Article

Local clinical excellence award (LCEA) arrangements

Information for employers on the arrangements for the LCEA awards.

12 July 2021

In 2017, NHS Employers and the British Medical Association (BMA) agreed an amendment to the terms and conditions for consultants (England) 2003. Between 1 April 2018 and 31 March 2021 (now extended to 31 March 2022), trusts must run annual local clinical excellence award (LCEA) rounds.

The tripartite negotiating group (NHS Employers, the British Medical Association (BMA) and HCSA) are currently in the process of negotiating a new LCEA scheme from 2022 onwards. 

You can find out more about the new reward system for NHS consultants in the related content section.

2021 round

The tripartite negotiating group has sought and received ministerial approval for an approach to 2021-22 LCEAs.

Please read our April 2021, joint statement about this from NHS Employers, the BMA and HCSA.

In light of the ongoing effects of the pandemic, and requirement to focus resources on recovery efforts, employers are advised to take the same approach as last year, and to equally distribute this year’s LCEA funds (and any remaining from previous years) among all eligible consultants. This will be a one‐off, non‐consolidated payment in place of a normal LCEA round. This has been agreed with NHS England and NHS Improvement (NHSEI) and the Department for Health and Social Care (DHSC).

Calculating the investment fund for 2021 round

Details of how to calculate the investment funds for the 2021 round is set out in Q4 of the FAQs below. It provides full details and includes a slide pack that outlines the steps employers should follow to ensure that they have calculated the necessary funds for investment over the four years covered by the interim LCEA arrangements. We have deployed an updated method of calculation to simplify the process for employers.

Updated Schedule 30.

2020 round

The 2020/21 LCEA was halted as a result of the COVID-19 pandemic, with the award money distributed equally among eligible consultants. This enabled clinicians and managers to focus on immediate priorities.

The existing funding (including any money rolled over from the last two years or from award rounds that may not have been run or completed) was redistributed equally among eligible consultants as a one‐off, non‐consolidated payment in place of normal LCEA rounds.

Read the joint statement about the awards being halted due to COVID-19, from NHS Employers, the BMA and HCSA.

  • Given the cumulative nature of the award funding, the investment ratio has gradually built up over time: 

    Award round 

    Investment ratio 

    2018

    0.3 

    2019

    0.3 

    2020

    0.424 

    2021

    0.218

    Total

     1.242

     

    2021 round

    To calculate the value of the investment pot for 2021-22 employers need to:

    • calculate the number of eligible* consultants (FTE)** as at 1 April 2021
    • multiply the number of eligible consultants (FTE) by 1.242 (the cumulative investment ratio as set out in the recently published joint statement)
    • multiply that figure by the unit value of an award (currently £3,092, as set out in the Pay and Conditions circular 2/2020, published by NHS Employers. The figure will be confirmed following the Government’s response to DDRB’s 49th report: 2021 and subsequently via an updated pay circular, expected to be published in September 2021)
    • deduct the cost of any time limited awards that remain in payment from the 2018 and 2019 award rounds (on costs should be excluded)
    • add/deduct any underspend/overspend carried over from previous award rounds.

    * Please note: There is a difference in ‘eligibility for calculation purposes’ and ‘eligibility for receipt of the award/equal distribution’ as detailed below. 
    **Please note: there has been a recent clarification that the calculation of available investment for this year should be on an FTE basis as it has been agreed that that those eligible consultants working less than full time should receive an equal value award to those working full time. This will ensure that employers are committed to spending the full investment and less than full time staff are treated equally to full time staff.

    LCEA reporting templates

    We’re currently in the process of updating the information and employer resources which reflect the investment ratios for the 2021-2022 LCEA rounds and will publish these soon.

    2020 round

    The investment ratio for the 2020 round of local clinical excellence awards (LCEA) was confirmed. The approval by NHS England and NHS Improvement (NHSEI) and the Department for Health and Social Care (DHSC) was welcome as it enabled employers to calculate the size of their funding pot for this year for distribution amongst eligible consultants. 

    The investment ratio for the 2020 round was set at 0.424.

    To calculate the value of the investment pot for 2020 employers needed to:

    • calculate the number of eligible consultants as at 1 April 2020
    • multiply the number of eligible consultants (headcount) by 0.424 (the investment ratio).
    • multiply that figure by the unit value of an award (£3,092, as set out in the latest pay and conditions circular, (M&D 3 2020) published by NHS Employers)
    • add the ‘Investment in new CEA in 2018 at 0.3 per head’ and the ‘Investment in LCEAs in 2019 at 0.3 per head’ 
    • deduct the cost of any time limited awards that remain in payment from the 2018 and 2019 award rounds (on costs should be excluded)
    • add any underspend carried over from previous award rounds.

    These are the reporting templates which reflect the 2020 investment ratio, they are based on a points-based approach and a locally-determined approach.

    Q4 of the FAQs listed below includes details of the steps employers should follow to ensure that they have calculated the necessary funds for investment over the four years covered by the interim LCEA arrangements. We have deployed an updated method of calculation to simplify the process for employers. Please note that this updated method of calculation uses a different formula than was put in place when the arrangements for 2020/21 were agreed, as detailed above. The updated method of calculation uses FTE rather than headcount (for this year only) and applies the cumulative ratio value to determine investment funds. 

