and HCSA agreed that the interim arrangements should be extended for a further year to facilitate agreement on a new local CEA scheme.

In addition, as per the arrangements last year, it has been agreed that instead of running a formal local CEA round, the CEA funds will be distributed equally between eligible consultants.

As part of the agreement to extend to a fourth year, DHSC, Employers and NHSE/I were insistent that the size of the CEA bill did not increase as a result of the extension. In effect this means that for year 4, the additional investment in terms of new ‘points’ should be equal to the attrition of existing pensionable CEAs that are relinquished as people retire.

This will of course vary between trusts and between years but detailed modelling undertaken by DHSC based on 2020 figures suggested that a ratio of 0.218 would be cost neutral across England.

However, the data is not available at present to validate this figure and it is as yet unclear how the impact of COVID-19 will alter retirements in 2021-22.

The BMA will therefore monitor the size of the CEA bill year by year and ensure that the size of the CEA funding pot will not significantly reduce as a result of this extension for a fourth year.

The interim CEA funding however is cumulative. This means that each year the size of the pot for new LCEAs increases as outlined in the table below.

One of the features of the equal distribution in 2020 was that this should have included any underspend from the 2018 and 2019 rounds, and the fact that there was no award round in 2020 means that there should be no pre-committed funds from remaining multi-year awards.

Consequently the amount of funding for equal distribution in almost all trusts should be 1.242 x the number of eligible consultants x the 2021 value of a Local CEA point.

In 2020, the value of a local CEA was £3,092 and the DDRB recommended not to uplift this value because of the impact of CEAs on the gender pay gap. The BMA strongly challenged this in our evidence to the DDRB this year.

Whilst we recognise that there have been issues with the gender distribution of CEAs, given the fact that the BMA , DHSC and NHS Employers have been working hard to address the equalities issues of the scheme, coupled with the fact we have agreed to an equal distribution amongst eligible consultants, we do not believe there is a rationale for not uplifting CEAs in 2021.

The BMA was aware of some trusts excluding certain groups of consultant staff from the equal distribution.

For the 2021 distribution, we have clarified that consultants who have retired and returned on fixed term contracts and clinical academics holding honorary contracts with NHS Employers are eligible for this payment provided these groups are covered by the 2003 terms and conditions of service.

In addition, we have secured agreement that those working part time should receive an equal rather than a pro rata payment.

Another feature of the agreement was that local CEAs would be subject to renewal from the 1 April 2021. However, as part of this extension, local CEAs will not be subject to the local renewal process until after the 1 April 2022. This includes planned renewals of local level 9’s that were due to occur in 2021-22. These will be deferred until after 1 April 2022

Whilst it remains possible to vary arrangements locally, variations made prior to the 1 April 2022 must be done by agreement with the joint local negotiating committee and certain provisions as outlined in Schedule 30 cannot be varied.

The applications for the 2021 national round have now closed. As expected, given the suspension of the 2020 round, there has been a significant increase in the number of new applications and renewals. DHSC have recently released a consultation on proposed changes to the NCEA scheme from the 1April 2022. The BMA is currently preparing a response and encourage consultants to respond to the consultation we will share further information in due course.

Vishal Sharma and Phil de-Warren Penny (BMA deputy chairs consultants committee, co-chairs for pay and terms and conditions of service)