    2019 round

    The investment ratio for employers to use for the 2019 LCEAs round was set at 0.3 points per eligible consultant.

    In 2018/19, in its response to the 46th Doctors’ and Dentists’ Review Body (DDRB) report, the government committed to target 0.5 per cent of pay bill to enhance the level of investment in LCEAs from 2019/20.
      

    This additional investment was used to enhance the 2020 LCEA investment ratio.
     

    We understand that due to the delay in the announcement of the 2019 ratio, some employers may have applied a different investment ratio for the 2019 round. If this is the case it was necessary for employers to adjust the 2020 LCEA round commitment accordingly.  If any employers have questions about this specific issue, please get in touch via doctorsanddentists@nhsemployers.org

  • Updated Schedule 30 (March 2021)

    We have temporarily removed our LCEA Employer slide pack following some recent employer feedback. We’re currently in the process of reviewing and updating the information and employer resources, to help organisations ensure they have allocated funds appropriately under the 2018-2022 LCEA arrangements, and will publish these soon.

    2018 LCEA guidance

  • Below is some useful information and guidance documents issued by DHSC, in relation to LCEAs.

     

    The Department of Health and Social Care (DHSC) Equality Analysis

    DHSC has published an equality analysis of the CEA scheme, which considers the effect of the collective agreement on different groups protected from discrimination by the Equality Act. 

    Government’s response to the 48th Doctors’ and Dentists’ Review Body (DDRB) report.

    The Doctors' and Dentists' Review Body (DDRB) has published its 48th report containing recommendations on pay for the year 2020/21. 

    Implications of the government's response to the DDRB report on LCEAs      

    For consultants, the government has committed to a 1.5 per cent increase to basic pay from 1 October 2018, with 0.5 per cent of pay bill to be targeted on the new system of performance pay to increase the amount available for performance pay awards from 2019/20. The government also confirmed that there would be no increases applied to the value of either national or local clinical excellence awards.

    The 1.5 per cent increase to basic pay from October equates to 0.75 per cent of the annual consultant pay bill. This leaves 0.25 per cent of the 1 per cent consultant pay bill uplift already included in the 2018/19 tariff.

    The government has stated that employers will be able to choose to use this:

    • as transitional funding to manage the costs of running the required 2018 CEA award round 
    • to increase the value of the investment pot for the 2018 CEA award round.

    Employers are advised that they should review their plans for running 2018 award rounds and make a decision on how to best use this discretion.

    The 0.5 per cent of pay bill to be targeted on the new system of performance pay to increase the amount available for performance pay awards from 2019/20 means that the investment in new CEA awards (as per the calculation set out in Schedule 30 of the terms and conditions of service) will be almost doubled.

    Until the end of March 2019, the minimum investment ratio for new LCEAs awarded from April 2018 will be set at 0.3 points per eligible consultant annually. 

Local clinical excellence awards FAQS

This below section contains information that responds to the frequently asked questions from employers about the LCEA scheme.

These FAQs were updated in April 2021. Apart from the first section on COVID-19, they are structured in line with the sections of the local clinical excellence awards guidance 2018-21.

  • Q1. Are there any changes to eligibility for the 2021-22 round? 

    Yes. 2021-22 is an additional year of the interim agreement (given that Schedule 30 arrangements have been extended due to the pandemic; Schedule 30 is being amended accordingly and will be published soon). As above, employers are to equally distribute the funds among all consultants, to enable employers and doctors to focus on the impact of the pandemic, and recovery efforts. Some changes to normal eligibility criteria have been agreed for this year (as set out below).

    Funding that will have been allocated to employers to pay for new LCEA in respect of 2020-2021 together with any outstanding LCEA funding which has been rolled over since 2018, shall be distributed equally among all eligible consultants by way of a one-off non-consolidated payment through the employer’s payroll. It has now been agreed, as part of the amended Schedule 30 provisions extending to the 2021-22 round, that this equal distribution shall include and be made in full to consultants on the 2003 terms and conditions that have completed a minimum of 12 months of service and who:

    • are working part-time
    • are not at work by reason of sickness, including sickness or self- isolation relating to the COVID-19 pandemic
    • are absent on maternity, paternity, adoption or shared parental leave
    • are clinical academics employed via an honorary contract (which applies the terms set out in Schedule 23)
    • are working for multiple employers and will only be eligible for a single payment from their main substantive employer)
    • are employed on a fixed term basis.

    Q2. Consultants who work less than full time (LTFT) are entitled to awards as per the LCEA guidance, but these are usually pro-rated in line with their working hours. Should we pro-rata the payment, or pay our LTFT consultants an equal share of the funds?

    As above, consultants who are working part-time should receive an equal share of the award pot in 2021-22.

    Q3. If an LTFT consultant works across two organisations, which organisation would pay for their award? 

    In the 2020-21 and 2021-22 rounds, as there is an equal distribution of awards across all eligible consultants, the principle should be that no doctor should receive more than one full-time award in 2020-21 or 2021-22. The consultant also has a responsibility to ensure that this does not happen and to flag with their employer any concerns about this. However employers are free to agree locally:

    • Which employer is the principal employer, and should therefore pay the award.
    • Whether there should be a contribution from the secondary employer if that is deemed fair.
    • Or if each employer pays a proportion of the award.

    Q4. How should employers calculate the investment pot for 2021? UPDATED JULY 2021

    The steps we advise employers to take to calculate the value of the investment pot for 2021-22 are:

    • calculate the number of eligible* consultants (FTE)** as at 1 April 2021
    • multiply the number of eligible consultants (FTE) by 1.242 (the cumulative investment ratio as set out in the recently published joint statement)
    • multiply that figure by the unit value of an award (currently £3,092, as set out in the Pay and Conditions circular 2/2020, published by NHS Employers. The figure will be confirmed following the Government’s response to DDRB’s 49th report: 2021 and subsequently via an updated pay circular, expected to be published in September 2021)
    • deduct the cost of any time limited awards that remain in payment from the 2018 and 2019 award rounds (on costs should be excluded)
    • add/deduct any underspend/overspend carried over from previous award rounds.

    * Please note: There is a difference in ‘eligibility for calculation purposes’ and ‘eligibility for receipt of the award/equal distribution’ as detailed below. 
    **Please note: there has been a recent clarification that the calculation of available investment for this year should be on an FTE basis as it has been agreed that that those eligible consultants working less than full time should receive an equal value award to those working full time. This will ensure that employers are committed to spending the full investment and less than full time staff are treated equally to full time staff.

    The steps employers should follow to ensure that they have calculated the necessary funds for investment over the four years covered by the interim arrangements has been set out in this slide pack. Should there be any discrepancies in previous calculations then these should be rectified during the 2021/22 award round (under the equal distribution approach). Employers do not need to retrospectively adjust the value of awards made to consultants in previous years.

    Employers are fully funded for this level of contractual investment.  

    Definition of eligibility for calculation purposes

    As set out in Schedule 30 para 5 ‘eligible consultants’ are those with at least one year’s service at consultant level and do not hold an employer-based level 9, a national clinical excellence award or a distinction award’. There is no condition that requires these consultants to be on 2003 TCS for calculation purposes, with the exception of agency locum consultants who should also be excluded from the calculations and are not eligible to receive award funds. Consultants on fixed term contracts are also eligible for the purposes of calculation and those on fixed term 2003 TCS are eligible to receive an award.  

    Definition of eligibility for equal distribution of investment funds

    As set out in the joint statement and FAQ above, eligibility for receiving the equal distribution in 2020-21 is slightly different in that it is by being on the national 2003 TCS that a consultant will have contractual entitlement to be included, though employers can choose to agree an extension or change to this arrangement with their LNC.  Where consultants on other employment contracts, such as pre-2003 contract holders, have previously had access to a LCEA scheme, it is expected that they will continue to be considered as eligible.

    Further details are in FAQ Q1 above.
     

    Please note that given the addition of another year of the interim LCEA arrangements (and a change in approach in terms of equal distribution for 2021-22), some of the information in the 2018 LCEA guidance and supporting documentation on the NHS Employers website may not apply. The information provided here supersedes it. We have published an updated Schedule 30 of the 2003 TCS in partnership with the BMA and HCSA to reflect the information provided here.  

    Although this is not an award for excellence per se, employers should continue to appropriately capture their LCEA spend on ESR as normal.   

    Cumulative nature of the investment funds

    It has been estimated centrally that there is an overall underspend at the end of the 2020/21 financial year on LCEA’s , which is most likely due to reduced engagement in the scheme in recent years, delayed rounds and as a result of funding miscalculations at local level. We are therefore advising employers to please ensure that calculations are made in line with this guidance in order to ensure that the full allocation of funds are appropriately spent during 2021/22

    The funds for investment are cumulative over the period 2018-22. This build up in the level of investment over the four period reflects previous investment levels as awards were paid on a consolidated basis until retirement.  Under the new arrangements, awards are time limited and non-consolidated allowing for reinvestment of the released funds when the award ends.

    Q5. Can we offer a higher proportion of the award money to eligible consultants who have performed over and above what is expected of them in terms of their response to COVID-19? 

    Funds are to be distributed equally (see Q1). This particular arrangement is not intended to be an award for excellence, but simply a one-off non-consolidated lump sum that meets the commitment to spend the allocated investment funds in light of extraordinary circumstances.

    As there is no excellence or performance-based criteria to be met to access an award for this round, any evidence of individual excellence (related to COVID-19 or pre-COVID-19 activity) can be saved for when arrangements return to normal in the next round of competitive applications.

    Q6. We feel that all staff have contributed to an outstanding COVID-19 response. Can we share this funding with other staff, such as SAS doctors and nurses?

    This funding comes from NHS England’s ring-fenced consultants’ pay budget. Whilst we know there may be some local appetite for sharing awards to other staff who contribute to the delivery of services alongside consultants, it is not the intention of the arrangements.

    Q7. With this one-off payment, are the doctors then in receipt of a CEA award?

    Technically, the answer would be no. The intention is to equally distribute the available LCEA funds in a way which is not administratively burdensome on the trust or doctors at a time when resource is needed on the frontline. As there is no excellence or performance-based criteria to be met to access an award, the payment can’t really be considered as an award for clinical excellence. As such, any evidence of individual excellence can be saved back for when we return to normal in the next round of competitive applications.

    Q8. How much money is each eligible consultant entitled to?

    The size of the award ‘pot’ will differ in each trust. As per the LCEA guidance, the level of investment is calculated using an ‘award value’ and an ‘investment ratio’.

    The award value currently stands at £3,092 and the investment ratio at 0.218 per eligible consultant (the cumulative nature of the awards makes the total ratio this year 1.242).

    Please refer to the joint statement for more information.

    Those trusts who have rolled funding forward will have more to add to ‘the pot’, so the individual payments may be higher. If employers are running rounds in arrears, then there is scope to combine all outstanding investment funds into this one-off consolidated payment.

    The value of existing awards (old style LCEAs) will remain static going forward.

  • These FAQs can be used for reference in relation to previously administered award rounds. Please note that much of the below information (i.e eligibility) will be superseded by the 2021-22 arrangements above.

    Introduction

    Q9. What does the Government’s response to the DDRB report mean for local clinical excellence awards (LCEAs)?

    The government has published their response to the 46th Doctors’ and Dentists’ Review Body (DDRB) report. For consultants, the government has committed to a 1.5 per cent increase to basic pay from 1 October 2018, with 0.5 per cent of pay bill to be targeted on the new system of performance pay to increase the amount available for performance pay awards from 2019/20. The government also confirmed that there would be no increases being applied to the value of both national and local clinical excellence awards.

    The 1.5 per cent increase to basic pay from October equates to 0.75 per cent of the annual consultant pay bill. The leaves 0.25 per cent of the 1 per cent consultant pay bill uplift already included in the 2018/19 tariff (the tariff assumed a pay award in line with public sector pay policy of 1 per cent in 2018/19; see para 235) and the government has stated that employers will be able to choose to use this:

    • as transitional funding to manage the costs of running the required 2018 CEA award round or
    • to increase the value of the investment pot for the 2018 CEA award round.

    Employers are advised that they should review their plans for running 2018 award rounds and make a decision on how to best use this discretion.

    The 0.5 per cent of pay bill to be targeted on the new system of performance pay to increase the amount available for performance pay awards from 2019/20 means that the investment in new CEA awards (as per the calculation set out in Schedule 30 of the terms and conditions of service) will be almost doubled.

    Until the end of March 2019, the minimum investment ratio for new LCEAs awarded from April 2018 will be set at 0.3 points per eligible consultant annually.The minimum investment ratios for the 2019 and 2020 award rounds will be confirmed in a future pay circular.

    Q10. Why change the current scheme?

    There is a strong case to modernise the local clinical excellence awards (LCEA) scheme in ways that will reward consultants more fairly. In 2012, the Review Body on Doctors and Dentists’ Remuneration (DDRB) published a report on the CEA scheme. Their recommendations included that, in future, LCEA should be time limited, payable for up to three years and non-pensionable. Further recommendations on performance pay from the Public Accounts Committee have also been accepted by the government. These recommendations formed the basis of the discussions with the British Medical Association which resulted in this agreement. Some of the key principles which underpinned those discussions were focused on:

    • developing a fair, transparent and equitable scheme
    • ensuring that performance awards are distributed fairly
    • ensuring that there is a stronger link between excellent performance and reward based on a fair way of assessing current excellence through work that is done over and above job plans
    • making future awards non-pensionable, paid annually and time limited for a maximum of three years
    • establishing a regular review process
    • clarifying employers’ flexibility to introduce further changes locally, such as creating a clearer link with organisational objectives.

    Q11. Why move to time limited awards?

    This is in line with the DDRB and other recommendations which suggested a move towards a scheme which rewarded consultants for their current performance rather than historical performance. As such there is a much closer and fairer link between reward and the consultant’s most recent contribution towards delivering local aims and objectives. Time limited awards will also help to increase the accessibility of awards by allowing available funding to be targeted towards the excellent performers of today. This may also help to close the gender pay gap.

    Q12. Can the NHS afford this deal? Should resources not be focused on patient care?

    Some form of merit or performance pay has been part of consultant remuneration for many years, and we want to target this towards providing incentives and rewards for consultants who are currently meeting exceptional standards in the planning and delivery of care for their patients, and in teaching and innovation, rather than maintaining awards for past performance.

    Q13. Clearly this agreement benefits consultants but what are the potential benefits to employers and patients?

    There are a number of benefits that arise from this deal.

    • Funding is now being focused on rewarding current rather than historic performance. Most of the current spend on LCEA is used to cover the cost of paying for historic performance awards, for example, a level 9 award would cost an employer c£430,000 plus on-costs over 12 years. Time limited payments will ensure award funding is no longer tied up servicing existing awards for the duration of a consultant’s career. The aim is to enable funding to be better targeted towards rewarding those that can demonstrate current excellence. This should also help to support moves to address the gender pay gap.
    • Awards will be more accessible. As the new awards are non-consolidated and only paid for between one and three years, employers will be able to focus more of their local spend on new awards. This should also help to address the gender pay gap by ensuring performance pay is more accessible to the next generation of consultants, who are more likely to be female.
    • It will help employers maintain fairer and more appropriate systems of performance pay and thus help to engage more of the consultant body.
    • Trusts and, in particular, medical managers will be able to incentivise excellence through the availability of awards and use the domains structure for accessing awards to better steer consultants’ work to appropriately deliver agreed objectives in line with changing organisational priorities.
    • The agreement introduces a system for reviewing all those existing LCEAs awarded under the previous process (before 31 March 2018). This will enable trusts to remove some awards from consultants who are no longer performing at historically exemplary levels and refocus such payments on current high performers.
    • From 2021, subject to further agreement being reached, NHS organisations can introduce new schemes that are tailor made to suit their priorities, including linking payments to local performance assessment processes.

    Q14. What about the BMA’s legal challenge on LCEAs?

    The BMA was pursuing a legal claim regarding the contractual status of the pre-2018 awards.

    While both sides believed they had strong arguments, there was a small risk that at least part of the case would be upheld in favour of the BMA. This could have led to claims against trusts who had not run an annual round and/or who were not complying with the original investment ratio for the local scheme of 0.35 consolidated, pensionable points per eligible consultant.

    The potential cost to trusts of defending such claims and in compensation payments would have been considerable. This agreement has mitigated this risk.

    Q15. If the new style awards are to reward current performance, why can they be awarded for up to three years?

    The DDRB recommended that the maximum length of local award, in exceptional cases, should be three years, to be paid in annual lump-sums. The expectation is that most awards will be made for one year only however, for a number of reasons, it was decided to permit a degree of local discretion and allow for an award period of up to three years; these reasons are as follows.

    • The expectation is that most, if not all, consultants will apply for an award, and in order to manage the workload arising from a high number of applications, trusts may find it preferable to make an award for two to three years. Although being in receipt of a new multi-year award does not mean that they are no longer eligible to apply for an award, they may find that they have limited new evidence of excellence to support a new application for a further award. As a result, we would expect applications from those in receipt of a new award to be limited. Employers should make it clear that only new evidence of excellence since their last award would be taken into account when considering applications for further awards.
    • Some employers may consider it appropriate to award multi-year awards for contributions that will have a continuing impact. The DDRB recommended that awards in excess of one year should require ‘sign-off’ by the employing organisation's chief executive on an annual basis.

    It is intended that the system developed post 2021, will not have the same requirements and thus multi-year awards will be very much the exception.

  • Q15. Who is covered by the agreement?

    The agreement covers those consultants employed on the Terms and Conditions for Consultants (England) 2003.

    Consultants on other employment contracts, such as clinical academics, holding an honorary contract and pre-2003 contract holders, can apply for an award subject to agreement with the employer who is running the award round. Where they have previously had access to a LCEA scheme, it is expected that they will continue to be considered as eligible.

    Where eligibility to apply for an award is extended to those consultants employed on terms other than the 2003 contract additional investment will be necessary. The calculation of this additional investment should be as per the arrangements for 2003 contract holders.

    Q16. Are consultants on the pre-2003 contract eligible for LCEAs and does the 0.3 per cent provided for in Schedule 30 apply to them?

    It is our expectation that employers would continue to offer access to LCEAs to consultants on the pre-2003 contract where they have previously had access, however this is up to employer discretion. There is no contractual entitlement to LCEAs for pre-2003 consultants. If access to the local scheme is granted to pre-2003 consultants, the funding for this should come from outside the minimum investment ratio provided for in Schedule 30, otherwise there is a risk that the provisions in Schedule 30 which guarantee 2003 contract holders access to a minimum investment amount will not be satisfied.

    Q17. Are clinical academics eligible for LCEAs and does the minimum investment provided for in Schedule 30 apply to them?

    It is our expectation, which is supported by the DDRB, that employers would continue to offer access to a LCEA scheme to clinical academics, in agreement with the substantive (university /higher education institution) employer, however this is up to employer discretion. There is no contractual entitlement to LCEAs for clinical academics as they are employed via honorary contract arrangements.

    If clinical academics are accepted as being eligible, the funding for this should come from outside the minimum investment ratio provided for in Schedule 30, otherwise there is a risk that the provisions in Schedule 30 which guarantee 2003 contract holders access to a minimum investment amount will not be satisfied.

    Q18. Can locums apply for LCEAs?

    Locum consultants are not eligible to apply for awards, although if subsequently appointed to a substantive consultant post it will be acceptable for their application to draw on evidence from their time as a locum consultant.

    Q19. Can nominated consultant members of the Employer-based Awards Committe (EBAC) also apply/be considered for an award?

    Where they meet the necessary eligibility criteria, members of the EBAC can apply and be considered for an LCEA, although they should not be involved in any decision concerning their own application or award.

    Q20. Can a consultant on local level 9 apply for an award?

    No. The eligibility criteria is set out in Section 2.2 of the lCEA guidance as:

    A fully registered medical or dental practitioner, who is included on the specialist register of the General Medical Council (GMC) or specialist list of the General Dental Council (GDC), who has been substantively appointed as an NHS consultant with at least one year’s service at consultant level on 1 April in the award year and who does not hold an existing LCEA level 9, an existing NCEA, or a distinction award.

    Q21. Why would someone with a distinction award not be eligible for a LCEA?

    This is because distinction awards at levels A+, A and B are the predecessors to national CEAs and were awarded by the advisory committee on distinction awards.

    Q22. Would a consultant with a discretionary point be eligible to apply for a LCEA?

    This will depend on their contract terms. If they are employed on 2003 contract terms, then they would be considered eligible. If they are employed on other contract terms, such as the pre-2003 contract, that can apply for an award subject to agreement with the employer who is running the award round.

    Q23. If a consultant has a two-year award, can they apply the following year, for example. get an award on top of the existing one?

    Yes, although the consultant would need to demonstrate that they were providing excellent service over and above the normal delivery of their job plan, which they were not already being rewarded for by their existing two-year award. See FAQ number 6 for more information.

    Q24. Are consultants only eligible each year for the value of one-time limited award to reflect current performance rather than historical scheme where their CEA ‘pot’ increased with each successful application?

    The new scheme provides for non-consolidated, non-pensionable time limited awards which may be made for one, two or three years after which consultants will need to re-apply. However, they will continue to keep any existing awards made under the old scheme, although these will become reviewable and renewable from 2021.

    The application process

    Q25. Will an updated template application form be available?

    Template application forms can be found on the GOV.UK website. These have not been amended following agreement of the new arrangements.

  • Q26. What do employers need to do to give effect to the agreement?

    For the terms of the agreement to be binding on employees, employers will need to inform them of the change and/or issue them with a copy of the schedule (or a link to where it may be found). There is no need to secure individual agreement, but if the change in the collective agreement has not been brought to the attention of the individual employees, it would be possible for them to argue that they were not bound by it.

    Q27. When do employers need to open 2018 award rounds?

    The schedule states that employers ‘will normally open awards rounds in April every year’. We know that employers will need some time to consider the detail of the changes and review the supporting guidance (to be published shortly) in light of their own local circumstances before opening 2018 award rounds.

    Employers will therefore have some flexibility in determining when award rounds will be opened for this first year of operation. We recommend that the employers engage their joint local negotiating committee (JLNC), or another appropriate consultant representative group where a JLNC does not exist, to determine when 2018 award round will be opened.

    Q28. We are currently undergoing our LCEA award process for 2017, these awards will not be reviewed and awarded until April 2018, do we use the new process or the old?

    The transitional arrangements are that:

    • An awards round for 2017/18 (based on work done prior to 1 April 2017) where decisions have been made prior to 31 March 2018 on awards payable from 1 April 2017, will proceed under any local LCEA arrangements in place prior to 1 April 2018.
    • An awards round for 2017/18 where the process began prior to 31 March 2018 and concludes after that date but where awards are backdated to 1 April 2017, will proceed under any local LCEA arrangements in place prior to 1 April 2018.
    • An awards round for 2017/18 which commences after 1 April 2018 and where the award is payable from 1 April 2017, will proceed under any local LCEA arrangements in place prior to 1 April 2018.

    Q29. We run our round effectively a year behind so, in October 2018, we will be running our round but backdated to April 2017. Can we continue to run this round as we have done in previous years and with the 0.2 investment ratio calculation? Do we need to do two rounds to catch up?

    The new schedule 30 requires all 2018 award rounds to be run according to the terms of that schedule. There is no requirement to run rounds for previous years. Any 2017 award round that an employer may choose to run and which concludes after 31 March 2018, should be granted in line with any local LCEA arrangements in place prior to 1 April 2018.

    For employers working year behind, one option could be to run one round in 2018 as required by the contract but supplement it with any committed funding for the 2017 award round, which could mean awarding more candidates or by increasing the value of awards.

    Q30. If a consultant holding existing awards as at 31 March 2018 applies and is granted a new award, for example they achieved level 6 and the trust is making one new award in 2018, do they receive a lump sum of one award or level 7 award? When the award from 2018 ends, do they revert to level 6, or level 7 for the next time they apply?

    The consultant will continue to hold a level 6 award under the old scheme rules, that is consolidated and pensionable, unless any of the change of circumstance provisions apply or is removed following review (for awards other than level 9 awards, reviews will commence post 2021). In addition, they will receive a time limited new LCEA which may be one or more points or an award whose value is determined locally. See FAQ number 35 for more information. To avoid confusion, this is not called a level 7/8. The consultant would therefore have an existing consolidated award plus a new time limited non-consolidated award.

    Q31. Our trust has our own locally agreed scheme. Can we continue with this?

    There are some aspects of the new scheme which are mandatory as follows:

    • 0.3 of a point per eligible consultant must be awarded in 2018
    • New LCEA will be non-consolidated and non-pensionable and paid annually as a lump sum.
    • There must be an internal appeals mechanism.
    • There will be no uplift new awards for those undertaking APA.
    • There will be a review of LCEA awarded prior to April 2018 commencing after March 2021.
    • The national reversion mechanism.

    Subject to these provisions, it will be possible to vary the scheme by agreement with the joint local negotiating committee (JLNC) or another appropriate consultant representative group where a JLNC does not exist.

    For example, possible variations are (this list is not exhaustive):

    • A requirement for consultants to be employed at the trust for a year before being eligible to apply.
    • Other locally-agreed eligibility criteria.
    • A variation to the scoring system.
    • A change to the domains, for example merging the five domains into three.
    • The value of an award, for example, moving away from a points-based approach and allocating awards of different value, for example £5,000 / £10,000.
    • Rolling over money to the following year if agreed with the local negotiating committee.

    Q32. Will elements be set up in ESR to facilitate payment?

    Yes. Details have been confirmed via ESR User Notices.

    Q33. Will current holders of LCEA retain the APA uplift?

    Current award holders will retain their APA uplift but this will not apply to new awards made payable from 1 April 2018.

    Q34. How should concurrent employments be handled when considering awards?

    Where a consultant has separate contracts of employment with two or more NHS employers they may be eligible to apply for an award within each employment on the basis of their contribution in each separate role.

    Q35. What can we do to encourage more women to apply for awards?

    Only around 50 per cent of consultants received payment under the previous LCEA scheme and many consultants did not participate in the scheme at all. It is intended that all consultants should participate in the revised scheme and employers should actively encourage this for example by stressing the link to current performance, the clearer link to a consultant’s objectives and by widely promoting the process for the new scheme. Employers may also want to consider exploring the reasons for non-participation with groups of consultants as a further way of encouraging applications.

    The Department of Health and Social Care (DHSC) has published an Equality analysis of the CEA scheme, which considers the effect of the collective agreement on different groups protected from discrimination by the Equality Act. Employers have a Public Sector Equality Duty and will need to conduct their own equalities impact assessment of the introduction of the amendments to the contract and ongoing operation of their LCEA arrangements.

    Q36. Can employers continue paying LCEAs monthly with salaries, rather than in an annual lump sum?

    The expectation is that payments for new LCEAs will be paid annually by lump sum. However, as these are non-consolidated payments there is nothing to prevent trusts from agreeing with LNCs to spread payment of awards on a monthly basis.

  • Q37. What activity should be used as evidence for the 2018 round?

    Activity prior to April 2018 as a consultant within the NHS should be considered when assessing applicants and the activity must be since their last award (or first appointment to the consultant grade if not previously in receipt of an award).

    Q38. Do you have to weight scores? Could you discuss the aspect of weighted scoring?

    How to score new LCEAs and renewals remains unchanged from previous arrangements and is detailed in part 6 of the LCEA guidance. It sets out that as part of the assessment process, employers should score each domain using the following ratings.

    • Does not meet contractual requirements or when insufficient information has been produced to make a judgement – score 0.
    • Meets contractual requirements – score 2.
    • Over and above contractual requirements – score 6.
    • Excellent – score 10.

    Employers could, however, consider applying weighting to the domains. This would enable employers to focus rewards on those activities that best support organisational priorities. Employers would first need to discuss how this approach would be applied with the JLNC (or another appropriate consultant representative group where a JLNC does not exist) and if adopted all eligible consultants would need to made aware at the point the award round is opened.

  • Q39. Should investment in CEAs be calculated based on the headcount of eligible consultants or the FTE of eligible consultants?

    The LCEA investment ratio is per eligible consultant (headcount) from 2018-21. For this purpose, ‘eligible consultants’ are those NHS consultants employed on the Consultant Contract 2003 (England). 

    In 2021-22 the investment ratio is per eligible consultant (FTE) to take account of consultants working less than full time being eligible to receive an equal value award to those working full time.

    Q40. How will the increase in the investment ratio be funded?

    A significant part of the increase is funded by recycling money from the non-pensionability of the new awards, and by removing the requirement to uplift the value of an award by 10 per cent for every additional programmed activity (APA) a consultant works.

    However, there is a small funding gap to reach the increased investment ratio. In light of this, the government has identified funds in their response to the 2018 DDRB report on doctors’ and dentists’ pay. See FAQ number 1 for more information.

    Q41. In relation to the annual points calculation, is this cumulative? So, for example, in year one, we have 150 points to give out and we award all of these, one each to 150 applicants, but all the points are awarded for one year only. In year two, the 150 consultants apply to renew but only 130 of them have done enough to show they are still working at that level, what happens to the ‘spare’ 20 points that are taken away from them? Are they ‘lost’ or do they get added back into the investment pot?

    The points wouldn’t be removed from the investment pot. The 20 remaining points could either be redistributed to those successful applicants (as employers need to award all their available points each year to meet the minimum investment ratio) or alternatively, trusts can agree with the LNC to roll these remaining points over to the next award round.

    Q42. Under the old scheme, awards above level 6 were double. Do employers have to make double value new awards to consultants who have already reached level 6 of local awards?

    It is up to employers to decide how they distribute their minimum investment. They can retain a points-based system where one point equals the same as an existing LCEA point. They can award more than one point to a consultant. They can also choose to move away from a points-based approach and allocate awards of different value, for example, anything from say, £5k up to a maximum of £30,000.

    Q43. How will the value of the available funds change with time?

    The funds available to invest in new awards are calculated on the basis of eligibility so any changes in the number of eligible consultants as at 1 April each year will have an impact on the size of the investment pot.

    Until the end of March 2019, the minimum investment ratio for new LCEAs awarded from April 2018 will be set at 0.3 points per eligible consultant annually.The minimum investment ratios for the 2019 and 2020 award rounds will be confirmed in a future pay circular.

    From 2021/22, the investment baseline will change. The minimum amount invested and paid annually in future awards per eligible full time equivalent (FTE) consultant within each employing organisation will be circa £7,900.

    Q44. If a consultant does not have their national award renewed and they then revert to a local award, will employers have to fund this?

    The new schedule to the terms and conditions states that the funding for reversions from national CEA to LCEA will have to come from outside the 0.3 funding ratio for new LCEA, which is intended to fund new awards. We do not anticipate that there will be a large number of such cases (on average 80 national award holders lose their awards each year) and some employers already have arrangements in place to provide partial protection for those consultants who have lost local awards. Prior to October 2014, the value of awards was protected on a mark time basis in all cases where awards were withdrawn.

    Q45. Do we have to use up the entire funding for awards in any given year?

    Funding can be rolled over to the next financial year only where there is agreement with the JLNC, or another appropriate consultant representative group where a JLNC does not exist.

    Q46. What should we do with points carried forward from the 2017 scheme? Do we just add them to the 2018 total or do we have to recalculate them based on the 0.3 ratio?

    There is no requirement to carry forward any points from previous years. However, under the new scheme, in 2018, investment is based on 0.3 X eligible consultants which according to the schedule are those on the 2003 contract. If an employer wanted to include anyone else pre-2003 consultants, locally agreed contracts etc, they would have to add them into the investment calculation so that the pot available to 2003 contract holders is not diluted by the addition of non-2003 contract holders.

    Once a total investment pot has been created, awards should be distributed via open competition, meaning that awards do not necessarily need to be proportionally distributed according to the size of each consultant contract group.

    Q47. We understand we need to reinvest leaver awards for award funding for future years. Why is this?

    The LCEA scheme has always depended on the recycling of funds freed up from leavers/retirees etc. When funds are released they will be factored into an employer’s annual investment calculation to make sure it meets the minimum investment guarantee.

    Q48. When calculating eligible amounts, should we exclude those who haven’t completed appraisal etc before the calculations are done?

    No. The definition for the minimum investment ratio should be as per schedule 30 paragraph 5:

    From 1 April 2018 to 31 March 2021, the minimum investment ratio for new LCEAs will be set at 0.3 points per eligible consultant annually. For these purposes, ‘eligible consultants’ are those with at least one year’s service at consultant level and who do not hold an existing LCEA level 9, an existing NCEA a future NCEA or a distinction Award.

    The guidance states (at para 3.5) that applicants will not be eligible to apply for an award unless the employer confirms that the applicant has participated satisfactorily in the appraisal process, has fully participated in job planning processes, met contractual obligations and complied with the Private Practice Code of Conduct.

    Q49. Why do we have to protect national awards if the points are lost?

    Consultants who fail to renew a national award will lose the award and the financial element. This provision, brought in in 2015, has caused some concern among employers as it has had a noticeable effect on morale and motivation of senior consultants. We found that employers were in response, making local arrangements to provide some form of pay protection for affected consultants and it was accepted that this should be provided as a contractual protection as part of the collective agreement.

    Q50. The agreement provides a degree of protection for those consultants who lose a national CEA; will this protection be afforded to those consultants who have already lost such an award?

    No. While it is unfortunate that not all consultants will benefit from this part of the agreement, it is important to appreciate that the terms of this agreement only come into force from April 2018. Trusts that have previously agreed a form of partial protection for this small group of doctors may continue to use this for those affected before April 2018, but for those affected from April 2018, only the agreed arrangements can be used.

  • Q51. What happens if a consultant leaves the trust in a year they have received an award?

    If a consultant leaves an organisation where a one-year award has been made, for example, they retire, in the same year they should receive the value of any annual award made in their final salary. If a multi-year award is made then the employer can withhold any unpaid annual lump sums if a consultant leaves the trust. For a consultant moving to another NHS employer, the responsibility for paying the remaining annual lump sum passes to the new NHS employer. The withdrawal or withholding of any award will need to be factored into an employer’s calculations to ensure they meet minimum funding requirements in a given year.

    If a consultant leaves the NHS during a multi-year award, the consultant retains the full value of any lump sum award(s) already made but does not receive any remaining entitlement (unless they subsequently re-join an NHS employer during the period for which the original award was made)

    Q52. If a consultant retires, takes their pension and then returns to work for the same trust within a matter of a few weeks, is there anything in the terms of their employment that indicates the employee should retain the clinical excellence awards they held under their previous contract?

    If a consultant’s existing LCEA was taken into account for pension purposes, then they would no longer retain the award. New LCEAs are non-pensionable lump-sums. The consultant would be able to apply for a new LCEA on return to the trust, where they meet the necessary eligibility criteria.

    Q53. Should the value of an award be included in calculating redundancy pay?

    New awards are non-consolidated therefore if a consultant is made redundant their value will not be relevant to determining redundancy pay. If the consultant has been awarded a new CEA and they are subsequently made redundant in that year, they should receive the value of the award in their final salary payment if it has not previously been made. This is because the payment is based on assessment of work done in the previous year/s.

  • Q54. Is the intention that existing LCEAs will be reviewed and potentially removed if they no longer meet the criteria set? UPDATED DEC 2020

    The agreement in previous years was that Level 9 LCEAs should be reviewed as per part 10 of the LCEA guidance (this aspect remains unchanged from previous scheme arrangements). However in line with the decision taken to suspend LCEA processes in 2020/21 in light of the pandemic, the tripartite negotiating team (NHS Employers, BMA and HCSA) has agreed that it makes sense for the Level 9 reviews which were due to take place in 2020 to be deferred and carried out in 2021.

    From April 2022, all existing LCEAs will be reviewed as per schedule 30 of the terms and conditions.

    Q55. Do we continue to follow our own local process in managing local level 9 reviews that are unsuccessful, or should we follow the same principles as the national unsuccessful renewals that renter the locals at level 7 or 8?

    The process for level 9 reviews remains unchanged, the detail of which is set out in part 10 of the LCEA guidance. Employers can continue to follow their own locally agreed processes for this.